What Is It?

It is estimated that over 29 million Americans (which is over 9% of the population) have diabetes. Many of those people (an estimated 8.1 million, over 27% of people with diabetes) do not know that they have it. One study found that nearly half of adults who live in the United States have either diabetes or pre-diabetes (which is elevated blood sugar with a risk to develop diabetes).

Diabetes is a condition with elevated levels of blood sugar. Persons with diabetes have a problem related to insulin, which keeps blood sugar at a normal level. There are two types of diabetes:

• Type 1 – In people whose bodies do not produce enough insulin
• Type 2 – In people whose bodies are resistant to insulin

Diabetes is often associated with obesity, poor diet and/or lack of exercise. Wounds can form on the feet that are hard to heal, and they may lead to amputations. Diabetes can also lead to blindness. Left untreated, diabetes leads to damage to blood vessels, eyes, kidneys and even death. Many people die each year due to complications associated with diabetes.

How We Treat It

The trained therapists at Salude will work with the patient, family and healthcare team to:

• Recommend safe and appropriate exercise
• Determine whether the person has cognitive and physical abilities to monitor blood sugar, manage insulin injections, and count carbohydrates and other factors related to diet
• Provide education about foot health and appropriate shoes
• Assess the need for treatment of wounds that will be harder to heal with diabetes
• Explain strategies to compensate for visual problems that often accompany diabetes (such as diabetic retinopathy, glaucoma, etc.)
• Develop a plan to deal with diabetic neuropathy (nerve damage that occurs due to diabetes, usually in the legs and feet, which causes pain and numbness and sometimes urinary tract infections and problems with the digestive system, blood vessels and heart)

What You Can Expect

Physical activity and exercise is very important for people who have diabetes. Diabetes can be prevented, delayed or put into remission with appropriate lifestyle changes including exercise, which can affect the actual disease of diabetes. The Aegis Physical Therapist (PT) at Salude can design a low-impact form of weight training with elastic exercise bands that can be used at home. This type of exercise program puts less stress on the joints.

Modified yoga stretches and tai chi movements can help reduce stress and promote flexibility and relaxation. The recommendation may be for exercise three days per week. Studies show that the effect on insulin sensitivity can last 24 to 72 hours after some aerobic exercise sessions (depending on the intensity and duration of the exercise). It has even been shown that increased physical activity and modest weight loss can reduce the likelihood of acquiring Type 2 diabetes.

The benefits of rehabilitation involvement for persons with diabetes include reduced falls, enhanced exercise, increased ability to manage medications, modified environment to accommodate for reduced vision, and overall improved education about the disease and potential complications. Even people with complications from diabetes can benefit from rehabilitation. Improved diet and exercise with a healthy lifestyle can go a long way towards improving health and quality of life in persons who have diabetes.