National Diabetes Week 12-18 JUNE 2016

FACTS ABOUT DIABETES

Diabetes is a common medical condition which affects 370 million people worldwide. In the UK, 3 million people have been diagnosed with diabetes and a further 850,000 people are believed to have the condition but are as yet undiagnosed. In Ireland, we have an approximate figure of 225,000 people having the condition.

One person every day has a lower limb amputation due to diabetes, and one person every week goes blind due to diabetes in Ireland.

There are two types of Diabetes, Type 1 and Type 2. Type 1 is an autoimmune condition where the body can no longer produce insulin. Stem cell research in the USA is predicting that by genetical engineering of pig pancreatic cells, it may be possible to implant in people with Type 1 diabetes, so they are able to produce insulin again. Over 1000 successful surgeries have already been performed by Harvard Medical School professor, Gordon Weir, using human donor cadavers, but these are in short supply. Nano-technology advances also improve the likelihood of effective implantation of cells.

Type 2 diabetes is an insufficiency of insulin production and is much more common than Type 1, accounting for 90% of people with diabetes worldwide. The body uses insulin ineffectively and high blood glucose, high blood pressure and high cholesterol and triglycerides.

Too much glucose from the liver is released when blood sugar levels are low. The liver sends out glucose and should cease output when blood sugar levels increase, as after eating. Some people’s livers do not slow down, and keep producing sugar.

Being overweight and not getting enough exercise, all contribute to diabetes onset.

EXERCISE

Exercise is beneficial in many ways in Type 2 Diabetes management. Exercise helps to lower your blood sugar level and makes the treatment you are receiving for the condition, more effective. Exercise also helps you to lose weight. Exercise is important in improving joint mobility and will help to strengthen your muscles. Blood pressure is lowered and this will assist in keeping cholesterol levels low which helps heart health.

Excess weight is often a problem as many report low self-esteem, so losing weight and getting into better shape will increase your self-confidence and help you to feel good about yourself.

Talk to your Chartered Physiotherapist to discuss your choice, intensity and frequency of exercise, as some sports may be more suitable to your specific condition than others.

Before Exercise

If your diabetes is well controlled, you may be able to engage in regular activities, like people without diabetes, but be cautious as strenuous activity can lower your blood glucose too excessively.

It is good to be monitored so that your body’s responses to different activities can inform you of the level and intensity of exercise suitable for you and your condition.

After Exercise

Test your blood sugar after exercise. If levels are low, eat carbohydrates. Hypoglycaemia can develop hours after a hard or strenuous exercise session if you are taking some forms of diabetes medication. As a precaution, if you have exercised late in the day, you will need to be vigilant about possible hypoglycaemia during the night.

Eating a substantial carbohydrate snack at bedtime after such exercise, and loading of carbohydrate rich food such as pasta the following day, will help to offset possible hypoglycaemic reaction.

How much exercise do I need?

Aim for a minimum of 30 MINUTES moderate intensity exercise on at least 5 days a week.

Exercise can be performed in a chair if you are unused to walking or find you are too exhausted with minimal exercise.

Chair Exercises:

(a). Sitting on a chair, stand up; straighten up to your full height. Sit down again. Use your arms to push on the arms or seat of the chair if you feel unable to do this unaided initially. You will eventually be able to sit and stand unsupported. Repeat up to 5 repetitions, rest and then repeat. You can gradually increase the number of repetitions until able to do 30 repetitions without any rest in between!

REMEMBER: Exercise at your own comfortable pace and take regular rests of 30-60 seconds between sets initially.

(b). Stand behind a chair, rest hands on chair back for support. Keep shoulders back, head up and symmetrical. Feet shoulder distance apart, slowly raise leg out to side and return to floor. Repeat each side x 5. Rest and repeat set again.

(c). Holding back of the chair, slowly squat down, bending both knees. Use your legs to push back up to standing. Keep feet apart and firm to the floor. Repeat x 5. Rest and repeat.

PROGRESS to FREE EXERCISES, unsupported as you become more confident

(d). Marching on the spot briskly can be done at any time, when waiting for the kettle to boil or when queuing for the bathroom! Raise your knee up in front as high as your hip if possible and if you can keep safe balance. Gradually increase to x 20 repetitions, with rests. Over time you will be able to increase the number of knee raises until you reach x 40 without rests.

(e). Wall Exercises: Stand facing the wall, feet apart, place your hands on the wall shoulder distance apart. Lean in towards the wall, bending the elbows. Push against the wall, pushing back to an upright standing posture. Repeat the exercise, building up the numbers to achieve 5 repetitions without need for a rest. Aim for x 20 repetitions in succession, as your arm strengthens.

Chair Exercises with WEIGHTS

(f). A good exercise to strengthen your upper arm and shoulder muscles is to raise each arm alternately, while holding a light weight. You may not be able to lift much more than 2-3 lbs. weight initially, or 1- 1.5 kgs. Raise each arm overhead, holding the weight in each hand. Raise slowly. Gradually build up to x 5 repetitions each arm. Gradually increase the number of repetitions until able to lift x 20 each arm without needing to rest.

GOAL SETTING

It may help to keep a diary of your daily activity each day and aim to be as active on 5 days a week at least for 30 minutes minimum.

Exercise can be carried out in bursts of 5-10 minutes initially, aiming for a minimum total of 30 minutes on 5 days. This equates to 150 minutes a week of more activity than previously, so think of the health benefits. Contact your Chartered Physiotherapist to help you stay motivated.

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