Diabetes - Sit and Be Fit

Diabetes is a serious disorder that affects approximately 17 million people in the US. It is the 5th deadliest disease in the country, contributing to over 200,000 deaths each year. Diabetes stems from a failure to produce or to properly use the hormone insulin. Insulin enables glucose, the basic sugar derived from carbohydrate foods, to move from the blood into the muscle cells. The muscle cells use glucose for energy. When glucose cannot enter the muscle cells, blood sugar levels increase. It is these increased levels that cause severe complications of diabetes.

There are two separate and distinct diabetes diseases: insulin dependent diabetes mellitus (IDDM), and non-insulin dependent diabetes mellitus (NIDDM). See the table below for a comparison of the two types.

INSULIN-DEPENDENT DIABETES MELLITUS (IDDM)	NON-INSULIN DEPENDENT (NIDDM)
Known as Type I or juvenile onset diabetes	Known as Type II or adult onset diabetes
10-15% of diabetes cases	85-90% of diabetes cases
Sudden onset, usually beginning in childhood	Gradual onset, usually diagnosed after age 45
Specialized beta cells in the pancreas fail to produce insulin. The body appears to attack its own beta cells.	Disease is due either to decreased sensitivity of muscle cells to insulin, or defective insulin secretion from pancreas. Heredity & obesity are important factors in its development.
Treatment aim: normalize blood sugar levels.	Treatment aim: normalize blood sugar levels.
Insulin by injection is required to control blood sugar levels. Careful monitoring and proper dosing of insulin is essential.	Diet, exercise, and weight control may adequately control blood sugar levels. If drugs are required, oral medications that enhance the release of insulin from the pancreas or increase sensitivity of muscle cells to insulin are generally used. Sometimes insulin may be necessary to achieve adequate blood sugar control.
Exercise aimed at improving health of the heart and circulatory system and decreasing disease complications. Blood sugar levels should be fairly well controlled for aerobic exercise to be safe.	Controlling diabetes with exercise should focus on controlling blood sugar levels; reducing body weight; and helping to decrease medication requirements. This is best accomplished by exercising daily with a low to moderate intensity and long duration. Improved cardiovascular health and reduction of disease complications are added benefits of exercise.

Risk Factors

Elevated blood sugar levels damage the blood vessels throughout the body and are responsible for the severe complications associated with diabetes. It is estimated that 60-70% of diabetics develop one or more complications. Major complications include:

• Heart disease • High blood pressure • Stroke • Kidney disease

• Poor circulation which hinders healing and may necessitate amputation

• Blindness due to damage to the small vessels in the back of the eye

• Nerve damage, especially to the nerves in the feet, hands, and legs

Results of living with Diabetes

The interactions between exercise, carbohydrate intake, blood sugar levels, and insulin regulation are complex. Therefore, if you have diabetes, it is important to work closely with your medical team (physician, diabetic educator, dietician, exercise specialist) to establish a treatment plan that accounts for your specific medication, exercise, and dietary needs. A team approach will help you learn more about your disease and determine what you need to do personally to minimize complications. Be sure to ask your health care provider about controlling diabetes with exercise.

Exercise and Diabetes

Physical inactivity is common among persons with diabetes. An estimated 70% of diabetics are sedentary. The more physically active a person is, the less likely he or she will experience problems with diabetes. Gentle exercise may help regulate glucose levels.

Here are some ways Diabetes is controlled with exercise:

improves the general overall quality of life
improves blood sugar control
improves sensitivity of muscles to insulin
reduces complications of the disease
reduces risk factors and may prevent NIDDM
improve posture
increase joint flexibility & range of motion
increase circulation
improve balance
improve breathing
increase muscle strength
reduce stress & increase relaxation

Diabetes Exercise Precautions

Avoid exercises that involve heavy resistance or holding the breath.
Avoid high intensity activity. Low to moderate exercise intensities are appropriate.
Avoid extreme temperatures. Provide adequate ventilation in the exercise room.
Protect the feet from injury with supportive, well-fitting shoes and socks.