At the 85th Scientific Sessions of the American Diabetes Association (ADA 2025), Professor Alison Evert from the Primary Care Clinic at the University of Washington School of Medicine received the ADA Outstanding Educator in Diabetes Award.
Professor Evert shared key insights on diabetes nutrition education, including translating research evidence into clinical practice, integrating educational services in primary care, and the role of technology tools in improving patient access. In an interview, she used practical cases and forward-looking perspectives to discuss strategies for strengthening educator competencies and optimizing resources. Below is a summary of her sharing.
How can educational strategies help implement “diabetes education” in primary care?
In the translation from research to practice, a notable gap comes from the design features of nutrition trials:interventions are often short (e.g., 12 or 24 weeks), rarely last 1 year, and sample sizes are often fewer than 50 participants.Results from such short‑term studies are hard to generalize to long‑term outcomes, whereas pharmaceutical trials typically run for years.Thus, applying conclusions from only weeks‑long research into clinical practice is challenging.
Another real‑world barrier exists in clinical settings.When diagnosing diabetes, physicians often work within limited consultation time and cannot fully implement or guide patients through lifestyle interventions.After diagnosis, the focus is usually on prescribing medications and providing glucose monitoring devices, with insufficient time to discuss the critical roles of healthy eating and physical activity.Although dietitians and diabetes educators can provide individualized management plans, physicians often do not make referrals, or clinics lack such support staff to deliver the necessary education.
During my work at the University of Washington Endocrine Clinic, we observed that 80%–90% of patients with diabetes are primarily managed by primary care providers.Based on this finding, we led a pilot project in primary care settings.The project received dedicated funding from the primary care network of our health system, aiming to provide diabetes education directly within primary care clinics.
We developed a specialized diabetes education curriculum for primary care patients who were not referred to endocrinology.The core of the program was integrating education into patients’ routine primary care workflow:after seeing their attending physician in the clinic, patients completed the education curriculum in the same setting.
Through systematic data collection and outcome evaluation, we found that after completing a 6‑hour curriculum, patients’ HbA1c levels decreased by more than 1.0% from education delivered in primary care clinics.Based on these results, we successfully secured ongoing funding from regulatory bodies for dedicated diabetes educator positions in the primary care system.In recent years, the program team has grown from an initial 2 members to 7.
With rapidly advancing nutritional science, what competencies do diabetes educators urgently need to strengthen?
As the former chair of the Diabetes Care and Education Practice Group of the Academy of Nutrition and Dietetics, I represent a professional body of approximately 4,000 registered dietitians practicing in diabetes education and nutrition.The Certification Board, on which I currently serve, oversees three key functions:certifying Certified Diabetes Care and Education Specialists (CDCES),accrediting the certifying bodies of the CDCES credential,and certifying the Advanced Diabetes Management Certificate.
Obtaining these credentials requires mastery of a core diabetes education curriculum covering six key areas of diabetes care:nutrition management, physical activity, behavioral health, medications, chronic complications, and acute complications.As a registered dietitian, I had a strong foundation in nutrition management, but before earning my CDCES credential, my knowledge was relatively siloed within a single discipline.The certification process pushed me to integrate multidisciplinary knowledge in diabetes care and education.I recognized that people with diabetes need not only nutrition guidance but also understanding of exercise physiology, medication principles, glucose monitoring technologies, and behavioral health interventions — given their significantly higher prevalence of depression compared with the general population.By systematically mastering knowledge across these core areas, clinicians can greatly enhance their professional practice.
Which technologies or models truly empower educators and patients?
One positive outcome of the COVID‑19 pandemic was the widespread adoption of telehealth in healthcare delivery.Within the University of Washington Primary Care Clinic system, the team of diabetes care educators and dietitians I lead now completes 60% of appointments via telehealth.This shift has effectively reduced disparities in healthcare access and removed major barriers for patients due to transportation challenges.
For dietitians and diabetes educators, telehealth offers unique advantages because physical exams are not required.The model allows me to see patients’ real‑life environments — for example, directly observing their food supplies, drinking water, and refrigerator contents — and effectively teach technical skills such as insulin injection and glucose monitoring device use, greatly improving access to care.
Notably, artificial intelligence (AI) shows great promise.Ensuring patients receive evidence‑based nutrition guidance is critical.However, if patients rely solely on AI and forgo care from specialized educators or registered dietitians, treatment precision may suffer.Individualized care depends on deep patient‑provider interaction, whether in person, in group settings, or via telehealth, to gather detailed information and tailor plans.True personalized care cannot be achieved through AI alone.
Our team is currently exploring a human‑AI collaborative model.When patients request time‑intensive support — such as “a one‑week sample meal plan to help with dietary changes” — colleagues use AI to generate an initial framework.Professionals then integrate the patient’s dietary preferences into the system to create a personalized plan.This confirms the need for collaboration between AI and clinical experts:technology should empower, not replace, human‑centered care.