My Job That Became My Why: Reflecting on 4 Decades in Diabetes Care
Oct 31, 2025, 08:35 AM
By Janice MacLeod, MA, RD, LD, CDCES, FADCES
My career in diabetes began with my very first job after my internship—a position as a diabetes dietitian at a large teaching hospital in rural southwest Virginia. At the time, I didn’t plan to specialize in diabetes, but I accepted the role knowing I could later explore other areas of dietetics. What I didn’t anticipate was that diabetes care would become not just my career but my calling.
One year after starting, the first CDE exam was offered. I became eligible the following year and earned my certification in 1987. Decades later, I remain deeply committed to this work as a Certified Diabetes Care and Education Specialist. From newly diagnosed families to an elderly man who once told me, “diabetes makes no sense,” I found purpose in helping people make sense of it—together.
As diabetes care and education specialists, we bring clinical expertise, but we also recognize another expert in the room: the person living with diabetes. The magic happens where those two areas of expertise meet—that’s shared decision-making. That’s how we learn to dance together.
From the start, I valued being part of a multidisciplinary team of endocrinologists, nurses, psychologists, and exercise specialists. We learned from one another and built a strong foundation in evidence-based, person-centered care. Membership in the Association of Diabetes Care & Education Specialists further strengthened my skills and connection to the broader community of diabetes professionals. My first ADCES Annual Conference, back in Dallas in the late 1980s, was transformative. The nurse educator and I who attended together returned home overflowing with ideas and renewed energy for our patients.
Equally important has been my membership in the Academy of Nutrition and Dietetics and the Diabetes Dietetic Practice Group (DDPG). While ADCES has connected me across disciplines, DDPG has provided an invaluable network of RDN colleagues, rich education resources, and leadership opportunities. I was honored to serve as Chair in 2021–2022, deepening my appreciation for the collaborative spirit and innovation within our profession. Being part of ADCES and DDPG has shaped my journey every step of the way—connecting me with a community that inspires, educates, and reminds me why this work is truly a calling.
My career has taken me from direct patient care to industry, digital health, and smart insulin delivery, and now to consulting in the broader cardiometabolic space. I’ve learned from world-class experts, but my greatest teachers have always been the people living with diabetes. Looking back to that first “job” in 1985, I could never have imagined where it would lead—but I’m profoundly grateful it led me here.
This was adapted from Janice's article in the Summer 2025 issue of ADCES in Practice. Note: This practice journal is a benefit of ADCES membership. If you like what you see, consider becoming an ADCES member. Learn more about membership