Exorcising diabetes

A diabetes diagnosis initially frightened Katrina Johnson, but the fear soon inspired her to launch a new life.

After 30 years of leading a sedentary lifestyle and eating chocolate, fast food, oversized portions and plenty of pasta, the 5-foot-tall woman weighed about 216 pounds. Then a physical exam revealed that obesity was not her only health concern.

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Katrina Johnson trains with weights, part of an exercise regimen she began after she was diagnosed with diabetes. ‘It’s absolutely amazing what a bit of weight loss and eating healthy can do,’ she said.

Johnson suffered from diabetes, a condition that often leads to kidney disease, heart disease and stroke. Other consequences can include amputation and blindness. Diabetes has grown at epidemic proportions, with more than 24 million Americans affected, yet an estimated one-fourth of them are unaware of their condition.

Once she was diagnosed, Johnson got educated about the disease and sprang into action to manage her glucose level and her health. She and her husband, Greg (not a diabetic), changed their eating habits and started exercising. She lost more than 50 pounds; he trimmed down by more than 90.

The diagnosis “was quite a blessing because we were able to take hold of it and not let it continue,” said Johnson, 33, a Canton resident who was diagnosed in 2006.

“We rebirthed ourselves,” she said.

Managing wellness

Diabetics such as Johnson, who combine aerobic and resistance/strength training, demonstrate greater improvements in glucose control, physical performance and body-fat composition, according to a new study by the American Physical Therapy Association.

Regular exercise has long been prescribed as part of a diabetic treatment program as studies show physical activity improves heart health, weight control and sugar levels. This is one of the first studies to explore the relationship between a particular type of exercise and diabetes.

This is not a new concept, but it underscores the importance of a balanced and comprehensive approach to diet and exercise for diabetics, said Wylene Watts, a physical therapist and executive director of rehabilitation services at WellStar Health System in Marietta.

Many diabetics lack the energy to exercise, but a regular exercise regimen not only increases their energy level but also improves their mobility, she said.

“Our approach is to not only manage illness but wellness,” Watts said. “A combination of approaches gives them the best outcome.”

Knowing isn’t doing

During exercise, muscles burn sugar for energy, lowering blood sugar levels. A more strenuous workout produces longer-lasting results. In Type 2 diabetics, exercise can reduce the amount of insulin needed to transport sugar into the cells, reducing dependence on glucose-lowering medication.

Resistance exercise in particular — such as slowly lowering a dumbbell in a bicep curl — strengthens muscles, and that can further improve the way insulin works in the body.

When muscles are more fit, they take in sugar more easily, said Scott Isaacs, an endocrinologist and clinical instructor of medicine at Emory University School of Medicine in Atlanta. In addition to a healthy diet and aerobic exercise, Isaacs prescribes at least 20 minutes of strength training two to three times a week for his diabetic patients. People with fitter muscles can handle more sugar than those whose muscles are out of shape, he said.

“Most patients understand the importance of physical activity, but still don’t do it,” Isaacs said. “We say that knowing doesn’t equal doing,”

Johnson is one of Isaac’s patients who followed doctor’s orders.

When diagnosed, her blood glucose level teetered about 110 to 120 while she took diabetes medication.

She implemented a low-calorie diet with protein shakes and an exercise regimen that burned 2,000 to 2,500 calories a week with 30 minutes of strength/resistance training twice a week. Her blood sugar level now reads in the 80s, and she has been taken off medication.

According to her doctor, Johnson is “essentially, no longer a diabetic.”

“It’s absolutely amazing what a bit of weight loss and eating healthy can do,” said Johnson, who plans to lose another 30 pounds.

EXERCISE AND DIABETES

• When you’re ready to exercise, start slowly. Work your way up to 30 minutes of moderate-intensity exercise most days of the week. While you’re working out, remember to take good care of yourself.

• Monitor blood sugar: Check your blood sugar before, during and after exercise — especially if you take insulin or medications that can cause low blood sugar (hypoglycemia). Carry glucose tablets or hard candy in case your blood sugar drops too low or you feel shaky, nervous or confused.

• Pay attention to your feet: Wear smooth-fitting socks and comfortable athletic shoes. Examine your feet before and after exercise for any signs of potential damage, such as cuts or blisters.

• Drink up: Drink plenty of fluids while you exercise, especially when it’s hot. Dehydration can increase your blood sugar. If you exercise for more than an hour, drink carbohydrate-containing beverages rather than plain water.

• Identify yourself: Wear a diabetes identification bracelet or shoe tag while exercising, in case of an emergency.

• Know when to stop: If you experience any warning signs — severe shortness of breath, dizziness, faintness, nausea, chest pain, heart palpitations, or pain in an arm or in your jaw — stop exercising. If you don’t feel better within 15 minutes, seek immediate medical help.

— Source: Mayo Clinic

— This article is a reprint from The Atlanta Journal-Constitution.