Julie Stelting RN, CDE, BSN, BSD

By Erin Flynn Jay

In 1978, Julie Stelting was working as a dietician in a small hospital. Part of her job included giving instructions to adult patients who were newly diagnosed with insulin-resistant diabetes. Stelting had a family member who was being treated for diabetes, so she continued to investigate the side effects of uncontrolled blood sugars. After starting a family and reentering the workforce, Stelting learned that she needed to update her education. Instead of getting a master’s degree in nutrition, she felt there would be more opportunities for her if she went back to school for a nursing degree. During nursing school, she focused her experiences in the area of diabetes. Stelting realized that by combining her nutrition knowledge with her nursing experiences, she could help many people with chronic disease associated with obesity. A few years ago, Stelting decided to become a Certified Diabetes Educator (CDE®) to formalize her knowledge and help patients with diabetes. This begins here CDE story.

The most difficult part about becoming certified was finding a job that qualified her to sit for the exam. She was willing to continue to work as a volunteer diabetes educator at Volunteers in Medicine, but the National Certification Board for Diabetes Educators (NCBDE) at that time required 650 hours of paid employment working as a diabetes educator.

While Stelting started out working with patients with type 2 diabetes, she had gained a lot of experience working with patients with type 1 diabetes. “I worked every day for eight years with children on insulin. This helped me to understand their daily challenges,” she said. “I worked in an outpatient clinic. People who work inpatient only have a more difficult time understanding diabetes from the patient’s point of view.”

She did not think sitting through a course was her best choice and opted to use a textbook that included self-exam questions at the end of each chapter. As soon as her two years were completed, Stelting quickly took the exam and passed.

Due to recertify in December 2020, Stelting said that the textbook she prepared with gave her 60 credit hours. You need 75 hours, so she has been going to conferences and doing online work to recertify by continuing education credits.

Stelting started her own company—Kids at Risk for Diabetes LLC—in 2015. She had witnessed a four-year-old child being diagnosed with type 2 diabetes due to morbid obesity. It was heartbreaking because unless the child’s blood sugars could be controlled, there could be serious complications, such as blindness or kidney failure, within 20 years. Stelting emphasized that all of this could be avoided through education. She felt that much needed to be done to protect the future of the next generation. Unfortunately, many of these children’s parents also have uncontrolled type 2 diabetes and are in denial about their children’s health. Kids at Risk for Diabetes has a Whole Family Program to assist the entire family in making lifestyle changes.

Stelting also knew that women who are diagnosed with gestational diabetes are at high risk of developing type 2 diabetes within a few years. Gestational diabetes presents a unique opportunity to provide emotional support to new mothers while educating them about the challenges of living with diabetes. So Stelting developed a 3-month program to assist these women through this challenging time.

Many CDEs® work regular office hours from Monday through Friday. Only a few CDEs® in her area work in outpatient clinics. A typical day for Stelting starts with email and checking in on her two Facebook groups for patients. After that, Stelting counsels her one-on-one clients over the phone or by Skype.

Stelting said a CDE® can have a tight time schedule. “Many CDEs® are challenged with completing paperwork during their office hours. Overtime hours are discouraged by hospital administration, so many of these positions have been changed to salaried. Since hospitals want to get patients discharged as soon as possible, CDEs® working inpatient usually work 60 to 80 hours a week,” she said.

Stelting’s favorite part of being a CDE® is helping children with pre-diabetes or type 2 diabetes to lose weight and reverse their diagnoses. “We’ve had children as young as four years old diagnosed with type 2; this is due to insulin resistance,” she said. “Kids can be motivated to take care of themselves.”

When asked to tell us about a memorable patient, Stelting recalled a woman in her 80s who was diagnosed with type 1 diabetes as an infant. “When I saw her, she did not have one side effect from uncontrolled blood sugars. I could not believe it!” The patient told Stelting that when she was a child, her mother explained how she was different from other children and if she didn’t want to get sick, she had to live according to her limitations. “I believe children diagnosed with type 2 diabetes can be taught to live within their limitations. Our country celebrates using sweet foods. We need to teach our children not to overindulge with food at any time,” said Stelting.

Julie Stelting plans to seek additional certification as a Certified Insulin Health Trainer.

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