Diabetes is a disease in which the body does not produce or properly use insulin. Insulin is a hormone needed to convert sugar, starches and other food into the energy necessary for daily life. While the cause of diabetes is unknown, factors such as obesity and lack of exercise play important roles. Diabetes can result in conditions such as: heart disease, stroke, high blood pressure, blindness, kidney disease, nervous system disease (neuropathy), amputations, and problems with the skin, including ulcers and infections.
There are 23.6 million children and adults living with diabetes in the United States. Of these an estimated 17.9 million have been diagnosed, while 5.7 million are unaware that they have the disease.*
How a Physical Therapist Can Help
Managing your diabetes can lower your risk of resulting health issues. Management includes controlling your blood sugar (glucose), lowering your blood pressure and cholesterol, maintaining a healthy weight, and exercising. Physical therapists are experts in restoring and improving human motion, and can play an integral role in the management of diabetes by establishing and, as needed, supervising exercise programs and providing treatment of complications.
The Importance of Exercise
Exercise is an important part of managing diabetes. Regular physical activity can lower your need for medications, reduce your risk of heart disease and stroke, and help manage glucose levels*. The American Diabetes Association recommends 30 minutes of moderate exercise at least five days per week. Both aerobic and strength workouts are helpful.
Your physical therapist can create an individual exercise program to help you achieve better health safely. You should see a physical therapist to help you with physical activity if you have:
- Pain in your joints or muscles
- Numbness or tingling in your feet
- Calluses or sores on your feet
- Pain or limping with walking
- Used an assistive device such as a cane or crutches
- Had a stroke
- Questions about what type of exercise is best for you
Diabetes that is not well controlled leads to problems in blood vessels and nerves, often in the legs. Low blood flow to the legs can create cramping pain when walking or lead to sores on the legs or feet. Diabetes can affect the nerves, which can result in tingling in the feet and may progress to complete numbness. This numbness can cause damage to the skin or joints because of the lack of pain sensation. These problems can lead to difficulty with daily activities, limit the ability to exercise, and also result in very serious consequences to one’s health. It is best to take action to prevent complications, but if these problems occur, physical therapists can help restore your quality of life. Physical therapists can:
- Use special tests to check the sensation in your feet
- Help decrease cramping pain during walking
- Evaluate and care for skin ulcers and sores that are slow to heal Improve your walking ability by adapting shoes or orthotics
- Show you how to protect your feet if they have lost sensation
- Recommend shoe wear or assistive devices if needed
*American Diabetes Association, accessed on 11/2/09
Acknowledgment: Susan A. Scherer, PT, PhD