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Disease Process
Diabetes Mellitus (DM) is a disease in which the body does not produce enough or properly use insulin (a hormone that converts sugars, starches and other foods into energy).
There are 4 types of diabetes:
Causes
The cause of diabetes is known, but there is a link between obesity and lack of exercise with developing diabetes. Environmental factors (cold weather, viruses, diet) and genetics are also thought to contribute.
Symptoms
The early signs of diabetes are often missed because they are mild or attributed to other factors. If identified early, diabetes treatment can be started and the chance of developing complications can be decreased
Contact your doctor if you have more than one of the following symptoms:
- Frequent urination
- Excessive thirst
- Extreme hunger
- Unusual weight loss
- Increased fatigue
- Irritability
- Blurry vision
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Diagnosis
A diagnosis of DM is made by blood testing. There are two primary test used:
- Fasting Plasma Glucose Test (FPG): is done on an empty stomach (no food or water for >8 hours before the test). Blood is usually drawn 1st thing in the morning.
- Fasting Blood GLucose Level should be less than 100mg/dL.
- 100-125mg/dL is considered pre-diabetic.
- >125mg/dL is considered diabetic.
- Oral Glucose Tolerance Test (OGTT): is done to see how well the body handles a standard amount of glucose. Blood glucose levels are measured after fasting for 8 hours (and eating a consistent diet of >150 grams of carbohydrates for 3 days before the test). Then the person is given a glucose-rich drink and the blood glucose levels are measured again 2 hours later.
- 2 hours after a glucose-rich beverage Blood Glucose Level should be less than 140mg/dL.
- 140-199mg/dL is considered pre-diabetic.
- >200mg/dL is considered diabetic.
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Current Treatment
- Diet:
a well-balanced diet that is high in fiber, low in saturated fat, and low in
concentrated sweets with a consistent number of calories will help control blood sugar (decrease calories if obesity is an issue).
- Exercise:
Regular exercise can help reduce the risk of developing diabetes.
It can also reduce the risk of developing complications of diabetes (such
as heart disease, stroke, kidney failure, blindness, skin disorders, neuropathy/nerve damage, gastroparesis, depression, foot problems and leg ulcers). Consult your health care provider before beginning an exercise program.
- Alcohol Use:
Limit the amount of alcohol consumed. Excessive alcohol consumption is a known risk-factor for developing diabetes. Alcohol raises the glucose level in the blood.
- Smoking:
STOP! Smoking significantly increases the risk of developing complications of diabetes.
- Monitor blood glucose levels:
self-check blood glucose levels frequently (at least before meals and at bedtime). A log of these levels allows your health care provider to determine if the current treatment is effective or if changes need to be made.
- Medication:
your healthcare provider will determine the proper medication for you.
How Can Physical Therapy Help
Physical Therapy can help a patient with diabetes establish an exercise program to help lose weight, decrease blood pressure and regulate blood glucose levels. They can also provide education on the complications of diabetes and how to manage them (such as proper foot care). If a patient with diabetes develops an open sore, physical therapists are specially trained to help care for the wound. If complications develop and a patient with diabetes requires an amputation, a physical therapist can help with the recovery and return to function.
Patient Resources
American Diabetes Association
Gestational Diabetes (.PDF File)
National Diabetes Information Clearinghouse
Center for Disease Control
Diabetes.com
Diabetes Info Sheet (.PDF File)
Medline Plus Diabetes Info
Diabetes Blog
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