Profile: United Healthcare Optum
diabetes clinical management program
By Terrance Thornton | Digital Free Press
There are an estimated 600,000 human beings living in Arizona whose bodies cannot any longer transform food into energy due to one of three variations of a diseases the medical community has coined, ‘diabetes.’
Arizona has a population just north of 7 million, according to a 2021 update at the United States census.
The disease, medical experts say, prevents one’s body from regulating sugar in the bloodstream as levels of insulin meant to be released by the pancreas into the blood to allow that sugar to be transformed to energy or fat is no longer occurring. Or, conversely, the body no longer can utilize the insulin created.
The end result? A range of health problems ranging from blindness to death.
Diabetes is the seventh leading cause of death in Arizona and is estimated to cost some $5 billion in medical expenses, but in the Phoenix metropolitan area great strides have been made in care, practice and education on how to manage the disease, experts contend.
Part of that effort is Patti Summers, a nurse practitioner spearheading a clinical diabetes management program part of United Healthcare serving some 4,000 Medicare Advantage qualified patients.
“We take anyone who has diabetes,” Ms. Summers told the Arizona Digital Free Press of those part of the Optum United Healthcare Medicare Advantage health insurance plan. “There are actually several definitions of the disease, but generally Type 1 is you can’t make insulin and Type 2 is you can’t use it — it is one of those two big buckets.”
Ms. Summers explains ‘Type 3 diabetes’ is not completely understood why it happens, but environmental factors play a role for those who develop this third type of the disease sporadically, medical experts opine.
“You can get diabetes from chemotherapy treatment,” she explained of the “odd-ball” things that happen. “Diabetes type 3 is not recognized by the American Diabetes Association at this time. They are still trying to understand some of the other ways in which you can have pancreatic failure that leads to diabetes.”
Ms. Summers says oftentimes patients in the program — one that takes in about 150 to 200 a month — encounters older adults entering the American health care apparatus in a time of distress.
“Most people at this age — people know what they should or should not eat,” she explained of the reality of human behavior. “We take into account the cultural aspects of the patients. A lot of them time, we are explaining why they take the medication to ensure they understand why they are taking the medication.”
The name of the game, Ms. Summers says, is the management of the all-important A1C level — a percentage of hemoglobin proteins present in the blood. A normal A1C level is below 5.7%, published reports state.
“Diabetes touches the whole body,” she pointed out. “The goal is to keep them out of the hospital as much as we can. We are managing about 175 patients who are in the program for 100 days, some less and some more.”
Diabetes: myths, misconceptions & the road to management
There have more advancements in the treatment of every variation and degree of diabetes in the last 10 years compared to the last 30 years, Ms. Summers explains.
“We spend a lot of time, an hour or two to initially, to get to know what is going on with them. We see a lot of misinformation,” she pointed out of a critical detail during the intake process. “People have done some education or encountered ‘hearsay’ and they have misconstrued the information and we spend some time educating them on what is myth and what is fact.”
Ms. Summers explains the No. 1 fear of patients is the loss of a limb.
“It is a common misconception — it is a myth,” she said. “It is often present because it happened to a family member, but that happened a long time ago. We have gotten much better at managing diabetes in the last 10 years. Before all we had was insulin and now we have many things we can choose from.”
United Healthcare delivers care through Optum at five different community centers throughout the Phoenix metropolitan area and can be reached at 623-293-9998.
Phoenix resident Bob Leary credits Ms. Summers and her program with getting his life back on track.
“In 1995, through a routine blood check I was told I was slightly diabetic and that pretty much stayed the same,” he said explaining, ultimately, he underwent an emergency heart-bypass surgery and following a successful hospital stay his phone begun to ring.
“I was seeing five doctors at the time and didn’t think much of their calls. I was already seeing five doctors,” he explained in a phone interview. “As my diabetes was getting worse and I was finding out how bad it was hurting my body, I did take the call and that was my introduction to the program.”
Mr. Leary explains a time in his life when he was facing dialysis, which is a procedure to remove waste products and excess fluid from the blood oftentimes a result of unbridled diabetes.
“When I entered the program, I was on the downhill side; I was being prepped for dialysis,” he said. “I was having problem with my vision. I had no quality of life — that is the best way I can put it.”
But the story doesn’t end there, Mr. Leary explains.
“Forget kidney failure, diabetes is the most diabolical disease you can have,” he said.
“You don’t know how much it is affecting you. The first part of the support from Patty was during the first 100 days I was talking to her weekly and during my appointments. What I didn’t realize was the environmental and physiological factors that can affect your glucose levels. Honestly, I just thought I wasn’t eating right, but there is much more to the disease. The thing that is so scary to me is the slow, slow and relatively non-painful death. It takes over parts of your body over a period of time that, day-by-day reduces your quality of life.”
Today, Mr. Leary reports, on the other side of his emergency medical experience and the lessons learned from Ms. Summers, he has saved him hundreds in prescriptions and an immeasurable boost in the quality of life he is living today.
