The National Certification Board for Diabetes Educators (NCBDE) is a small but important organization as it oversees the certified diabetes educator (CDE) program, thus vastly influencing the field’s  competencies. The organization’s new CEO, Sheryl Traficano, discusses her goals and how the organization is expanding its reach into new fields and advocating for CDE reimbursement.

By: John Parkinson, Clinical Content Coordinator,

NCBDE’s mission is to “define, develop, maintain, and protect the certification and credentialing process to promote quality diabetes education.”  With its certification program, the organization is advancing diabetes education by ensuring qualified health professionals are obtaining the CDE credential.  

Earlier this year, Sheryl Traficano (pictured, here) ascended to the organization’s CEO position. Traficano had been the Director of Operations and throughout her tenure with NCBDE, she has done everything from accounting to handling communications to working with the Board of Directors and various committees. As CEO, Traficano wants to ensure NCBDE moves forward with the vision and direction laid out by its Board of Directors.

One of the board’s recent decisions this year was to include the Master Certified Health Education Specialist (MCHES) credential for CDE eligibility starting in 2014. NCBDE expanded the eligibility requirement to this credentialed group, which consists of health educators who have met additional eligibility requirements through the National Commission for Health Education Credentialing, Inc., as the competences for achieving the MCHES credential. NCBDE determined the MCHES credential is closely aligned with the competencies outlined for CDEs. had an opportunity to interview current Chair of the Board, Carolyn Harrington, RD, LDN, CDE on this topic. People can read that interview here.

Along with the MCHES inclusion, another one of NCBDE’s significant initiatives has been their concentrated outreach to exercise professionals, both exercise specialists and exercise physiologists, and pharmacists. Traficano explains that these two fields may be engaged in diabetes education, but are not always aware they may qualify  for the CDE credential.

In addition to its core focus, NCBDE has also been getting involved in political advocacy as it pertains to reimbursement for individual diabetes educators. Congress currently has two bills in committee, and NCBDE has reached out to members of Congress to discuss the need for clarification of the definition of CDEs. If the current bills in Congress can be clarified regarding who is included under the CDE definition, the organization will encourage all CDEs to support these important federal bills. [Editor`s note: Here is some more information on this topic.]

With NCBDE’s recent changes and various plans in the works, wanted to speak to Traficano further about the exciting news from NCBDE, her goals as CEO, and the organization’s involvement with the potential reimbursement federal legislation. What are your main responsibilities as the CEO? What are two or three big objectives you are trying to reach as CEO?

Traficano: My main role is facilitating the organization’s direction as established by the Board of Directors. One of my short terms goals is to ensure the stability of the office here as we get ready to finish up the calendar year. We are a small staff, only three people in-house working on the program, but technology has allowed us to do things more efficiently and we are continuing to look at how it can help the organization grow effectively.

As a team, we are always looking to ensure a smooth application process for people who are interested in obtaining or renewing their CDE credential.

One of our organization’s goals is to make the renewal by continuing education process completely online. Right now, people can track their education online, but they still need to submit a paper application for the renewal. Recent requests for proposals (RFP) have gone out, and we’re waiting for responses. I’m hoping implementation would be no later than 2015, but depending on how long the process takes, it could be as early as 2014.

Long-term, I would like to see NCBDE obtain accreditation by the National Commission for Certifying Agencies (NCCA). Right now, we abide by most of their standards. We hope to apply for certification soon, and that is something I would like to see completed in the near future.

From our Board of Directors, we are going to seek out the best way to do strategic planning, find ways to strengthen the volunteer leadership—including development of a pathway leading to Board service—and explore collaborations with other diabetes-related organizations. How would you characterize the evolution of CDEs as well as NCBDE, the organization that serves them?

Traficano: The organization has been very consistent in wanting to hold the program to the highest standards. One major change is how people apply for the examination. In years past, the paperwork and applying for the CDE examination were more complicated. A lot of that has changed. Now, it’s about people more easily identifying that they meet the eligibility requirements. The incidence rate for the number of people with type 1 and type 2 diabetes keeps increasing. Do you think one of the great challenges in the diabetes medical fields is having enough certified diabetes educators to meet the needs of a growing patient base?  

Traficano: It is a challenge, but we also want to ensure the quality of diabetes education is held at a level that ensures patients get the best care. It’s a balancing act. Related to that, NCBDE included the Master Certified Health Education Specialist (MCHES) credential to be eligible for the certified diabetes educator (CDE) credential exam. Do you see the organization looking to expand the CDE credential by including more health professionals?

Traficano: We want to make sure all the people who are currently doing diabetes education in the current disciplines become certified—and we really don’t think that is happening. We don’t have a lot of pharmacists or exercise physiologists who are CDES, for example. And we know there are people in these two fields performing diabetes education. That is one of our main focuses right now.

For the MCHES inclusion, the Society of Public Health Education (SOPHE) applied for the ability for those holding the MCHES credential to qualify for the CDE program. They supplied us with information on the preparation to get the MCHES. We also typically refer to the National Standards for Diabetes Education and Support, and the most recent  standards include health educators as being potential staff for education programs. In looking at these factors, it made perfect sense to add that group as potential CDEs. Traditionally, organizations have approached NCBDE for consideration because we want to look at a whole group under a specific discipline who may be providing diabetes education. We want interested groups to approach us, which is exactly what SOPHE did.

For 2014, we have implemented the unique qualifications pathway. This is available for health professionals with advanced degrees in health related majors and concentrations who are doing diabetes education but don’t fall under our standard pathway’s list of disciplines. People are able to pre-apply with our office now. We do have some different qualifications for people within this category including more practice hours and continuing education. This pathway is really for the professionals who are passionate about diabetes, but their health field may not have been one that reflected that.





 Do you have any examples of fields that fit that mold?

Traficano: It would include people with a Master’s in Nutrition or Master’s of Exercise Physiology. For example, the exercise physiologists who may not have obtained the Registered Certified Exercise Physiologist (RCEP) credential, because the RCEP credential is fairly new, so having advanced degrees in that major could be a good fit. There might be some people that have existing credentials that qualify for the CDE, but are not taking advantage of it. Is NCBDE planning any outreach to professionals in these fields?

Traficano: We are. With the exercise physiologists, we reached out to the Clinical Exercise Physiology Association (CEPA). We recently held a webinar that was specifically focused on exercise physiologists and exercise specialists. We are also working to reach out to pharmacists. Many exercise professionals and pharmacists may not be thinking they are doing diabetes education. We will look to do a webinar and write articles aimed at helping pharmacists learn about the credential as well. There is a lot of misunderstanding about whether these two sets of providers are performing diabetes education, so we want to clarify that.

We also have an outreach consultant who is helping us to write articles about certification and diabetes education. What do you see as the other greatest challenges in diabetes education today?

Traficano: I think one of the big ones is obtaining reimbursement for CDE services. Right now reimbursement is limited to accredited or recognized diabetes education programs, but not the CDEs themselves. If they could be reimbursed directly, it would help increase access for people with diabetes, and it would help support CDEs in the tremendous work that they do.

There are two federal reimbursement bills in committee now, but we do have some concerns about the wording. We are talking with the offices, and we are hoping to fully support the bills once changes are made. At that time, NCBDE can encourage all our CDEs to push for passage. Obviously, it would be great to see Congress pass such a law. Any other NCBDE news to share with us that will go into effect in 2014?

Traficano: A health professional’s volunteer experience is being accepted for certification. In the past, the only volunteer experience that could be used towards the eligibility requirements was through our mentorship program that was developed in the last few years. People could get up to 400 hours towards meeting the eligibility.

Starting in 2014, people can start applying for the CDE exam and use any volunteer diabetes self management education (DSME) experience they have had. It’s no longer limited to the mentorship program. It still has to meet our definition of DSME; it can’t just be a general presentation you give for free at your children’s school. However, the entire 1,000 hours required can be volunteer-based.

To learn more about NCBDE, go to their website here.