PT Classroom - How Physical Therapy Can Help You Manage Type II Diabetes ׀ by Daniel Seidler, MS, PT


Daniel Seidler is the Executive Director of WSPT. He is a Columbia University graduate with a Masters in Physical Therapy. His areas of expertise are aquatic therapy and orthopedic manual physical therapy based on the Maitland technique of assessment and treatment. Daniel is a self-proclaimed fitness freak, having completed 3 NYC marathons and the 2010 NYC Triathlon.


How Physical Therapy Can Help You Manage Type II Diabetes

Type II Diabetes is usually a result of poor nutrition combined with a lack of exercise or activity. The body’s ability to produce insulin or use it to break down sugar becomes compromised from being overworked for a prolonged period of time. Some people are born with a predisposition for acquiring Type II Diabetes, but ultimately it is a preventable disease. For the same reasons, it also is manageable to the point that it’s effects are minimal if approached effectively.

If you do have diabetes, it’s important that you have a plan and you stick with it. Complications from diabetes tend to build and become more difficult to reverse over time. An effective means of managing diabetes is to have a capable health care team on your side to advise and work with you. A good doctor, nurse, pharmacist, nutritionist and Physical Therapist should all be on your speed dial if you have diabetes. A Physical Therapist can be an extremely valuable member of your team because of their knowledge, skills, and accessibility.

Ways a Physical Therapist can help someone with Diabetes:
1. The key to managing diabetes is being able to balance your blood-sugar levels. This can be accomplished through proper nutrition, exercise and medication. By prescribing an appropriate exercise program, a PT can be a vital piece of the diabetes management puzzle. Diabetes has varying effects on each person. Nutrition, exercise and medicine dosages have different effects on every person. These effects even change over time. By prescribing an appropriate exercise program, a PT can help you effectively manage your sugar levels and avoid many of the complications associated with dips and spikes in blood-sugar levels.

2. Many people with diabetes are either physically deconditioned or become less fit over time due to the complications of the disease. Deconditioning leads to additional complications and makes managing blood-sugar levels extremely difficult. I often hear from people with diabetes that they can’t exercise because they’re not in good enough shape. I understand this and I also realize that if you are obese, it may be painful to even walk due to complications such as arthritis or back pain. PTs are very experienced at working with people who have multiple complications. Treating conditions like arthritis is the norm for us, so we can help diabetics overcome the roadblocks that are preventing them from starting an exercise program. Once pain and orthopedic challenges are addressed, patients with diabetes can get down to the business of improving their overall heath.

3. One very serious effect of diabetes is diabetic neuropathy. Neuropathy is due to poor circulation associated with diabetes and results in pain, tingling, numbness and other discomfort in the feet and hands. It can also gradually spread more proximally up the limbs if not addressed. This pain and altered sensation leads to inactivity and feeds into the cycle of deconditioning mentioned above. In addition, due to poor sensation, a diabetic can easily injure, cut, or even puncture part of their feet and not become aware of the injury unless he or she is carefully inspecting their body.

A PT can help treat diabetic neuropathy with infrared light modalities such as Anodyne Therapy combined with massage, aquatic therapy, balance/gait training, and general conditioning. The first step is to get the diabetic patient back on their feet and out of the cycle of pain and inactivity. A PT uses their skills and motivation to make this happen safely and effectively.

Since diabetes can potentially affect every system of the body, the complications are potentially endless if not managed appropriately. PTs are very knowledgeable in the causes and effects of diabetes, so we have multiple solutions to the problems that arise for diabetics. Every patient is different, so we develop individual programs for the complications that each person is coping with. If you have diabetes or are pre-diabetic, it’s extremely important that you address it immediately and a PT can be a beneficial part of your team.

Last revised: December 4, 2011
by Daniel Seidler, MS, PT

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