November is National Diabetes Awareness Month
Therapy's Role with Type 2 Diabetes
What is Diabetes?With diabetes, the body either doesn't make enough insulin or can't use it as well as it should. Diabetes is a chronic health condition that affects how the body turns food into energy. When there isn't enough insulin or cells stop responding to insulin, too much blood sugar stays in the bloodstream. Over time, that can cause serious health problems, such as heart disease, vision loss, and kidney disease.
Fast Facts on Diabetes- In the US, over 37.3 million people have diabetes - this is 11.3% of the total US population.
- Of these, approximately 90-95% of them have type 2 diabetes.
- Over 28.7 million people, including 28.5 million adults are diagnosed with diabetes.
- Over 8.5 million people go undiagnosed (23.0% of adults are undiagnosed).
- 96 million people aged 18 years or older have prediabetes (38.0% of the adult US population).
- For those 65 years or older, 26.4 million people have prediabetes.
In the senior population, the risks for Type 2 diabetes and pre-diabetes are high. The risk factors for pre-diabetes and Type 2 are similar. A person is at risk for pre-diabetes or Type 2 Diabetes if they:
- Have prediabetes.
- Are overweight.
- Are 45 years or older.
- Have a parent, brother, or sister with type 2 diabetes.
- Are physically active less than 3 times a week.
- Have ever had gestational diabetes (diabetes during pregnancy) or given birth to a baby who weighed over 9 pounds.
- Are an African American, Hispanic or Latino, American Indian, or Alaska Native person. Some Pacific Islanders and Asian American people are also at higher risk.
The good news is that an individual can prevent or delay type 2 diabetes with proven lifestyle changes. These include losing weight if you're overweight, eating a healthy diet, and getting regular physical activity. How can rehabilitation help?
Therapy can help in many ways including developing an individualized exercise program, promoting self-management skills, addressing low vision, and others. Specifically:
- Healthy Eating: Managing blood sugar is the key to living well with diabetes, and eating well is the key to managing blood sugar. But what does it mean to eat well? Simply put, eat healthy foods in the right amounts at the right times so your blood sugar stays in your target range as much as possible. Therapy can assist in making healthy food choices and educating an individual about how to read nutrition labels.
- Physical Activity: The goal is to get at least 150 minutes per week of moderate-intensity physical activity. Therapists can promote activity with our clients teaching them exercises that will work all muscle groups and help them to find activities they will enjoy and stick with. Therapy can teach clients that everyday activities like doing housework, mowing the lawn, swimming, and dancing are all moderate-intensity physical activities and can assist them in developing a schedule of activity that works for them.
- Skin Care: Proper skin care is an essential ADL. Therapists can teach simple strategies such as avoiding hot baths and showers, preventing dry skin, using mild shampoos and cleansers, and checking the feet every day for sores or cuts.
- Hearing Loss: There is a link between diabetes and hearing loss. As part of taking an initial medical history, speech-language pathologists should always ask new patients if they have diabetes. If the answer is "yes", patients should be asked whether their diabetes is under control and for their most recent HbA1c number. Because individuals with diabetes are more likely to develop hearing loss, the speech-language pathologist should serve as an important member of the patient's management team.
- Diabetic Retinopathy: This is an eye condition that can cause vision loss and blindness in people who have diabetes. Diabetic retinopathy is a very common diabetes complication, and it's the leading cause of blindness in American adults. Over time, high blood sugar levels and high blood pressure can damage small blood vessels in the retina. New blood vessels can develop, but they don't grow properly and leak, causing vision loss. Usually both eyes are affected. For this reason, the occupational therapist's skills with low vision become important to the individual with diabetes.
- Diabetic Distress: Diabetes distress can look like depression or anxiety, but it can't be treated effectively with medicine. Symptoms of diabetic distress can be mild to severe, and may include feeling sad or empty, losing interest in favorite activities, overeating or not wanting to eat at all, not being able to sleep or sleeping too much, having trouble concentrating or making decisions, or feeling very tired. Therapy can assist by educating patients to reduce stress and anxiety by performing relaxation exercises like meditation or yoga, keeping a journal, or getting out and getting active.
As with any population, education about chronic disease will be an important part of the rehabilitation treatment plan. Diabetes is complicated, and it takes practice to manage it in everyday life. Therapists can help patients prevent diabetes and manage their risk factors. They can also provide a level of diabetes self-management education and support with practical skills to manage their lifestyle no matter what stage of diabetes the patient is in.
