Physical therapy is a treatment method that has the potential to play a highly valuable and effective role in managing both Type 1 and Type 2 diabetes. This form of therapy works by promoting safe types of physical activities, improving the overall functionality of the body, and preventing and/or directly addressing complications that stem from diabetes. Therapists create customized programs for diabetic patients that include exercise, direct support, and education. Combined, these physical therapy activities aid in controlling blood sugar and optimizing the quality of the patient’s life. Continue reading to learn more.
The Basics
Diabetes is considered to be one of the most prevalent of all chronic conditions worldwide. It actually impacts hundreds of millions of people and results in a wide range of serious health complications, the reduction of quality of life, and causes highly substantial costs in terms of healthcare.
In the United States, approximately 12% of the total population, or an estimated 40 million people, live with this condition. About 30 million are diagnosed, and it is believed that another 11 million people are undiagnosed. On a global level, the numbers are staggering. Projections indicate that the number of people impacted by diabetes will continue to grow.
Indeed, medication, proper nutrition, and monitoring glucose levels are all common parts of care for a diabetic; physical therapy has now emerged as a powerfully effective treatment that gives patients the empowerment to completely control their health through physical activities.
Therapists specialize in creating custom patient-centered exercise programs that are safe and offer therapies for both neurological and musculoskeletal issues that may be experienced. Furthermore, therapists help provide patients with educational material on lifestyle changes that will help prevent complications from diabetes.
According to information from the American Diabetes Association, adults who have this chronic condition should participate in approximately 150 minutes a week of moderate exercise. This includes – but is not limited to – aerobics, swimming, resistance training, and similar exercises – at least on two days or more each week. Throughout this article, you will learn about the multifaceted methods that physical therapy helps those with diabetes. The information contained throughout this guide stems from physiological evidence, clinical evidence, and applications that are practical in nature.
Diabetes and The Possible Complications
Diabetes consists of two different types.
Type 1 is a condition where there is direct autoimmune-based destruction of beta cells that produce insulin.
Type 2 is where there is resistance to insulin, and there is a deficiency of relative insulin. There is a third type that only affects pregnant women. It is identified as “gestational diabetes”.
Most cases are Type 2.
Poorly managed blood glucose levels lead to a wide array of health issues. These include stroke, disease of the heart, and even peripheral artery disease. These are called “macrovascular complications”.
There are microvascular issues, too. These include retinopathy, neuropathy, and nephropathy. Additionally, sufferers may experience an increased risk of developing infections, slow wound healing, and an increased chance of falling due to impairments stemming from balance issues.
If a person with diabetes is physically inactive, it increases the risk of developing health problems. If physical activity is structured, it actually improves insulin sensitivity in the body. It also improves the uptake of glucose within the muscles and lipids, and helps with blood pressure and overall cardiovascular fitness.
Physical therapy goes beyond the benefits associated with basic exercise. This is because it provides progressive physical activity tailored to the patient, based on their body composition, comorbidities, general fitness level, and limitations.
Glycemic Control Through Exercise
Exercise is known for having a heavy influence on the metabolism of the body in many different ways. While engaging in physical activities, the muscles actually contract, and they facilitate the uptake of glucose through the mechanisms in the body that are dependent on insulin. In addition to this, blood glucose levels are lowered. By regularly engaging in physical activities, insulin sensitivity is enhanced throughout the body. The mitochondrial density throughout the body is increased, and the composition of the body is improved.
When reviewing the meta-analysis’s levels, physical therapy demonstrated a wide range of benefits to the individual that suffers from diabetes. It can reduce A1C levels up to 0.7%. These benefits may be enhanced if resistance training is added to the regimen.
If physical therapy training includes both aerobic exercises and resistance training, the greatest improvements will be yielded. In fact, these results rival the success of various types of diabetes medications in exceptional magnitude. If a patient engages in high-intensity interval training (HIIT), there is a pronounced improvement in terms of insulin resistance and the peak of V02. It must be performed in a careful and precise progression, though, for the overall safety of the patient.
Resistance training is highly productive due to the fact that the muscles in the body account for a large portion of the glucose disposal that is mediated by insulin. If muscle mass is accumulated, it goes through a steady overload that helps to improve the metabolic rate of the body and helps in terms of glycemic control. Physical therapists focus on something called the “FIIT Model”. This stands for:
- Frequency
- Intensity
- Time
- Type
Top-Rated Physical Therapy Interventions
The following represents the top-rated physical therapy interventions:
- Aerobics – This includes walking in a brisk manner, swimming, and water exercises. If you have joint issues or problems with your feet, it is advised that you opt for exercises that are considered to be low-impact. Otherwise, go for high-impact activities as they will help heart health, weight loss, weight management, and lower the glucose levels of the body. Physical therapists will typically start with short sessions and move you up to 150 or more minutes each week.
- Strength Training – In this type of physical activity, you will be required to use free weights, bands, specially-designed machines, and exercises that use your body weight. The major muscle groups are targeted and activities are done up to three times each week. This helps prevent muscle loss as you age and also benefits glycemic control. This type of training can reduce the A1C by approximately .60%. It also helps to increase the sensitivity to insulin in the body.
- Balance Training – If you have peripheral neuropathy due to diabetes, a physical therapist will have you do exercises that improve your balance and optimize your gait. Not only does this help in reducing the risk of your falling, but it can assist in eliminating neuropathic-based pain. This type of exercise program is also very beneficial in improving nerve function. This is because when you do these activities, the body releases endorphins that help with pain and help to improve circulation.
- Manual Exercises – There are many manual exercises that may be encouraged in physical therapy. These include massage of the soft tissues, joint mobilizations, exercises for nerve gliding, and other techniques that help to improve circulation and eliminate pain throughout the body. Many manual exercises will also help with the relief of uncomfortable symptoms on a short-term basis.
In addition to the above-listed treatments, the following are specialized treatments encouraged by physical therapists for those who suffer from diabetes:
- Functional Training – This includes activities of daily living. You will be encouraged to rise from chairs, climb stairs, and engage in activities that help you in your daily life.
- Water Therapy – This is basically just aerobics in the water. The benefits are that the buoyancy helps in eliminating the stress on the joints while helping provide a light degree of resistance.
- Education – Physical therapists specialize in providing information on choosing footwear, foot care, and recognizing when the blood glucose levels drop during exercise.
Getting Started
If you have an interest in engaging in physical therapy as a diabetic, you will need to understand that every patient must be screened to determine if the program is right for their individual needs. You will need to undergo a history assessment, engage in a physical examination, go through tests that determine your level of functionality, and turn in glycemic logs.
Most insurance plans will cover physical therapy treatment for those who have impairments that are related to diabetes. Physical therapy is optimal when other specialists are involved. Examples of these specialists include endocrinologists, diabetes doctors, podiatrists, dietitians, and – of course – primary care providers. Most prefer diabetics to undergo continuous monitoring of their glucose levels in order to direct the intensity of the program and the timing of the exercises.
If you want to join a physical therapy diabetic treatment program, contact us here at Back to Motion Physical Therapy today. When combined with lifestyle changes, you will find that it is even possible to reverse some types of diabetes. For more information, you may visit our website or call us directly. We can direct you from a passive level of reliance on medication-based therapies to an active process that gives you full and absolute control over diabetes:303-832-5577