Perspectives on Diabetes Care

By Donna Ryan, MPH, RN, CDCES, FADCES 

The practice of diabetes care and education specialists has evolved significantly over the years in response to the changing healthcare system, scientific and technology advancements and focus on equitable, quality driven, integrated person-centered care. While passion drives the specialty, it is competence and proficiency that differentiates the diabetes care and education specialist from the general practitioner. Competency and passion together are our interprofessional power to ensure our sustainability and positive impact on the healthcare system and people we serve.

In 2019, ADCES convened a working group made up of diabetes care and education specialists from diverse backgrounds and sectors, including diabetes experts from the areas of pharmacy, dietetics, nursing, mental health, exercise physiology, public health, healthcare providers (medical, advanced practice nursing), community health workers and people living with diabetes. The team was tasked to develop a set of core competencies for the field that would meet the current needs and future trajectory of the specialty, with emphasis on language choice and the goals and pillars of the strategic vision. In essence, we wanted to ensure our professional competencies are:

1. Relevant to the individual practicing in the field.

2. Aspirational to support continued evolution and professional growth.

3. Clear in their communication to stakeholders, including healthcare systems, providers, payers and persons we serve, of the exceptional skill, knowledge and behaviors that diabetes care and education specialists offer.

How we developed the competencies

To accomplish this important, albeit daunting, task, the committee conducted an in-depth literature review and explored the competencies across 22 national and international healthcare organizations and applied the six concepts of the vision to identify gaps in competencies. Additionally, the team matrixed existing ADCES competencies, standards of care for diabetes and related conditions, and conducted quantitative research to guide the revisions. A modified Delphi survey was used to gather consensus from a wide group of experts to help validate results.

The final 2020 competencies for diabetes care and education specialists have been revised to align more closely with the vision of ADCES. The domains have been updated to underscore specific sets of knowledge, skills and abilities critical to fulfilling the role of a diabetes care and education specialist: to drive integration, include related conditions, focus on behavioral health, leverage technology, provide person-centered care and achieve the Quadruple Aim.

Six core competencies for diabetes care and education specialists  

We are thrilled to introduce the competencies for diabetes care and education specialists developed by the 2019-2020 Competency Committee. The team incorporated feedback from the field into a final set of 6 core competencies:

• Domain 1: Clinical Management Practice and Integration 

• Domain 2: Communication and Advocacy 

• Domain 3: Person-Centered Care and Counseling Across the Life Span 

• Domain 4: Research and Quality Improvement 

• Domain 5: Systems-Based Practice 

• Domain 6: Professional Practice 

In addition, a key is provided to highlight the competencies related to 1) technology and 2) behavioral health, which are translated throughout many of the domains. 

Resources for career growth  

ADCES has developed several resources to help you advance in your career, available now at DiabetesEducator.org/DCEScompetencies. On this page you’ll find a self-assessment to help you identify opportunities for growth and create a plan for continued success. A job description template is also available for those looking to hire or expand their programs.  

The association is committed to identifying and supporting the competencies and the needs of members and stakeholders to ensure that the specialty is able to adapt to the dynamic healthcare environment and meet the evolving needs of the people served by diabetes care and education specialists. 

Download the Competencies for diabetes care and education specialists. 

For more information on the Delphi study, download the report.

Thank you 

The Association of Diabetes Care & Education Specialists (ADCES) gratefully acknowledges the following individuals for their role in creating this document: Ruben Diaz, NP, RNC, CDCES, BC-ADM David Dixon RPh, PharmD, CDCES, BCPS Alison Evert MS, RD, CDCES Sheila Harmon APN, CDCES, CNS, MSN, RN Chelsea Hawkins, MPH, MCHES John “Tommy” Johnson, PharmD, CDCES, BC-ADM Alex Le, PA-C, CDCES, BC-ADM Kelly Rawlings, MPH Ardis Reed, CDCES, LD, MPH, RD Floribella Redondo, MS Andrew Rhinehart, MD, CDCES, BC-ADM LaurieAnn Scher MS, RD, CDCES.  

Chairs: Donna Ryan, RN, RD, MPH, CDCES Sandra Drozdz Burke, PhD, RN;  

Michelle L. Litchman, PhD, FNP-BC Lauren Bronich-Hall, MS, RDN Leslie Kolb, RN, BSN, MBA Joanne Rinker, MS, RDN, CDCES Kirsten Yehl, MS, MLIS 

For questions, please email [email protected].  

Ryan, D., Burke, S. D., Litchman, M. L., Bronich-Hall, L., Kolb, L., Rinker, J., & Yehl, K. (2020). Competencies for Diabetes Care and Education Specialists. The Diabetes Educator, 46(4), 384–397. https://doi.org/10.1177/0145721720931092

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ADCES Perspectives on Diabetes Care

The Association of Diabetes Care & Education Specialists Perspectives on Diabetes Care covers diabetes, prediabetes and other cardiometabolic conditions. Not all views expressed reflect the official position of the Association of Diabetes Care & Education Specialists.

Copyright is owned or held by the Association of Diabetes Care & Education Specialists and all rights are reserved. Permission is granted, at no cost and without need for further request, to link to, quote, excerpt or reprint from these stories in any medium as long as no text is altered, and proper attribution is made to the Association of Diabetes Care & Education Specialists.

HEALTHCARE DISCLAIMER: This site and its services do not constitute the practice of medical advice, diagnosis or treatment. Always talk to your diabetes care and education specialist or healthcare provider for diagnosis and treatment, including your specific medical needs. If you have or suspect that you have a medical problem or condition, please contact a qualified health care professional immediately. To find a diabetes care and education specialist near you, visit DiabetesEducator.org/Find.