Type 2 Diabetes: Self-Management and Support

Relationship between Patient Activation and Social Support among People Suffering from Type 2 Diabetes

The evidence-based research by Miller and Matteo (2013) revealed that about 90% cases of diabetes are type 2. Their study involved collection of both primary and secondary data to determine the relevance of social support on patient activation. It is important to find ways of managing this type of diabetes in order to improve the patients’ life quality. Patient activation is very important in managing type 2 diabetes. The controlled clinical trial research by Miller and Matteo (2013), which involved 45 participants, describes patient activation as the knowledge, skills and high level of confidence that people have in the management of their own health. The ability of a type 2 diabetic patient to lead a normal life heavily relies on the knowledge one has about the disease, his or her skills on the management of the disease, and the level of confidence the patient has in achieving success. According to a case study by Menke, Orchard, Giuseppina, Bullard and Cowie (2013), patient activation and social support among type 2 diabetic patients are closely related. These scholars conducted a study primary research on 157 type 2 diabetes patients at John Hopkins Hospital. Their study revealed that these patients need the support of the health professionals and other members of the society to have the right knowledge about this disease and the skills on how to manage it. The randomized clinical trial by Valde (2011) involving 45 type 2 diabetic patients found out that very few members of the society who are not suffering from type 2 diabetes have enough knowledge about it.

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A cohort study by Valde (2011) revealed that type 2 diabetes is very common among the elderly population, especially people who are aged over 45 years. The study, which was conducted on 67 diabetic patients, reveals that when it strikes at this late stage in life, they always lack the necessary skills and knowledge on how to manage it. It is at this stage that the social support becomes very important. Such a patient will need the support of the society to know how to deal with the new lifestyle. Sometimes the support may not come easily in case the patient has limited financial resources to reach out to the right people. When the support fails to come, the condition may worsen. The study by Hendriks and Rademakers (2014) that involved 94 participants found out that hope and confidence are very critical tools when managing a chronic disease such diabetes. The scholars say that confidence and hope play an important role in managing stress among these patients.

Hendriks and Rademakers (2014) conducted a case control study which revealed that when a patient is subjected to positive comments from the members of the society and the right support, the patient will have all the reasons to be positive. The study, which relied on the analysis of primary data, showed that patient will feel valued, and this will make him or her be willing to learn more about the disease. Their study which involved 178 participants revealed that patient activation is stronger among those who get social support from the members of their families. When they are constantly encouraged, these patients get to appreciate that their condition is not permanent and neither is it terminal. They get the courage to fight the disease, and this makes it easy to manage the disease. This means that family and friends should understand the fact that they have a role to play in managing this type of diabetes whenever a member is diagnosed of it.

Relationship between Patient Activation and Diabetes Self-Management among People Suffering from Type 2 Diabetes

A phenomenological study by Snoek, Douglas and Lawton (2007) revealed that type 2 diabetes is a problem that needs self-management among patients for them to lead a normal life. In their primary research, it was determined that those who exercised self-management had 78% higher chances of preventing related complications than those who failed to take care of themselves. The study revealed that patient activation and diabetes self-management are closely related. According to case study by Schiøtz and Willaing (2012), one of the biggest challenges that nurses do face when handling diabetic patients is self-rejection. Their study found out that most of the 238 participants interviewed would despair the moment they are informed that they are suffering from diabetes. They will develop withdrawal symptoms that make them avoid the members of the society who may be of help to them.

According to an ethnographic study by Schiøtz and Willaing (2012), self-management is very critical in order to manage type 2 diabetes. The results from this study show that patient activation and self-management are closely related. For one to be able to manage one’s condition, one should be aware of the health complication that one is dealing with in his or her life. Successful management of type 2 diabetes can only take place when the patient understands his or her condition and how it can be managed. Patient activation will help in dispelling some of the common myths about this disease. Some of these myths always hinder successful management of diabetes. Hendriks & Rademakers (2014), in their controlled clinical trial, found out from their study that some myths make patients feel that their fate is sealed, and that nothing can be done to rectify it. This is where patient activation comes in handy. It helps the patient understand that some of the common myths about this disease have no basis. It helps them understand that their condition is manageable if one makes a personal effort towards the same.

The research by Caccamo (2014), which majorly involved review of literatures, reveals that self-management heavily relies on what the patient knows about the disease. Having the right knowledge and skills is the first step in managing type 2 diabetes. For a patient to develop a positive attitude towards the new condition, and engage in activities that will elevate the condition of his or her life, it is necessary to have the right knowledge. A case study by Caccamo (2014) revealed that a patient suffering from type 2 diabetes should refrain from some types of food. The study, which involved review of secondary sources, found out that for this to happen, the patent needs to know about these types of food that should be avoided, and those that are encouraged. It is only then that the patient will be responsible enough to take the right diet that is in line with his or her health condition. Many people believe that the need to engage in physical exercise is a common knowledge, as noted by the phenomenological research by Mayberry (2010) and Dam (2003) that collected data on patients at different hospitals in the United States to determine the level of knowledge of diabetic patients on the issue of self-management.

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Relationship between Patient Activation and Glycemic Control among People Suffering from Type 2

According to the study Gillies (2008), which was a randomized clinical trial, glycemic control among type 2 diabetic patients has become a common approach used to manage the disease. Recent randomized clinical trials have shown that glycemic control may help in reducing the short-term or even long-term health complications among the diabetic patients. An observational study by Schiøtz (2012) showed that proper glycemic control may help ease the financial burden that is associated with the management of type 2 diabetes. Managing type 2 diabetes may be very costly, especially to those in the lower social status. When it comes to defining the type of food one can or cannot take, this may be a luxury that cannot be afforded by those in the lower social class. This explains why so many people still succumb to this disease despite the fact that science has brought simple ways of managing the disease. In some cases, the patient may be the only breadwinner of the family. This would mean that the patient may not avoid strenuous jobs that are very risky given their delicate conditions. According to the findings of a case study by Gillies (2008), glycemic control still remains very elusive to a large number of people because of two main factors. One of the two factors is object poverty. When a patient comes from a poor background, the prescribed lifestyle for a diabetic patient would be a luxury. The food to be taken, the jobs to be avoided, and the amount of rest needed would not be easy to achieve because of the limited resources. This means that such a patient will be forced to lead a life that is contrary to the expectation. This will make it difficult to fight some of the health complications related to diabetes type 2 (Gillies, 2008).

Patient activation is a common factor that always affects glycemic control. The cohort study by Ahlgren, Shultz, Massey, Hicks & Wysham (2005) that involved review of literatures, confirmed that tight diabetes control plays an important role in giving the patient extra years of healthy and active life. This study conducted on 113 patients in a community-based research, revealed that this it helps in slowing or even preventing the progress of diabetic complications on a patient. However, glycemic control can only be attained if there is the patient activation. As mentioned previously, glycemic control highly relies on the direct effort put in place by the patient in managing the disease. Poor glycemic control occurs when patient engagement is poor as observed in an ethnographic study by Mayberry (2010). Patients can only take an active role in managing their health conditions if they know what should be done. An increase of blood glucose level to an unprecedented high level is a clear indication that the patient has limited or no skills and knowledge about the management of this disease. It is not common to find people taking something that they know can be poisonous to their body. Very high levels of sugar in the body of a diabetic patient can be very dangerous. However, some patients have failed to engage in proper glycemic control because they lack the right knowledge.

Relationship between Social Support and Diabetes Self-Management among People Suffering from Type 2 Diabetes

According to a quasi experimental research by Xie (2010) which involved review of secondary sources of data, there is a close relationship between the social support and diabetes self-management. The society in which one lives defines so many factors in one’s life. Type 2 diabetes is common among the adults who are aged more than 45 years. At this stage of life, one always has strong social ties, with others having children and grand children. These social ties play an important role in diabetes self-management. Supportive families are very important in self-management programs. When patients get love and support from the family members, they will realize that they are valued by the society. These supportive members of the family or society will instill a sense of responsibility into the patient (Xie, 2010). They will make the patients realize that they still have a role to play not only in their own lives, but also in the lives of other members of the society.

According to a clinical trial by Connolly (2000), social support has been considered as one of the main pillars of diabetes self-management. The ability of a diabetic patient to press on with the fight against the disease heavily relies on what they believe their worth is in the society. What other people say about a person heavily influences their view about life. Issues such as stress will define how well one can manage such a serious health complication. A family that cares less about their diabetic patients will make the patients feel worthless. They will not value their lives, and this will make self-management worthless to them. The emotional torture will make them want to terminate their lives to avoid what they consider as a burden to their family members. This problem is very common among the elderly diabetic patients who are in the lower social cadre. When such poor diabetic patients realize that there is some form of reluctance among the family members, they will develop a feeling that they are a burden to their family members. The clinical trial by Cameron (2006) conducted on 274 elderly patients suffering from type 2 diabetes revealed that patients who do not get direct support from the society have lower capacity to manage the disease than those supported by people close to them. Such patients would always develop stress to the levels of taking their own lives because of the rejection. In other cases, a patient would lead a reckless life in an attempt to escape from reality. They may engage in alcoholism to help them hide the frustration in life. Some would try to lead normal lives by taking some types of food that are only recommended for healthy people. Some do this in an attempt to convince themselves that they are normal. Such patients would live in denial of the truth because of the desire to receive acceptance from the members of the society. They would convince themselves that trying to lead a normal life would help them fight their complications and in the long run they might be free of their medical problem. This high degree of ignorance is very common among the less educated patients who have limited knowledge about this disease as noted by Norris (2002) in their case study. Their ignorance about the disease is aggravated by the lack of support from the people around them.

Relationship between Social Support and Glycemic Control among People Suffering from Type 2 Diabetes

According to a correlational analysis research by Khattaba, Khaderb, Abdelkarim, Ajlouni (2010), glycemic controls have helped diabetic patients to lead a healthy lifestyle despite their delicate conditions. Their study revealed that Glycemic control is highly recommended for patients suffering from type 2 diabetes. Glycemic controls may help in reducing hospitalizations and other expensive processes among the diabetic patients. However, the ethnographic study by McCain, Kirk and Ramsay (2008) notes that glycemic control largely relies on the social support those patients get from the people around them. Glycemic control involves continuous medical care that a patient gets and constant awareness creation in an effort to empower the patient in the fight against this disease. The best weapon that can be used against type 2 diabetes is to empower the patient by making him or her understand how to manage the disease. Glycemic controls seek to find a way of bringing the relevant stakeholders in managing the disease. The stakeholders in this case will be the patient, family members, team of experts involved in managing the patient, and the society at large. Each of these stakeholders has a vital role to play in this fight. The patients need to understand the new lifestyle they must lead in order to be responsible for their own health, as Khattaba, Khaderb, Abdelkarim and Ajlouni (2010) in their case study. Family members have a moral and material responsibility to the patient. They must help the patient adapt to the new system of life that involves taking the right medication, taking the recommended diet, and maintaining regular exercises to manage their condition. These family members also have a role to play in financing the regular medications that will be needed for the patient to stay healthy. This is specifically so when the patient is in his or her old age and may not afford the medication. The society also has a major role to play as friends and motivational speakers. Psychological therapy is very important when managing type 2 diabetes, especially when the patient has been subjected to various forms of myths about this disease, as shown in the randomized control trial by Egede and Chandra (2010), which took place in India. This therapy may not necessarily be given in hospitals. The message from the survivors of this disease or friends within the society may be very beneficial to these patients. It may help in lifting their spirit and their resolve to fight the disease. Of the 326 people interviewed in the study by Egede and Chandra (2010), it was established that glycemic control was higher among those with strong social support (67% noted that they had a strong social support). The 67% of the population registered a better glycemic control than those who lacked the social support.

This clearly demonstrates that glycemic control is largely dependent on the social support that a patient gets during this delicate stage of life. A case study by Monira (2011) involving 74 participants revealed that glycemic control was strong among members of the society in high social class. It is easier for people who are rich to get the social support they need from the members of the society than it is to a poor person. To the poor, there is always the socio-economic burden that will tend to repel the members of the society as they try to avoid the financial responsibility in managing the patient. On the other hand, the rich will easily attract the sympathy of the members of the society because they know that their closeness will not involve any financial responsibility. As Egede and Chandra (2010) observe in their observational study, this makes it easy for the rich to have the right information from a variety of sources on how to manage this disease. It explains why glycemic controls have been more successful among the rich than the poor.

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Summary

Proper management of type 2 diabetes is very important in enhancing the quality of life of diabetic patients. From the review of literatures done above, it is apparent that there is a close relationship between patient activation and social support among people suffering from type 2 diabetes. Patients need social support from the members of the society in order to gain the right knowledge on how to manage this type of diabetes. The review also reveals that patient activation and diabetes self-management are closely related. When a patient has the right knowledge on how to manage this disease, then self-management becomes an easy task for them. They will know what to do, how and when to do it in order to lead a healthy life after being diagnosed of the disease.

The review of literatures reveals that patient activation is closely related to glycemic control. In order to have a tight control of diabetes type 2, one needs to have the right knowledge and skills about the disease. Patient activation makes glycemic control a simple process that can easily be done with the patient without any constant support from the medical experts. The literatures also reveal that social support plays an important role in enhancing diabetes self-management among people suffering from type 2 diabetes. It is clear that for diabetic patients to be responsible for their lives, they need the support from the people around them. They need to be encouraged to fight the disease. They should be made feel that they are valued. Finally, the literatures also show that there is a close relationship between social support and glycemic control. For there to be a tight control of the disease, the patient will need the social and financial support from the people around them.

References

Ahlgren, S., Shultz, J., Massey, M., Hicks, B., & Wysham, C. (2005). Development of a Preliminary Diabetes Dietary Satisfaction and Outcomes Measure for Patients with Type 2 Diabetes. Quality of Life Research, 13(4), 819-832.

Caccamo, R. (2014). Diagnosis and Management of Type 2 Diabetes Mellitus in Adults. Journal of Nursing, 52(4), 45-98.

Cameron, B. (2006). CE Credit: Making Diabetes Management Routine. American Journal of Nursing, 102(2), 26-33

Connolly, V. (2000). Diabetes Prevalence and Socioeconomic Status: A Population Based Study Showing Increased Prevalence of Type 2 Diabetes Mellitus in Deprived Areas. Journal of Epidemiology and Community Health 54(3), 173-177.

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Dam, R. (2003). The Epidemiology of Lifestyle and Risk for Type 2 Diabetes. European Journal of Epidemiology, 18(12), 1115-1125.

Egede, L. & Chandra, O. (2010). Role of Motivation in the Relationship Between Depression, Self-care, and Glycemic Control in Adults With Type 2 Diabetes. The Diabetes Educator, 26(3), 11-38.

Gillies, C. (2008). Different Strategies for Screening and Prevention of Type 2 Diabetes in Adults: Cost Effectiveness Analysis. British Medical Journal, 336(7654), 1180-1184.

Hendriks, M & Rademakers, J. (2014). Relationships between patient activation, disease-specific knowledge and health outcomes among people with diabetes; a survey study. Health Services Research, 3(8), 1-28.

Khattaba, M., Khaderb, Y., Abdelkarim, A., Ajlouni, K. (2010). Factors associated with poor glycemic control among patients with Type 2 diabetes. Journal of Diabetes and Its Complications, 24 (7) 84–89.

Mayberry, R. (2010). A High Level of Patient Activation Is Observed But Unrelated to Glycemic Control Among Adults With Type 2 Diabetes. Diabetes Spectrum, 23(3), 171- 210.

McCain, S., Kirk, C. & Ramsay, E. (2008). Transient Type 2 Diabetes Mellitus in a Raccoon. Journal of Zoo and Wildlife Medicine, 39(4), 622-625.

Menke, A., Orchard, T., Giuseppina, I., Bullard, K., & Cowie, C. (2013). The Prevalence of Type 1 Diabetes in the United States. Epidemiology, 24(5), 773-774.

Miller, T. & Matteo, R. (2013). Importance of family/social support and impact on adherence to diabetic therapy. Dove Press Journal, 6(1) 421–426

Monira E. (2011). Self-reported Racial Discrimination in Health Care and Diabetes Outcomes. Medical Care, 49(7), 618-625.

Norris, S. (2002). Increasing Diabetes Self-Management Education in Community Settings: A Systematic Review. Journal of Nursing, 4(8) 79-138.

Schiøtz, M. & Willaing, I. (2012). Self-management behavior among patients with Type 2 diabetes. Diabetic Medline, 16 (24), 20-91.

Schiøtz, M. (2012). Social support and self-management behavior among patients with Type 2 diabetes. Diabetic Medline, 16 (22), 23-70.

Snoek, E., Douglas, M. & Lawton, J. (2007). Self Monitoring of Blood Glucose in Type 2 Diabetes: Longitudinal Qualitative Study of Patients’ Perspectives. British Medical Journal, 335(7618), 493-496.

Valde, G. (2011). Community Program to Prevent Diabetes in School Children. Journal of Community Health Nursing, 28(4), 215-222.

Xie,J. (2010). A quick self-assessment tool to identify individuals at high risk of type 2 diabetes in the Chinese general population. Journal of Epidemiology and Community Health 64(3), 236-242.

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