Diabetes mellitus (DM) is a condition that makes it hard for the body to control the level of glucose in the blood. Glucose is the main form of sugar that the body uses for fuel. Insulin, made by the pancreas, is a hormone that helps the body control the level of glucose in the blood.
The two most common types of diabetes mellitus are called type 1 and type 2.
Type 1 diabetes is a disorder in which the body's immune system attacks the insulin-producing cells of the pancreas, resulting in an insulin deficiency and abnormally high levels of blood glucose. A person with this condition usually has symptoms beginning in childhood or adolescence. It is estimated that 5-10% of Americans who are diagnosed with diabetes have type 1 diabetes.
Type 2, on the other hand, usually appears in overweight or obese adults. This results from insulin resistance (a condition in which the body fails to properly use insulin), combined with relative insulin deficiency. Most Americans who are diagnosed with diabetes have Type 2 diabetes.
Almost all people who develop type 2 diabetes have a condition called prediabetes first. This condition used to be known as "impaired glucose tolerance" or "impaired fasting glucose." The American Diabetes Association (ADA) estimates there are 41 million Americans who have pre-diabetes, in addition to the 20.8 million with diabetes. Pre-diabetes occurs when blood glucose levels are higher than healthy levels but too low to be called diabetes.
Gestational diabetes affects about 4% of all pregnant women - about 135,000 cases in the United States each year.
Benefits of exercise
Persons with either type of diabetes benefit from exercise. However, the most dramatic benefits occur in people with type 2 diabetes or pre-diabetes. Without lifestyle changes, most people who have prediabetes will progress to type 2 diabetes within 10 years. But by eating a healthy diet and exercising regularly so as to maintain a healthy body weight, many times type 2 diabetes can be prevented.
Exercise is a vital part of diabetes treatment. It can lower the level of glucose in the blood and may also: help the body make better use of its food supplyallow the body cells to better use insulin and glucoseaid a person in losing excess weightimprove blood circulation throughout the bodyincrease the heart's ability to pump bloodlower high blood pressurehelp a person feel better physically and mentally
A recent study showed that walking briskly for only 30 minutes a day at least 5 days a week greatly reduces the risk of type 2 diabetes.
Evaluation before starting an exercise program
It is important for a person who has diabetes to visit the doctor before starting an exercise program. The doctor can help design an exercise program that is right for the person. He or she will take many factors into account, including the person's: need for activityphysical abilities and limitsblood glucose controlmedicine routinecoronary risk factors, including smoking,obesity, and high blood pressure
The ADA states that a graded exercise test may help if a person is at high risk for heart disease. He or she can build up to a moderate- to high-intensity exercise program. Those at high risk include people who: are 35 years of age or olderhave had type 2 diabetes more than 10 yearshave had type 1 diabetes more than 15 yearshave other coronary risk factors, including high blood pressurehave significant diabetic nephropathy, or kidney damage from diabeteshave significant retinopathy, or retinal damage in the eyehave peripheral vascular disease, or impaired circulation in the legs and armshave autonomic neuropathy, or damage to the part of the nervous system that controls blood pressure
Guidelines for exercise
The ADA stresses the importance of regulating the body's glucose levels in response to exercise. It has issued these exercise guidelines for people who have diabetes: Monitor blood glucose levels before and after exercise. Each person should talk with the doctor about what his or her healthy range is. Find out if there is ever any time that exercise should be avoided because of the blood glucose level.Include warm-up and cooldown periods in the exercise program. The warm-up should include 5 to 10 minutes of aerobic activity such as low-intensity walking. Follow this with 5 to 10 minutes of gentle muscle stretching. The cooldown after exercise should last about 5 to 10 minutes. It should slowly bring the pulse down to the level it was before exercise.
Because people who have diabetes often also have poor circulation in their feet, good shoes are important. The ADA recommends the use of silica gel or air midsoles in athletic shoes. Polyester or polyester and cotton socks help prevent blisters and keep the feet dry.
People who have diabetes should tell those exercising with them that they have diabetes. They should also tell them what to do if they become weak. A bracelet or shoe tag showing the person's diabetes should be clearly visible. People who exercise alone should tell others where they are going and when they will be back.
Mayo Clinic Family Health Book, David E. Larson, 1996.