In Type 2 diabetes, the body either fails to produce enough of the hormone insulin, or is unable to use that insulin properly. Insulin is a hormone in our body that allows the glucose (sugars from the food we eat) in the blood stream to enter our body’s cells, where it is converted into energy. So, people with diabetes have an abnormally high blood sugar level.
The main symptoms are excessive thirst; urinating frequently, particularly at night; fatigue; and loss of weight and muscle mass. If untreated or not properly controlled, diabetes can cause damage to the blood vessels, nerves and organs such as the kidneys, or the eyes, leading to serious problems. However, with a healthy lifestyle and the right treatment people with diabetes can lead full and normal lives.
There is no single known cause of diabetes, but there are several associated risk factors. These include being overweight, particularly around the waist, while genetics, age and ethnicity also play a big part. Type 2 diabetes is most common in people over 40 but in people from South Asia, who are at greater risk, it often develops in the late 20s and 30s.
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There is no cure for Type 2 diabetes. Treatment, then, aims to help people manage lifestyle changes in order to control their blood glucose levels. This minimises the risk of complications in people with the condition, or can prevent Type 2 diabetes developing in the first place.
Exercise and a healthy diet are recommended both for prevention and for people already diagnosed. People with diabetes often have other medical problems or risk factors for ill health, such as heart disease, high blood pressure, a history of stroke or obesity. In these cases, it's especially important that your lifestyle changes, including your exercise programme, meet your individual needs.
Your physiotherapist is the key health professional to advise about this. In trying to prevent the onset of diabetes, or to stop the condition becoming worse, a physiotherapist will advise on exercise to reduce body fat and to improve how the body processes glucose. Both are key factors in managing diabetes.
Physiotherapists also have a role in treating people with some of the complications of diabetes. These include difficulties with vision and sensory changes due to circulation problems and nerve damage, both of which affect a person’s safety. Some people may develop a dropped foot, causing them to trip, which requires exercise and also assessment for a foot splint. In extreme cases, the altered circulation may result in an amputation. Here, a physiotherapist will be part of the team that gets you walking again.
Your physiotherapist will assess both your general health and fitness and also your specific needs. They will then give you advice and may draw up an individual exercise programme or give you a specific treatment. For example, they might recommend exercises to improve your balance or adaptations to your house so that you are less likely to trip up. If you have had an amputation, they might provide walking training and mobility aids.
You may need to wear shorts and a T-shirt during an assessment so that your physiotherapist can see how your joints and muscles move.
Ensure you are receiving an annual health check that includes the National Institute for Health and Clinical Excellence's nine key tests for people with diabetes. These include screening your eyes and feet, taking your blood pressure and testing your blood glucose levels. See www.nhs.uk/NHSEngland/NSF/Pages/Diabetes.aspx.
See your doctor immediately about problems with your feet; for example, loss of feeling, or wounds that won't heal. Diabetic ulcers can develop very quickly.
Consult a health professional such as a physiotherapist for advice on exercise and diet
- Stay a healthy weight
- Maintain good general fitness levels through regular exercise. Maybe combine exercise with social activity – this will help motivate you and give you some support
- Eat a healthy, balanced diet that is low in salt, sugar and fat
- Check your feet every day
- Don’t smoke – see your GP if you need help giving up.
- NHS Choices on Type 2 Diabetes
- Diabetes UK: What is Type 2 Diabetes?
- National Service Framework for Diabetes
- NICE Type 2 Diabetes Quick Reference Guide
DISCLAIMER: Physical activity should not cause any harm. If you do experience any pain or discomfort, stop immediately and speak to a health professional such as a chartered physiotherapist or your GP.