According to the American Diabetes Association, n early 21 million children and adults in the U.S. have diabetes and 41 million more have pre-diabetes. Every November, the association encourages the public to learn more about diabetes.
Rhonda Barr, clinical specialist in physical therapy and coordinator of the REACH program at University of Iowa Hospitals and Clinics, answers these questions:
You help people who have several different conditions related to diabetes - can you tell us about those?
Type 2 diabetes, prediabetes, and insulin resistance syndrome.
Exercise and physical activity are beneficial to patients with insulin resistance, a condition associated with sedentary lifestyle and weight gain.
Basically, the body's tissues become resistant to the function of insulin, a hormone that regulates metabolism of sugar and fat. Insulin resistance may be a precursor to pre-diabetes and diabetes.
Pre-diabetes is defined as having a fasting plasma glucose of 100-125 mg/dL (normal is under 100 mg/dL). Type 2 diabetes is when the fasting glucose is 126 mg/dL or greater.
All of these conditions are treated with intensive lifestyle interventions to reduce weight, increase lean muscle mass and increase physical activity.
How does exercise help each of these conditions?
Exercise conditioning helps the body use insulin better to burn glucose and fat. Muscle is the only tissue in the body that we have control over, whether we rest or whether we use them to do work. The more muscle that is worked, the better it uses insulin (less insulin resistant). Exercising also helps burn extra calories to control weight gain.
Do people have to go to the gym to exercise?
It is not necessary to go to a gym to get enough exercise. Most people walk for exercise, and the primary form of exercise in the Diabetes Prevention Program, a large study that identified how important lifestyle intervention is for preventing type 2 diabetes. All that is needed for a walking program is a good pair of shoes and a safe place to walk.
Other forms of conditioning and physical activity can also be used, however, even house or yard work, sporting or recreational activities that are at least moderate in effort and last at least 30 minutes. )
What types of exercise do you usually recommend for your patients?
I usually start with a conditioning program, using walking, biking, swimming or other activity that uses a large number of muscles. The effort should be moderate, or like the effort needed for brisk walking. I recommend 30 minutes a day for at least five days per week, but this does not need to be done all at once. Some people can only fit in 10 minutes at a time, several times per day, and this has been shown to be just as beneficial in preventing diabetes. I also recommend doing some form of resistance training, using low weights and high repetitions. This can be done with weight machines, light free weights, resistance bands or calisthenics where the body weight is the resistance. Stretching is very helpful to prevent muscle tightness and improve joint function.)
If someone is having a difficult time getting into the habit of exercising, what can they do?
I usually try to find out what is preventing someone from exercising more. Many find it difficult to set aside time to exercise in a busy day. Sometimes people are bored with exercise, or just don't know how to start an exercise program. However as a physical therapist, I work with people that also have other reasons that makes exercise difficult for them: joint pain, back pain, fatigue or deconditioning. I do an evaluation to make sure the exercises they are doing will improve their condition, or at least not harm them. It is important to find ways to enjoy moving while improving health and function. |
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