Diabetes Mellitus
Introduction
Diabetes is a chronic metabolic disease in which the body is unable to appropriately regulate the level of sugar, specifically glucose, in the blood, either by poor sensitivity to the protein insulin, or due to inadequate production of insulin by the pancreas.
There are various forms of diabetes, with the most common being Type 2 Diabetes (T2D). Previously referred to as adult onset diabetes or non insulin dependent diabetes, risk factors for T2D may include
- Obesity
- Family History
- Increasing Age
- History of Gestational Diabetes
- Race (more common with African American, American Indian, Hispanics and Asian American)
Complications of Diabetes
Acute complications of diabetes include:
- Hypoglycaemia
- Diabetic ketoacidosis
- Hyperosmolar nonaerobic coma
Chronic complications of diabetes relate to the long term effects of hyperglycinemia on the vasculature and can be divided into:
- Microvascular complications consisting:
- Retinopathy
- Nephropathy
- Neuropathy (including peripheral distal symmetric polyneuropathy, autonomic neuropathy, proximal painful motor neuropathy and cranial mononeuropathy)
- Macrovascular complications including:
- Cardiovascular disease
- Peripheral vascular disease
- Stroke
PHYSIOTHERAPY MANAGEMENT
PHYSICAL ACTIVITY & EXERCISE
- Exercise programmes are geared towards improving quality of movement, participation in activities of daily living, managing pain if any, lowering blood sugar and ultimately slowing the progression of the condition and its multi systems complications.
- A combination of aerobic and resistance training exercises has been recommended in planning exercise programmes for this population as it has been reported to produce positive effects on blood glucose levels.
Flexibility and balance exercises are reported to be beneficial for older patients with diabetes as the former will help in improving range of motion at joints, while the latter can aid in reducing fall risks.
