Diabetes, Nutrition and Exercise

By Nancy McCarron, PTA –

This month is Diabetes Awareness Month. Are you aware of:

• What the disease is
• The symptoms of undiagnosed diabetes
• The secondary effects of diabetes, especially when left uncontrolled
• How physical therapy can help you control diabetes and its secondary effects
• The costs of diabetes treatment to our society
• How the Affordable Care Act addresses health care for diabetics

DIABETES, AN OVERVIEW
Diabetes is a group of diseases in which blood sugar (glucose), produced during digestion of food as fuel for the body, is unable to be used or stored efficiently by the cells. This is caused by the failure of the pancreas to make insulin or failure of the cells to respond to insulin in order to take the glucose out of the blood and either use it or store it. The major types of diabetes are type 1, also called juvenile or insulin-dependent diabetes; type 2, also called adult onset diabetes, and gestational diabetes which occurs during pregnancy.

SYMPTOMS OF UNDIAGNOSED DIABETES
The symptoms used in diagnosing diabetes are: excessive thirst; frequent urination, extreme hunger or constant eating; unexplained weight loss; presence of glucose in the urine; tiredness or fatigue; changes in vision; numbness or tingling in the extremities (hands and feet); wounds which are slow to heal; and an unusually high occurrence of infection.

SECONDARY EFFECTS OF DIABETES
Diabetes is a complicated disease which can have dramatic effects on the human body. Complications and secondary illnesses related to diabetes include:

• Heart disease and stroke—the risk for stroke is 2 to 4 times higher among people with diabetes
• High blood pressure
• Blindness
• Kidney disease—diabetes is the leading cause of kidney failure
• Neuropathy (nervous system damage)
• Amputation—more than 60% of the non-traumatic lower-limb amputations occur in diabetic patients

PHYSICAL THERAPY AND DIABETES
Diabetic nerve damage, neuropathy, makes the feet and hands numb in varying stages from pain to total inability to feel light touch. When this happens to feet, balance is significantly affected because our brain relies on nerve receptors to tell it where the body is and where it is going. Skilled therapists can teach balance strategies and strengthen muscles to aid in control of the feet and legs when neuropathy is present

In type 2 diabetes, the inability of cells to uptake the extra glucose in the bloodstream is affected by the amount of fatty tissue (adipose tissue) in the body. Exercise can reduce adipose tissue and, research shows, make the cells more receptive to the uptake of glucose for its efficient use by the body. For someone who is deconditioned and inactive, starting to exercise can be challenging. A physical therapist can start with a safe level of exercise, monitor your response and, eventually, have you be independent with your own program or guide a personal trainer in helping you expand your exercise program.

A live-in study at the Weimar Center of Health & Education (CA) documents a program of diet and exercise can reverse type 2 symptoms by nearly 80% in just three weeks.

Although physical therapists are not dieticians, we do have a great deal of knowledge about diet and nutrition and how to make healthy eating choices to help you control diabetes and to exercise safely.

And, when amputation becomes necessary because of uncontrolled wounds and poor healing, physical therapists are the ones who get you “back on your feet.”

THE AFFORDABLE CARE ACT
Medicare is now required to reimburse for diabetes screening; the hope is that finding and treating pre-diabetes through nutrition and lifestyle changes will reduce the cost of care. And the reduction in the burden of the “donut hole” in Medicare Part D will result in lower drug costs for diabetics.

Also, there are programs initiated for prevention of diabetes:

• The Prevention and Public Health Fund which invests in wellness programs
• Incentives for Prevention of Chronic Diseases in Medicaid
• Healthy Aging, Living Well Grants which is for community wide, public health interventions (funding in 2014)
• National Diabetes Prevention Program for community-based education and care

WHY ALL THESE PROGRAMS ARE IN THE ACT
In 2007, one of every five health care dollars was spent on caring for patients with diabetes — expenditures that are 2.3 times higher than patients of any other chronic disease. This comes to a total of $116 billion in treatment costs and $58 billion in lost productivity. In 2002, these costs were $91.8 billion in treatment costs and $24.6 billion in lost productivity. If these trends continue, in 2020, 52% of American adults will have diabetes or pre-diabetes and the trend is, also, growing alarmingly in youth.

All for a disease (type 2) that can be treated, and sometimes prevented, with nutrition and exercise.

Nancy McCarron
Physical Therapist Assistant
Nancy has been with Progressive Physical Therapy since 2007 and plans to stay for many more years as she is dedicated to the caring attitude, the chance to interact with patients on a one to one level and the team approach of the clinic. An avid member of the “Gator Nation”, Nancy started her college studies at the University of FL, graduated with a BS in Business Management from Johnson State College in Johnson, VT, and Associate of Science degree as a Physical Therapist Assistant from Broward College. Nancy is also a certified personal trainer and a Reiki practitioner.

In a mentoring role, Nancy is a clinical instructor for physical therapist assistant programs guiding students in the transition from “school world to real world” through clinical internships. She is a member of the Advisory Committee for the Broward College Physical Therapist Assistant Program which gives her a chance to help update the program so that it may hold its reputation as one of the best in the state.

When Nancy is not at work, you will find her out sailing with Michael, trying to grow orchids, and doing beadwork.

Progressive Health and Racquet Club
941-423-5668
www.progressivehealthplex.com