November is National Diabetes Month
According to the Centers for Disease Control, nearly 26 million children and adults are living with diabetes. It is estimated that 7 million of these are unaware that they have the disease. Nearly three times as many people have "pre-diabetes," a condition in which blood sugar (glucose) levels are abnormal but are not yet considered diabetic.
What Is Diabetes?
In diabetes, the body does not produce or properly use insulin. Insulin is a hormone produced in the pancreas and is needed to allow glucose (sugar) to enter the cell and provide the energy necessary for daily activities. When the pancreas doesn't produce adequate amounts of insulin, or when the muscle, fat and liver cells don't respond to insulin properly, glucose builds up in the blood (hyperglycemia). This can be toxic to your cells. In addition, because of the reduced glucose uptake into the cells, they can use an abnormal amount of fats for fuel (ketoacidosis) and may become undernourished.
There are 3 main types of diabetes:
Although the exact cause of diabetes is unknown, factors such as obesity and lack of exercise play important roles in type 2 diabetes.
In a condition called "pre-diabetes" or "insulin resistance," blood sugar levels are normal or only moderately elevated and often are accompanied by elevated insulin levels but have not yet reached the diabetic stage. With pre-diabetes, you have a greater risk not only for diabetes but for heart attacks and strokes.
Signs and Symptoms
Diabetes symptoms include:
The onset of type 1 diabetes can occur quickly. If you have ketoacidosis, your cells are using abnormal amount of fats for fuel and may become undernourished to the point where you could lapse into a diabetic coma unless you receive insulin. The onset of type 2 diabetes typically develops more slowly, and you might not have any symptoms at all.
American Diabetes Association*
How Can a Physical Therapist Help?
Physical activity, along with diet and medication, is a cornerstone of treatment for diabetes—and physical activity is a cornerstone for prevention of diabetes. If you already have diabetes, you know that you need to control your blood glucose (sugar), lower your blood pressure and cholesterol, maintain a healthy weight, and exercise to reduce your risk of heart disease and stroke. Regular physical activity also can reduce your need for medications, particularly if you have pre-diabetes.
The American Diabetes Association recommends 30 minutes of moderate exercise at least 5 days per week. Both aerobic and strength workouts are helpful. Your physical therapist will perform an evaluation, including a review of your medical history and medications, and develop an individualized exercise program.
Improve Your Blood Sugar Levels, Manage Your Weight, and Reduce Your Risk of Heart Disease
Based on your health status, your physical therapist will prescribe aerobic exercise tailored to your needs:
Your therapist likely will recommend physical activity at least 3 days per week, with no more than 2 days in a row without physical activity.
If you have type 2 diabetes, your physical therapist will prescribe "resistance" exercises (exercises with weights or elastic therapy bands), unless you have another medical condition that makes them unsafe. The goal usually is to do them 3 days per week; your therapist will determine a safe beginning weight and number of repetitions.
Your physical therapist also will help you manage exercise precautions:
Always see a physical therapist to help you with physical activity if you have:
When You Have Complications
If your diabetes isn't being managed well, it can lead to problems in blood vessels and nerves, often in the legs. Low blood flow to the legs can cause cramping pain when walking or lead to skin breakdown (ulcers, sores) on the legs or feet. Diabetes can affect the nerves, which can result in tingling in the feet and may progress to complete numbness. This numbness can mask any damage to the skin or joints because you don't feel pain in the normal way. These problems can lead to difficulty with daily activities, limit your ability to exercise, and also harm your overall health. If these problems occur, physical therapists can: