Diabetes and Tour de Cure

Diabetes is a complex diagnosis that deserves more awareness, education, and discussion. As a Board Certified Geriatric Specialist and Doctor of Physical Therapy, I work extensively with many patients who are diabetic. But to live it, is to understand it better.

My diabetes story began in 2014 when pregnant with my son. I was diagnosed with gestational diabetes. This was a complete shock to us since I had no symptoms, was very active, not overweight, and had no other typical risk factors. This experience forever changed viewpoint, including how to keep my blood glucose within acceptable limits through diet and exercise.  I now try to educate everyone I can about diabetes, including research and resources like the American Diabetes Association (ADA).

Diabetes is a complex, chronic metabolic disease characterized by hyperglycemia. In other words, elevated blood glucose that results from defects in insulin secretion, insulin action or a combination of both.  Management of this disease is a life-long process with support and education needed throughout every stage of the disease.  It can often be very scary and confusing, especially when trying to navigate what to do and when.

It is important to know that you have control and can make lasting changes in your own life to help. Determining how to control your diabetes is overwhelming. Educating yourself is the first step. Let’s begin with the exercise portion.

Exercise helps control glucose and regulates it in the blood.  Most people with diabetes know their A1c number.  A1c is the portion of hemoglobin found in the blood with glucose attached.  People without diabetes have A1c between 3.0-6.5% and those with it are between 7-14%, when not controlled.  Activity decreases blood glucose immediately by using it as energy and it remains lower hours after being active. Use of a glucose meter is helpful to understand how the foods you eat, activity, diabetes medication and other variables affect blood glucose.

Exercise or physical activity can be classified by a combination of intensity, duration, frequency and mode.  Intensity is how hard an activity is, duration is how long it’s performed, frequency is how often and mode is the type of activities you do.  It is recommended people get at least 150 min of exercise 3-4 days per week with no more than 2 consecutive days without physical activity. Good exercise should be considered fairly hard to hard. The 30 minutes per day can be broken down into 3 separate ten minute sessions and progress to 30 minutes of continuous duration, as you are able.

Ultimately, you need to start moving.  You have the power to change your life and take control.  If you need help starting, physical therapists are your key health care professionals to help you navigate and start initiating the process.  Exercise should be individualized, and you may need co-management of other diagnoses or precautions to minimize difficulty during exercise.   Exercise also improves quality of life, energy, psychological and emotional aspects, so you have nothing to lose!