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Am Fam Physician. 2007;75(7):979

Author disclosure: Dr. Weiss is on the speakers' bureau for Amylin Pharmaceuticals.

to the editor: The article, “Tight Control of Type 1 Diabetes: Recommendations for Patients,”1 provided a nice basic discussion of type 1 diabetes; however, it only made one statement, in passing, about certified diabetes educators. This was a striking omission.

Frankly, it is absurd to expect this complex and burdensome disease to be managed by only the physician and the patient. As a board-certified endocrinologist, physician nutrition specialist, and certified diabetes educator providing care for patients with types 1 and 2 diabetes over the past 22 years, I understand the fundamental need for an ongoing, interdisciplinary approach to this disease. Education regarding self-management of diabetes provided by certified diabetes educators is strongly endorsed by all expert organizations (e.g., American Diabetes Association,2 American College of Endocrinology, the Endocrine Society). Physicians alone, regardless of their specialty, cannot be expected to provide adequate instructions in such areas as carbohydrate counting, proper insulin injection technique, or insulin dose adjustment.

I urge physicians who care for patients with type 1 or type 2 diabetes to routinely utilize the expertise of certified diabetes educators. To find educators in a specific community, physicians and patients can visit the online resource for the American Association of Diabetes Educators at

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This series is coordinated by Kenny Lin, MD, MPH, deputy editor.

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