EXERCISE
AND DIABETES
Written
by: Govinda
Allin, student, University of Florida
With
the rising advances in science and technology,
health has become a widely popular public
interest. Tools like the internet provide
many opportunities to obtain educational
information related to health. People
are exploring new ways to stay healthy
and everyone has his or her own health
philosophy.
As information
becomes more accessible, the general
concept of health is slowly changing
into an all encompassing definition.
According to Charles Corbin and Robert
Pangrazi “Wellness is a multidimensional
state of being describing the existence
of positive health in an individual
as exemplified by quality of life and
a sense of well-being” (1,
p7). Many people define health
as having two parts: physical and mental.
Slowly, through health education, the
definition of health is changing and
is now encompassing multiple dimensions
including these six: environmental,
mental, emotional, spiritual, social,
and physical.
Daily exercise
has been proven to raise self-esteem,
create positive social attitudes, increase
neuromuscular coordination and physical
fitness, and increase cognitive abilities
(3). Exercise
has been shown to reduce muscle loss
from aging, improve bone density, decrease
migraine headaches, and improve sleep
(2). Exercise
is the answer and supports all of these
six dimensions of health.
Diabetes
Mellitus is a condition in which
the pancreas does not produce enough
insulin, or the body does not properly
respond to insulin
(4). Our bodies have the ability
to break down the foods we ingest and
can convert it to energy. Different
complex processes and hormones are used
to break down, move, and store food
for energy use. One of the key hormones
used to break down starches into energy
and facilitate storage is insulin (4).
Insulin is a transport hormone that
moves glucose from the blood into cells.
There are
three different types of diabetes. With
type
1 diabetes, the pancreas does not
produce insulin (4).
Type 1 diabetes is usually identified
in children and young adults, affecting
only about 5-10% of people with diabetes
(4). The
disease was previously known as juvenile
onset diabetes; however, recently, the
name has been changed due to the fact
that children are now also being diagnosed
with type 2 diabetes.
Type
2 diabetes is much more common and
is caused from insufficient insulin
production or existing insulin being
ignored by cells. Insulin transports
glucose from the blood into the cells,
and if insulin is not recognized by
cells the blood sugar levels will rise.
If the blood glucose levels are not
lowered, then devastating diabetic complications
can emerge. Lastly, during around the
28th week of pregnancy women can be
diagnosed with a third type of diabetes
referred to as gestational
diabetes. Women with gestational
diabetes must watch their diet to remain
healthy so they do not contract type
2 after the pregnancy or harm the health
of the baby (4).
Some symptoms
of diabetes include frequent urination,
excessive thirst, unexplained weight
loss, extreme hunger, sudden vision
changes, tiredness, very dry skin, slow
healing sores, and more infections than
usual (5).
These symptoms can be explained through
different complications occurring in
the body due to the high levels of sugar
in the blood. People with diabetes can
develop atherosclerosis,
and eventually, full blown heart disease
from the damage of sugar build up in
blood vessels (3).
People can develop retinopathy,
neuropathy,
nephropathy,
hypoglycemia,
and ketoacidosis
from diabetes mellitus (3).
Diabetic
retinopathy
refers to the damage of the retina due
to high levels of glucose, leading to
vision changes or blindness (3).
Diabetic neuropathy is associated with
injury to small blood vessels that would
otherwise supply blood to nerves. If
the nerves’ blood supply is diminished,
the nerve cannot function optimally
(3). Diabetic
nephropathy is a progressive disease
caused by angiopathy
of capillaries and the destruction of
glomeruli
in the kidney (3).
Diabetic
hypoglycemia
is caused when a person with diabetes
takes medication to lower their own
blood sugar levels. In the process they
may not take the correct amount of medicine,
or the medication does not match their
body’s needs, or they are not
eating a proper diet and glucose levels
can fall far below the normal level
(6). People
with Diabetes can obviously also have
hyperglycemia
which is blood sugar levels that are
higher than normal (4).
Diabetic
ketoacidosis
results from a critical shortage of
insulin in the body. The body, instead
of using glucose as energy, starts burning
fatty acids and produces acidic ketones
that enter the blood stream causing
a chemical imbalance which can eventually
lead to death (6).
There is a close link between gum disease,
or periodontitis,
and diabetes. People with diabetes have
to take extra care of their oral health,
otherwise gum disease will develop in
their mouth, and their teeth will be
destroyed (4).
People with
diabetes can become subject to anger,
stress, or depression. It is important
for a person with diabetes to surround
him/herself with people that will support
him/her and give emotional and mental
encouragement.
The exact
mechanisms and causes for diabetes mellitus
are unknown. Both type 1 and type 2
are partly inherited because people
that have relatives with diabetes mellitus
have a much higher risk of developing
the disease and should take the necessary
preventable measures. “The appearance
of type 1 diabetes is suspected to follow
exposure to an environmental trigger,
such as an unidentified virus, stimulating
an immune attack against the beta cells
of the pancreas (that produce insulin)
in some genetically predisposed people”
(5). Clinical
characteristics such as obesity and
lack of physical activity are regarded
as the most important risk factors,
both independently associated with diabetes
and diabetes related co-morbidities”
(8).
Diabetes
screening is recommended for anyone
with any risk factors at different stages
of life. As discussed, many medical
conditions are associated with diabetes
and synergistic effects can occur between
the diabetes and the complication. Understandably,
people with diabetes must be routinely
monitored for complications and promote
and incorporate different preventable
actions in order to remain healthy.
Because diabetes
is a chronic disease, the medical field
emphasizes prevention and avoidance
of potential future diabetic complications.
Treatment for diabetes includes insulin
therapy, oral medications, medications
to reduce blood pressure, injectable
medications, and aspirin, which has
be proven to reduce the risk of heart
attacks (4).
Self-treatments include monitoring blood
sugar and ketone levels.
There are
many different types of glucose meters
from which patients can choose. Together,
the physician and the patient should
have a discussion about the different
types of measurement tools and select
the most appropriate tool that fits
the patient’s lifestyle. This
increases the chance that the patient
will regularly use the glucose meter
to monitor his/her diabetes on a daily
basis. As mentioned earlier, people
with diabetes have a significantly high
chance to contract periodontitis; therefore,
strict brushing and flossing must become
a daily activity (4).
In certain extreme cases, kidney replacement
therapy or pancreas transplants are
options; however, due to the complexity
of the procedures, results vary and
the results are not always a success
(4).
Exercise
has been proven to significantly increase
insulin sensitivity, enhancing the transport
of sugar into cells which would lower
the blood sugar levels in the body and
give a person with diabetes more energy.
“With continued moderate exercising
your muscles take up glucose at almost
20 times the normal rate. This lowers
blood sugar levels” (6
p1). “Research studies
have found that moderate weight loss
and exercise can prevent or delay type
2 diabetes among adults at high-risk
of diabetes” (5
p1). Exercise is arguably the
number one key component to preventing
and treating diabetes. Exercise improves
the body’s use of insulin, burns
excess body fat to gain weight control,
increases bone density, increases muscle
strength, lowers blood pressure, increases
HDL and lowers LDL preventing heart
disease, increases energy level, and
reduces stress and tension which promotes
relaxation.
Education is a key aspect for people
with diabetes. A person with diabetes
must have the desire to learn as much
as they can so they can always be prepared
for different situations and circumstances.
Whether a person has diabetes or not,
maintaining a proper diet is a tremendous
part of ensuring a healthy lifestyle.
There are many resources available with
thousands of ideas and food recipes
that are healthy and tasty for people
with diabetes. Gaining a strong support
group to help deal with stressors and
give encouragement is incredibly essential.
Children can play a very supportive
role and positively influence parents
who have diabetes (9).
Reports were given that children exercised
with the parents, shopped for healthy
foods, reminded parents what to eat,
reminded parents to take medications
and assisted with tasks such as taking
blood pressure or checking blood glucose
levels (9).
If a person with diabetes has friends
who have diabetes, they can together
become a team and prevent potential
complications by maintaining their health
and exercising. If diagnosed with the
disease it is vital to continue to set
goals and continue to have life aspirations
for the future. “If you want to
live a happy life, tie it to a goal,
not to people or things – Albert
Einstein” (7).
This will avoid depression and will
ensure the maintenance of a productive
lifestyle.
The ability to dream is crucial to
maintaining all six dimensions of health
and living a healthy life. “If
I do this…I can do anything.”
Perseverance is important for any person,
and no one should ever give up on his
dreams. Lastly, exercise is an amazing,
simple behavior that everyone should
incorporate into their daily living
to help facilitate the maintenance of
the six dimensions of health in order
to reach a state of peace and wellness.
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