Type 2 Diabetes and Exercise

PHYSICAL EXERCISE THERAPY

Diabetes is increasing at an alarming rate globally and is the major cause of death related to cardiovascular disease (Lumb, 2014). Diabetes has impacted over 300 million people in the last 30 years and is expected to hit 600 million within the next 20 years (Bloomgarden & Li, 2015). These numbers are really an educated guess because there are many people who do not know they have this disease. This is mostly due to obesity and lack of exercise, although in some cases such as mine that is not the case. By exercising, people can reduce the risk of developing diabetes by 47% to 58% (Lumb), (Bloomgarden & Li). As a matter of fact, many clinical studies have shown that diet and exercise in pre-diabetes patients can slow the onset of diabetes, and improve the control of glucose in people with diabetes (Bloomgarden). Exercise for me means less insulin and other drugs, and I can eat a little more to keep hyperglycemia from occurring.

The American Diabetes Association states that adults with diabetes should perform at least 150 minutes per week of moderate-intensity aerobic physical activity (50–70% of maximum heart rate), spread over at least 3 days per week with no more than 2 consecutive days without exercise. That’s 50 minutes of exercise every two day. If you think about it, it is not really that much and you do not have to kill yourself doing it.  Remember, this is moderate-intensity or relative intensity. Not absolute intensity. Below are some of the positive effects of exercise and diet for people with pre-diabetes and type 2 diabetes;

·      Less medication

·      Reduction of sleep apnea

·      Enhanced mobility

·      Decreased urination

·      Reduced cardiovascular risk

The problem is that people with diabetes fail exercise while self-monitoring, mainly due to lack of motivation or poor health. There is research currently being done and being considered for approval by the Food and Drug Administration called Physical Exercise Therapy (Balducci, et al, 2014) and is designed for people with diabetes to help them get the exercise they need and provide support and help while doing it. Like a pharmaceutical drug prescribed by a physician or a restricted diet by a dietician, specific exercises would be prescribed with a therapist designed to help keep glucose levels at the desired levels while being monitored not just to make sure exercises are done but also to ensure they are done correctly and that no more exercise is done than the body can physically handle. The dose and intensity of exercise would be prescribed by a doctor in conjunction with the patient.

Physical Exercise Therapy would include:

Leisure time activities – Walking in the park, gardening, sports or dance, and formal exercise training.

Absolute intensity training to get the heart rate up if the patient can do this.

Relative intensity training. This is more like warm up training but designed for patients who cannot do absolute intensity training.

Exercise training such as cardiorespiratory fitness such as walking on a treadmill or other equipment to get the heart rate up.

Muscular strength and resistance training such as lifting weights to get back muscle lost due to high glucose levels.

Flexibility training to help work on joints for mobility.

Occupational physical activity so patients can do their jobs.

Conclusion

There is a long way to go for this type of therapy to work. Question such as payment for therapy by insurance companies and exercise facilities that would allow therapists and patient to work together on exercise equipment would need to be answered.  Also, would patients need to be in therapy long term or short term with the hope that this type of therapy would eventually pave the way to self-monitoring? Cost is most certainly a factor. Clearly, fiscal exercise therapy would be helpful for the control of glucose levels in patients with type 2 diabetes.

When more information becomes public regarding physical exercise therapy it will be posted on this website. Stay tuned!

References:

Balducci, Stefano, et al, (2014) Physical exercise as therapy for type 2 diabetes mellitus: Exercise as Therapy for Type 2 Diabetes, Diabetes/Metabolism Research and Reviews, 30 (S1) Retrieved from http://el2ne5ae7f.search.serialssolutions.com/?ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Physical+exercise+as+therapy+for+type+2+diabetes+mellitus&rft.jtitle=Diabetes%2FMetabolism+Research+and+Reviews&rft.au=Balducci%2C+Stefano&rft.au=Sacchetti%2C+Massimo&rft.au=Haxhi%2C+Jonida&rft.au=Orlando%2C+Giorgio&rft.date=2014-03-01&rft.issn=1520-7552&rft.eissn=1520-7560&rft.volume=30&rft.issue=S1&rft.spage=13&rft.epage=23&rft_id=info:doi/10.1002%2Fdmrr.2514&rft.externalDBID=n%2Fa&rft.externalDocID=10_1002_dmrr_2514&paramdict=en-US

Bloomgarden, Z. & Li. X (2015) Healping People with Diabetes to Exercise. Journal of Diabetes, 7(2), 150-152. Retrieved from http://web.a.ebscohost.com.contentproxy.phoenix.edu/ehost/detail/detail?sid=070092e7-a9ab-4df6-af89-556d961dac63%40sessionmgr4006&vid=0&hid=4214&bdata=JnNpdGU9ZWhvc3QtbGl2ZQ%3d%3d#AN=100696491&db=a9h

Lumb, A. (2014). Diabetes and exercise. Clinical Medicine, 14(6), 673-676. Retrieved from https://search.proquest.com/docview/1635285524?accountid=458

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