Diabetes

Contents

 

 Introduction

 

 Overview of Diabetes Type I

 

  What is diabetes type I

           Health implications of diabetes type I

 

 Physical Activity

 

  What is physical activity?

  Why do we need physical activity in our lives?

 

 Physical Activity and Diabetes (Epidemiology)

 

 Conclusion

 

 Bibliography

 

 

 

 Introduction

 

  For our seminar topic "physical activity and disease" we chose diabetes as the focus of our

  research.

 

  Since diabetes is such a complex disease with many different forms, we decided to focus on

  diabetes type I. This is known as insulin-dependent diabetes mellitus (IDDM). This type of

  diabetes includes people who are dependant on injections of insulin on a daily basis in

  order to satisfy the bodies insulin needs, they cannot survive without these injections.

 

 

 

 OVERVIEW OF DIABETES TYPE I

 

  What is diabetes type I?

 

  In order to understand the disease we firstly need to know about insulin. Insulin is a

  hormone. The role of insulin is to convert the food we eat into various useful substances,

  discarding everything that is wasteful.

 

  It is the job of insulin to see that the useful substances are put to best use for our

  well-being. The useful substances are used for building cells, are made ready for immediate

  expenditure as energy and also stored for later energy expenditure.

 

  The cause of diabetes is an absolute or lack of the hormone insulin. As a result of this

  lack of insulin the processes that involve converting the foods we eat into various useful

  substances does not occur.

 

  Insulin comes from the beta cells which are located in the pancreas. In the case of

  diabetes type I almost all of the beta cells have been destroyed. Therefore daily

  injections of insulin become essential to life.

 

 Health implications of diabetes type I

 

 

  One of the products that is of vital importance in our bodies is glucose, a simple

  carbohydrate sugar which is needed by virtually every part of our body as fuel to function.

 

  Insulin controls the amount of glucose distributed to vital organs and also the muscles. In

  diabetics due to the lack of insulin and therefore the control of glucose given to

  different body parts they face death if they don't inject themselves with insulin daily.

 

  Since strict monitoring of diabetes is needed for the control of the disease, little room

  is left for carelessness. As a result diabetic patients are susceptible to many other

  diseases and serious conditions if a proper course of treatment is not followed.

 

  Other diseases a diabetic is open to: Cardiovascular disease, stroke, Peripheral artery

  disease, gangrene, kidney disease, blindness, hypertension, nerve damage, impotence etc.

  Basically there is an increased incident of infection in diabetic sufferers. Therefore

  special care needs to be taken to decrease the chances of getting these other serious

  diseases.

 

 

 

 PHYSICAL ACTIVITY

 

 What is physical activity?

 

  (Bouchard 1988) States that physical activity is any bodily movement produced by skeletal

  muscles resulting in energy expenditure. Therefore this includes sports and leisure

  activities of all forms.   

 

 Why do we need physical activity in our lives?

  Physical activity and exercise helps tune the "human machine", our bodies.

 

  Imagine a car constantly driven only to stop for  fuel. It would be a client for all sorts

  of damage, rusting, oil leaking, dehydration and the chances are most likely it would die

  in the middle of the road not long after. This is what the body would be like if we didn't

  exercise at all. We would be and as a result of todays lifestyle many of us are,  the

  perfect target to all kinds of diseases and infections.

 

  For those of us who are carrier of some disease or illness we are still encouraged to

  exercise by our physicians if we have the strength to. This is to help make our organs,

  muscles, bones and arteries more efficient and better equipped to fight against the disease

  or illness. This is our way of counter attacking. And if we are still healthy then we

  reduce the chances of  getting an illness or a disease.

 

 PHYSICAL ACTIVITY AND DIABETES (EPIDEMIOLOGY)

 

  Recently insulin injections have become available to dependant patients. However in the

  pre-insulin era physical exercise was one of  the few therapies available to physicians in

  combating diabetes.

 

  For an IDDM carrier to benefit from exercise they need to be well aware of their body and

  the consequences of exercising.

 

  If an IDDM carrier has no real control over their situation and just exercise without

  considering their diet, time of insulin intake, type of exercise, duration of the exercise

  and the intensity, then the results can be very hazardous to the patient.

 

  In the first journal article that I used for this part of the research (Sutton 1981) had

  conducted an investigation on "drugs used in metabolic disorders". The article is designed

  to provide some background information on previous beliefs and research conducted early

  this century. As well as his own investigations conducted during the beginning of the

  1980's. He has compared the results and came to the same conclusion as the investigations

  done early in this century. 

 

 

  Sutton's findings show that decrease in blood glucose following an insulin injection was

  magnified when the insulin was followed by physical activity/exercise (see figure 1). This

  shows that if a person gets involved in physical activity or exercise after insulin the

  volume of glucose drops dramatically. This leads to symptoms of hypoglycemia. The reason

  this occurs is that glucose uptake by muscles increase during exercise, in spite of no

  change or even a diminishing plasma insulin concentration.  As a result of this type of

  information we know now that if a patient is not controlled through a good diet and program

  then they could put themselves in danger. A person who might be poorly maintained and

  ketotic will become even more ketotic and hypoglycimic.

 

  Good nutrition is of great importance to any individual especially one that exercises. In

  the case of diabetes even more consideration must go into the selection of food before and

  after exercise. Doctors suggest large intakes of carbohydrates before exercise for diabetes

  carriers to meet the glucose needs of the muscles.

 

 

 

  The second article that I used was that of Konen, et al. He and his colleagues conducted

  testing and research on "changes in diabetic urinary and transferrin excretion after

  moderate exercise". This article was a report of the way the research was conducted and

  it's findings.

 

  The researched found that urinary proteins, particularly albumin, increase in urinary

  excretion after moderate exercise. Albumin which is associated with micro- and

  macrovascular diseases in diabetic patience was found to increase significantly in IDDM

  patients, while remaining normal in non-diabetics. (See table 1 and 2 for results)

 

 

 

  These results cannot be conclusive to say that this shows that exercise causes other micro-

  and macrovascular diseases in diabetics. Since albumin is not associated with any disease

  in non-diabetics then the same may be the case for diabetics as well. However further

  research is required to find out why such a significant increase occurs in diabetic

  patients and what it really means.

 

  It obvious that there are many very complicated issues associated with diabetes which

  cannot be explained at this stage. Therefore much more research is required and it's only a

  matter of time for these complications to resolved.

 

  Although there are no firm evidence to suggest that exercise will improve or worsen

  diabetes still it is recommended by physicians.

 

  Aristotle and the Indian physician, Sushruta, suggested the use of exercise in the

  treatment of diabetic patients as early as 600 B.C. And during late last century and early

  this century many physician claimed that the need for insulin decreased in exercising

  patients.

 

  The benefits of exercise in non-diabetic individuals is well known. For example reduce the

  risk of heart disease. This makes exercise very important to diabetic carriers since they

  are at a greater risk of getting heart disease than non-diabetics.

 

  Unquestionably, it's important for diabetics to optimise cardiovascular and pulmonary

  parameters as it is for non-diabetic individual. Improved fitness can improve one's sense

  of well-being and ability to cope with physical and psychological stresses that can be

  aggravated in diabetes.

 

  In well controlled exercise programs the benefits are many, as shown on table 3.  

 

 

 

 CONCLUSION

 

 

  In conclusion we can see that although there are many factors that need to considered when

  a diabetic person exercises, still there are many benefits when an IDDM carrier controls

  and maintains a good exercise program. The risks of other disease such as heart disease and

  obesity are reduced.

 

 

 

 Bibliography

 

 

  1. Sutton, J.R, (1981), Drugs used in metabolic disorders, Medicine and Science in Sports

  and Exercise, Vol 13, pages 266-271.

 

  2. Konen, J.C, (1993), Changes in diabetic urinary transferrin excretion after moderate

  exercise, Medicine and Science in Sports and Exercise, pages 1110-1114.

 

  3. Bouchard, C, (1990), Exercise, Fitness and Health, Human Kinetics Publishers.

 

  4. Burke, E.J,  (1980), Exercise, Science and Fitness, Mouvement Publishers.

 

  5. Sanborn, M.A, (1980), Issues in Physical Education, Lea and Febiger.

 

  6. Marble, A, (1985), Joslin's Diabetes Mellitus, Twelfth Edition, Lea and Febiger.

 

  7. Kilo, C, (1987), Diabetes - The facts that let you regain control of your life, John

  Wiley and Sons, Inc.

 

  8. Seefeldt, V, (1986), Physical Activity and Well-being, American Alliance for Health,

  Physical Education, Recreation and Dance.