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Diabetes and Exercise – Why the Connection is Vitally Important
About twenty-one million people in the United States are living with diabetes and about 6.2 million of these people do not know they have diabetes because it is undiagnosed. People with diabetes, on average, have medical expenses that are 2.3 times higher than non-diabetics, according to the American Diabetes Association. Another study in the Population Health Administration estimates that diabetes costs our country $218 billion dollars in health care each year. However, most cases of diabetes can be prevented or reversed through exercise, weight loss and a healthy lifestyle.
I am surprised. What if the 6.2 million undiagnosed people knew they had diabetes? The nearly 57 million Americans with pre-diabetes were taught how they can improve their health and avoid Type 2 diabetes?
Being diagnosed as Pre-Diabetic does not mean Type 2 diabetes is inevitable. If you lose weight and increase your physical activity, you can prevent or delay diabetes and return blood sugar levels to normal (ACSM 2006). (See sidebar for defined diabetes terms)
This is a very important topic that most people don’t understand – if you exercise and lose weight you can prevent or delay diabetes.
Do you know the symptoms of diabetes? Look around you. Are you seeing any signs of diabetes in your friends and family right now? (See sidebar for common signs of diabetes) You have people with diabetes (or diabetes) every day. The Centers for Disease Control and Prevention estimates that one in three Americans will die in their lifetime. Those statistics are surprising and AWESOME for many.
What types of diabetes are diagnosed? What if we learn that through diet and exercise they can reduce their medication or even eliminate it? What will this do for our health problem? I know we have to break a lot of myths, magic solutions, and superstitions. The pharmaceutical companies will not be happy if I give this secret away. But, why, our health system is in trouble! Our Nation is dying! There, I said. So, let’s get down to work and take some responsibility for our health.
Many of you who are trying to understand diabetes and take responsibility for your health have many questions:
o Should you cut out sugar?
o Are you worried about your weight?
o If you’re a nurse, you don’t have to worry, right?
o Can exercise and diet really help YOU?
o How do I control my blood sugar levels?
So here are the reasons you may not know how to ask about:
o Having diabetes for more than five years increases your risk of heart disease
o Exercising regularly increases your insulin sensitivity and lowers medication dosages
First, let’s talk about insulin, the main drug that keeps diabetics working and then you will clearly see the answers to your questions.
How does insulin work? Insulin is the main hormone that controls the entry of blood sugar from the bloodstream into the body’s cells to be used as energy. How does exercise affect the hormone insulin? Exercise is like insulin. When you exercise, blood sugar needs to flow to your muscles to keep them contracting and moving. Exercise increases the rate at which muscles remove sugar from your bloodstream; so exercise works like insulin by sending more sugar in your bloodstream into your muscles. By doing this, it lowers your blood sugar. Walking twenty minutes a day can lower blood sugar levels by twenty points.
Here is a good example to explain how insulin works in your body. Think of insulin as a short-term bus. Glucose (sugar) is the passenger. There are two types of diabetes. People with Type 1 diabetes who do not have insulin (or no insulin), according to the Center for Disease Control, account for 5% – 10% of all diagnosed cases. The second type (Type 2), insulin resistance, means that the bus is there, but it does not pick up passengers and there are few buses running on the road. According to the Center for Disease Control, Type 2 diabetes accounts for 90%-95% of all diagnosed cases.
When you exercise, your muscles work harder than usual and require more fuel than before; so the veins send their own buses to pick up the sugar in the blood and return it to the veins. Muscles that work take insulin and (for Type 2 diabetics) they can show the buses (insulin) how to do it again (pick up passengers).
Exercise has many benefits for people with diabetes. It increases cell penetration, improves insulin sensitivity by improving glucose metabolism and reducing the risk of heart disease. Lowering blood sugar levels improves insulin sensitivity by making it more effective. Exercise reduces dosage requirements and the need for medication and improves the ability to lose and maintain body weight if combined with a healthy diet. (See sidebar for Safety Training Checklist)
There are many popular myths about diabetes. Here are some of the times I hear it.
Myth #1 – Diabetics can’t eat sugar or sweets, the only reason they have diabetes is because of the amount of sugar they eat. Yes, simple carbohydrates and sweets can raise blood sugar levels but if you eat them and include them in your meal plan, you can indulge in sweets once in a while.
Myth #2 – If I’m skinny I’m fine. Diabetes is a disease that affects obese people.
It’s not really true, 20% of people with Type 2 diabetes are mild. Yes, obesity puts you at risk for Type 2 diabetes, high blood pressure and high cholesterol. The important thing to remember is that there is no “diabetic” body type, genetics, race, age or gender. Type 2 diabetes is caused by lifestyle choices and diabetes is a disease of great concern.
Myth #3 – There is no cure for diabetes. If I take insulin or hormone sensitivity drugs I can continue with my lifestyle and be fine. Well, there is a natural remedy, called exercise and a balanced diet. You can prevent diabetes by monitoring your sugar levels, combining exercise with a balanced diet, or using medication.
Myth #4 – Yes, I am borderline normal and a 170 mg/dl blood sugar reading is normal for me. You may have heard of diabetes but high blood sugar levels are not safe. There is no such thing as a border. You are either diabetic or you are not diabetic. This is a serious disease that you want to take with your body. There are many health problems associated with diabetes, especially when you stress your body with high blood sugar levels. You need to start making lifestyle changes so that you can live a quality life for a long time.
Sign #5 – Lightning! What does that do for me? Blah! Blah! Health Care Blah! Yes, Yes, I know. The American Diabetic Association recommends 150 minutes of physical activity per week. This is done for 20-60 minutes, in continuous stages, 3-5 times a week. The Diabetes Prevention Study found that exercising for two hours a week can reduce the risk of diabetes by 50%, or as little as 20 minutes, 6 days a week. A short, ten-minute walk before and after exercise can help prevent diabetes or lower your blood sugar levels.
In fact, more than 90% of diabetes cases are preventable and can be maintained with some natural remedies such as exercise, a healthy diet, or combined with low doses of medication and will not affect our health care system to the tune of $218 billion. Start slowly and exercise a little each day until you reach the recommended guidelines. Eat a balanced, healthy diet and lose weight all or nothing. Know your disease, decide what your beliefs about diabetes are and change the way you live from today. (See the sidebar if you want to learn more)
Diabetes is stressful but you can do it!
o Type 1 = Autoimmune disease that destroys insulin-producing cells in the pancreas. The body cannot make its own insulin because the beta cells of the pancreas that are responsible for insulin production have been lost. Approximately 5-10% of all diagnosed cases (CDC 2005)
o Type 2 = the body loses its sensitivity to insulin so the body’s cells cannot use insulin properly (known as insulin resistance or mature diabetes). Approximately 90% – 95% of all cases are diagnosed (CDC 2005).
pre-diabetes = If you have a blood glucose (FPG) test and your levels are between 100 mg/dl and 125 mg/dl you are likely to be showing signs of diabetes if you are not change the lifestyle.
o Gestational diabetes = When pregnancy hormones interfere with the mother’s insulin, sugar levels rise. This is a form of insulin resistance that usually goes away after the child is born.
o Metabolic Syndrome = A group of health conditions that increase the risk factors of developing heart disease, obesity, hypertension, low high-density lipoprotein (HDL), high cholesterol levels and triglyceride levels high plasma.
o Hypoglycemic = low blood sugar caused by excess insulin or your diet. Symptoms include: tremors or tremors, nervousness, rapid heartbeat, excessive sweating, headache, poor concentration or attention, unconsciousness and coma.
o Hyperglycemic = high blood sugar. Symptoms include: frequent urination, excessive thirst, nausea, abdominal pain, dry skin, confusion, shortness of breath, and drowsiness.
Do you know the symptoms of diabetes? Some very clear signs are:
of thirst, hunger and urination
of weight loss
of the noise
of frequent illnesses
of confused vision
Cuts/bruises are slow to heal
of the lungs and disease of the hands and feet
of skin disease, gum disease and cancer
Safety Work Checklist
o Get a doctor’s approval before starting an exercise program
o Test your blood sugar levels before exercise, immediately after exercise, and two hours after exercise
o Follow general guidelines for a safety training session; warm up, cool down, stretch, stick to Type 1 (3 to 5 RPE) and Type 2 (3 to 6/7 RPE) intensity, drink plenty of water
o Wear comfortable, well-fitting, supportive shoes
o Wear polyester or polyester cotton socks to keep your feet dry and reduce foot pain
o Avoid strenuous, high-intensity or static activities unless approved by your doctor
o Carry a carbohydrate snack with you 10-15 grams of carbohydrates
o Wear a symbol that tells others you have diabetes if you have a hypoglycemic reaction http://www.n-styleid.com
o Recognize and monitor for signs of hypoglycemia
o Do not exercise with a blood glucose level of 250 mg/dl, if you have ketones in your urine
o If you have idiopathic neuropathy, peripheral neuropathy, neuropathy, retinopathy or other diabetes-related conditions, you must get a doctor’s approval before starting an exercise program. These methods require specific and rigorous guidelines.
o Exercise with a partner to learn how you respond to exercise
o Always check your feet before and after work for injuries
o Drink plenty of water. A good rule of thumb is to take a mouthful or two at least every fifteen minutes
Do you want to learn more? Additional Materials:
of Living Free! CD and System Workbook http://www.livingfreediabetes.com
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