Exercise, Physical Therapy, And Other Resources To Fight And Prevent Diabetes

The Diabetes Control & Complications Trial (DCCT) was a famous research project (1993) funded by the National Institute of Diabetes.

The results revealed keeping blood sugar levels as close to normal as possible can drastically reduce or eliminate damage to eyes (retinopathy), kidneys (renal failure) and nerves (neuropathy) while also greatly reducing risk of a stroke or a heart attack.

A key component to successful management (or reversal) of diabetes mellitus is a balanced diet and exercise regimen. Aerobic exercise makes your body’s insulin work better, as does resistive strength training.

The Effects of Insulin

Insulin is a hormone the pancreas creates which normally keeps blood sugar levels from getting too high (hyperglycemia) or too low (hypoglycemia).

Similar to a key allowing a door to open, insulin allows glucose from the blood to enter muscle, fat, and liver tissues.

In type II diabetes, resistance occurs where the body has insulin available but is not able to use it effectively; tissue cells no longer respond well to insulin. This typically is related to obesity and inactivity. As a result, excessive amounts of glucose can build up in the blood creating conditions of prediabetes and type II diabetes.

Exercise Benefits

There are many benefits to exercise. Aerobic exercise by definition involves large muscle groups, it is rhythmical and is continuous in nature. Walking, dancing and biking are great examples.

Besides helping to control glucose levels, aerobic exercise improves circulation and weight control often improving cardiovascular fitness. With improved heart efficiency, individuals can do more with less energy.

Exercise also can be very social and a lot of fun! The American Diabetes Association recommends 30 minutes of aerobic exercise at least 5 days a week. Unfortunately, much of America is not active and inactivity-related obesity is on the rise.

Chronic Pain, Instability, and Inactivity

Chronic pain and instability often lead to inactivity. About 20% of the population has chronic pain and many become progressively more sedentary.

A doctor of physical therapy works closely with other health care professionals to manage and often reverse both chronic pain and diabetes. Physical therapy improves quality of life in many ways.

Through skilled evaluation & treatment, doctors of physical therapy help eliminate pain, reduce fear of movement and educate individuals on their condition and lifestyle issues. Often physical therapy reduces the need for medication and helps prevent diabetic complications.

It’s vital to think of exercise as a drug. Under the correct conditions it can be of significant value in optimizing health and managing diabetes. Under the wrong conditions it can do more harm than good.

Individuals with diabetes should not exercise on an empty stomach as this can lead to dangerously low blood sugar. On the other hand, if glucose levels are too high, the individual is at risk of dehydration.

Exercise for Diabetics

While exercise can make insulin work more effectively and lower glucose levels, it can also increase high blood glucose levels if ketones are present in urine (typically when glucose levels are above 240 mg/dl). If not addressed appropriately, ketones can lead to ketoacidosis and diabetic coma. The American Diabetes Association has many helpful resources (www.diabetes.org).

It’s important for an individual to work closely with their medical doctor to best manage this condition. While target glucose levels are individualized based on medical status, the ADA generally recommends pre meal levels of 80-130 mg/dl. There are accurate & portable blood testing machines available to monitor glucose levels.

Presently, 86 million Americans have prediabetes and 90% don’t even know it! This presents a huge opportunity for preventative medicine. Amazingly, individuals can reduce their risk of type II diabetes by 50% just by losing weight, getting more active, and eating properly.

Appropriate coaching and physical therapy can help individuals avoid onset of diabetes. Some oral supplements can also be of value (“Fortify Your Life,” Dog, 2016, https://drlowdog.com/).

In summary, consider too often as a society we wait until we are really sick before seeking treatment. Prevention is obtainable and is always the best medicine!


Dr. L. Voigt Smith, PT DPT CredMDT

About Dr. L. Voigt Smith, PT DPT CredMDT

Dr. Smith is a state licensed Doctor of Physical Therapy, owner of the Backsmith Advanced Physical Therapy clinic in Weston, Wisconsin, and inventor of the Backsmith Selective Stabilization Support. Dr. Smith prides himself on advanced and high value physical therapy care. He has been exceptionally effective with many outlier chronic pain patients. Dr. Smith is often able to save patients significant time and money, while restoring mobility and reducing chronic pain. Dr. Smith can be reached at the Backsmith Advanced Physical Therapy Clinic in Weston, WI (by appointment) or at (715) 298-5888.

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