Type 2 Diabetes Patient Advocate, Navigator or Health Advocate
The concept of patient advocacy in its current form was developed in 1950’s as the treatment of patients grew more and more technically complicated, as a means to make the voice of the patient more readily heard. In today’s world of constantly evolving medical techniques, treatments, and services, the average individual cannot be expected to be thoroughly acquainted with any and all this material. So it becomes the function of the type 2 diabetes patient advocate to perform a variety of services to ease the burden of the patient, and their family, as they learn to deal with every aspect of the disease.
The primary concern of the type 2 diabetes advocate to the support the patient in all aspects of life with the disease, whether they be physical, emotional, or financial. An advocate can assist the patient in investigating available treatment options and educating the patient on the efficacy of each of them, be it pharmacological or surgical. By educating the patient, the advocate can be of great assistance in helping them make an informed decision about their course of action, and the possible side effects and outcomes. Support may also involve recommending counseling services for the patient, and their family members, to help them cope from day to day. Type 2 diabetes patient advocates may also be of assistance in helping the patient, and their caregivers, deal with any physical debilitation resulting from the disease, and its treatment.
Another aspect of type 2 diabetes patient advocacy is assistance in navigating the financial aspects of treating the disease. An advocate can act as a liaison between the patient and his or her insurance company, assuring that the patient receives any and all benefits to which they are entitled. When one is dealing with a serious disease, it is quite easy to lose track of other aspects of your life. An advocate can help to seek out sources of assistance which can ease the financial burden of the patient.
Education is also a major function of a health advocate. Both the patient, and their caregivers, are often in need of information about how the disease will affect their lives, both during its progression, and in its aftermath. Patients must be informed about how their condition will affect their mobility, the ability to care for themselves, and if they will be left with any permanent impairment to their lifestyle. Caregivers need to be instructed in mechanisms, or techniques they must use to cope with the patient’s daily care, such as injections, proper care of surgical dressings, etc.
The patient, above everything else, needs to know that there is someone in their corner. Someone who will help them find their way through the confusing, and sometimes daunting, world of modern medicine. Someone who will have their best interests in mind as they face challenges presented every day in their struggle to find, secure, and finance the best treatment available.
What is Type 2 Diabetes Mellitus?
Type 2 Diabetes Mellitus is one of the two primary types of diabetes. The other is Type 1 Diabetes Mellitus. In the primary type there are no conditions or infections that precede the appearance of the disease. Type 2 Diabetes Mellitus is seen in adults aged over 50 years and rarely seen in those under 40. This is why it is sometimes referred to as Adult Onset Diabetes Mellitus (AODM). It also doesn’t always need insulin to control it. For this reason it is also called Non-insulin Dependent Diabetes Mellitus (NIDDM). Regardless of the type, the end results are an abnormality in the metabolism and control of blood sugars in the body – among other problems.
Type 2 diabetes mellitus can take a long time before a person present to a doctor. This is because the onset may be gradual, unlike the type 1 which usually present as a medical emergency. The symptoms the person may present with include:
· Excessive passing of urine – polyuria.
· Having to wake up many times to pass water at night – nocturia.
· Excessive thirst.
· Taking too much water and other fluids – polydipsia.
· Slow healing wounds.
· Skin spots and patches.
· Generalized tiredness
· Weight loss.
· Dry mouth and other mucous membranes.
· Women may complaint of intense vaginal itching and unusual discharge. This is due to the fungus candida albicans infection.
· Men who have a foreskin will also complain of itchiness and sores under the foreskin. This is due to the same infection with candida albicans fungi seen in women.
· Impotence and other erectile dysfunctions.
· Impaired vision.
· Numbness with a ‘pins and needles’ sensation in the limbs.
· If advanced, may complain of changing color and total numbness in the toes.
Cause and Risk factors
The cause is not well understood but prevalence is associated with obvious risk factors.
Genetic predisposition is one of the major risk factors. However, the occurrence of the disease even in those likely to be sick due to their genetic likelihood is enhanced mostly by the environment and lifestyle choices more than their genetic make-up. Family history of the disease and race (in the U.S African Americans, American-Indians and Hispanics are affected more). Other risk factors include:
· Fat distribution in the body. Belly fat accumulation appears to increase the risk compared to those whose body fat is in the hips.
· Sedentary lifestyle.
· Gestational diabetes (a temporary diabetic state that appears only in pregnancy).
· Presence of polycystic ovary syndrome.
The history and presentation of the patient are almost diagnostic in themselves. Laboratory testing and other tests help only to assess the degree of the disease. Some of these tests are:
· Urine analysis will show presence of sugar alone or with ketones in the urine.
· Glycated hemoglobin test will give an up to three months’ previous picture of how blood sugar has behaved.
· A random blood sugar test.
· Glucose tolerance test (GTT)
The aim of treatment is to help the patient live as normal a life as possible. Prevention of complications related to the disease is also a priority. Treatment includes:
· Health education to patient and family.
· Dietary instructions may be all that is needed to control the disease.
· May need diet and an oral hypoglycemic drug.
· May involve diet and insulin therapy.
· Common oral drugs used include sulphonylureas, biguanides, DPP-4 inhibitors and GLP-1 receptor agonists. Under these main groups are many brands.
· Insulin comes in various types. There are short acting ones, intermediate and long acting ones.
· Treatment can also involve treating complications of primary treatment as when the blood sugar has been over-controlled and needs to be raised to normal.
· Some centers do Bariatric surgery where body fat is reduced. The operation can give good results but can also be fatal.
· Treatment of complications
Type 2 Diabetes Mellitus Statistics
According to the National Diabetes Statistic Report 2014, in 2012:
29.1 million Americans had diabetes. Those above 65 years were 11.8 million or 25.9%.
New cases in the same year were 1.7 million.
234 051 deaths were related to diabetes in one way or the other.
Diabetes incidence can be greatly reduced by adopting a healthy lifestyle. Hideous complications of the disease can be prevented by following the guidelines of your health care giver. Joining a support group can be a source of continuous encouragement even when the going is really tough.