Key health issues from Type 2 diabetes
Key health issues from Type 2 Diabetes
Type 2 diabetes can cause many different types of health problems. Although a General Practitioner can address many of them, certain other types of health professionals are best able to care for patients with certain types of problems.
The key areas are listed below. Much of this information is taken from the Royal Australian College of General Practitioners website and thanks is extended to them for providing the information.
Diabetes education
People with diabetes should see practitioners called Diabetes Educators, who help them adapt their lifestyle to new regimes. Diabetes Educators can often spend more time than the General Practitioner has available, consolidating the patient’s knowledge and skills regarding eating plan, physical activity, self-monitoring, medication usage, foot care, etc. If available, the services of a Diabetes Educator are useful in the early stages after being diagnosed with diabetes, and a continuing relationship can be established.
Diet
People with diabetes usually need to modify their diets to eat foods that do not aggravate their condition. It is important for people diagnosed with diabetes to be under the care of a Dietitian to manage their diabetes . Lifestyle changes alone (healthy food and regular exercise with ensuing weight loss) are enough for glycaemic control (control of blood sugar levels) in the majority of patients with newly diagnosed type 2 diabetes. Recommendations should be individualised to maximise patient cooperation.
Exercise
It is important that people with diabetes have regular and appropriate exercise. When initiating a physical activity program in a patient who has been relatively inactive, the help of a Physiotherapist with a special interest in exercise routines or an Exercise Physiologist may be of benefit.
Eyes
All people with diabetes need to be assessed regularly by an Ophthalmologist or Optometrist. These practitioners can detect early signs of retinopathy before visual loss occurs, and this markedly improves the patient’s chances of retaining their vision. Any deterioration in vision requires immediate referral back to the Ophthalmologist.
Feet
Diabetes commonly causes significant problems with feet and is the most common cause of amputation of feet other than injuries. Podiatrists specialise in keeping feet healthy and give expert preventive care for diabetes. If there is evidence of any serious foot problems (neuropathy, macro vascular disease, anatomical problems or a previous foot problem), early referral to a Podiatrist is desirable and regular review is necessary. Foot complications account for over 50% of hospital bed days occupied by patients with diabetes.
Nursing
In many practices, the Practice Nurse is invaluable in establishing, managing and implementing systems for diabetes care. The Practice Nurse can do a lot of the regular monitoring of diabetic patients that is necessary to ensure they remain healthy. Nurses can monitor blood levels, examine the patient and offer advice about how to live with diabetes and reduce risk factors.
Oral health
Dental and periodontal problems are common in people with diabetes and people with diabetes should see a dentist regularly (e.g., yearly).
Pharmacist
Pharmacists are frequently consulted by members of the community about a wide range of health issues. Pharmacists usually know the health problems and prescribed medications and can provide useful advice on medication usage and potential problems. Diabetic patients frequently take many medications and require advice related to how they should take all of these.
Mental health
A diagnosis of diabetes can be very stressful for patients. Initial denial of the condition (i.e., a grief reaction) is normal, but if denial continues, diabetes care can be compromised. Patients whose difficulties with accepting the diagnosis compromise their treatment may benefit from Cognitive Behaviour Therapy or other psychological interventions. General Practitioners can engage the help of a Psychologist, Social Worker or Counsellor. Older patients particularly can face increasing vulnerability to sickness, disability and loss of function. Fears may include job security, physical disfigurement and loss of ability to contribute to present relationships.
Aboriginal Health Workers
Where they are available, Aboriginal Health Workers have a key role in providing culturally appropriate and practical support and counselling, thus improving patient understanding and adherence to treatment programs.