Diabetes Management and Physical Therapy
November is National Diabetes Awareness Month. Diabetes is a condition in which the body either does not produce enough insulin or does not respond normally to insulin, causing glucose levels in the blood to become too high. In the United States, 34.2 million Americans (1 in 10) have diabetes and 88 million American adults (1 in 3) have pre-diabetes. Physical therapists can help reduce diabetic symptoms and guide diabetic patients through a personalized exercise program, which can lower blood sugar levels and improves mobility.
What is Diabetes?
In those with diabetes, the body does not properly produce or use insulin, which is a hormone produced in the pancreas. Insulin allows sugar to enter cells and provide the energy needed for daily activities. If the pancreas doesn’t produce enough insulin or the body doesn’t respond correctly to insulin, too much sugar builds up in the blood. The individual becomes hyperglycemic and the body begins breaking down fats for fuel.
Signs & symptoms of diabetes include:
Slow-healing sores
High blood pressure
Frequent infections of the gums, skin, vagina, and bladder
Unexpected weight loss
Increased thirst and frequent urination
Constant hunger
Fatigue and weakness
Tingling or numbness in feet and hands
Blurred vision
Pain in joints and muscles
Cramping or pain in legs or limping when walking
There are three types of diabetes:
Type I: common in kids and young adults; immune system destroys insulin-producing pancreatic cells.
Type II: can occur at any age; preventable; cells of the body develop insulin resistance and the pancreas does not produce enough insulin to override resistance.
Gestational Diabetes: occurs in women during pregnancy; cells of body develop insulin resistance; goes away following birth; however, it can heighten the risk of developing Type II diabetes later in life.
Physical Therapy & Exercise for Diabetes
Physical therapy helps diabetic patients manage the condition and improve their physical fitness, mobility, and balance through a customized exercise program. Physical activity has been shown to improve insulin sensitivity and lower blood sugar levels in diabetic patients. Exercise under the guidance of a physical therapist helps patients learn how their body responds to exercise in a safe environment and builds endurance, fitness, and mobility gradually. Exercise reduces other health risks associated with diabetes like heart disease and stroke by lowering blood pressure and cholesterol.
It is important for diabetic patients to be supervised and guided through an exercise program by a medical professional, particularly if the patient has Type I Diabetes. For those with Type I Diabetes, it is important to have metabolic control before exercise, monitor blood glucose levels before and after physical activity, and have carbohydrates to consume during and after exercise. Engaging in regular physical activity can prevent or delay the development of Type II diabetes in individuals.
Physical therapy also treats complications from diabetes, such as blood vessel and nerve issues in the leg (i.e. leg cramping or numbness). Physical therapists use specific tests to check the sensation of the feet in diabetic patients regularly, help to decrease cramping pain during walking, improve walking ability, and show how to protect feet if a patient has lost sensation in the feet.
Physical therapy treatment for diabetes may include:
Graded, progressive aerobic exercise program
Strengthening exercises with resistance bands and weights
Stretching to improve muscle flexibility
Balance and coordination training to prevent falls
Chronic pain treatment
Foot pain assessment and strengthening
Home exercise program
Diabetes is a long-term condition that requires consistent monitoring and management. Physical therapists play a key role in diabetic management and prevention by helping diabetic and pre-diabetic patients engage in safe, effective, and specialized exercise programs.
