In 2012, Mississippi ranked second in the nation for overall diabetes cases with over 276,000 adult Mississippians suffering from type 2 diabetes. That’s 12.5% of adults in the state. Left unchecked, diabetes can cause complications that can lead to lower extremity amputations, kidney failure, blindness, heart disease and death. But the fact is diabetes is preventable, treatable and manageable. The most important steps a person can take toward conquering diabetes are eating better, controlling their weight and becoming more active.
Well-Being spoke with Marshall J. Bouldin, M.D., of Diabetes Care Group, which operates diabetes management clinics in Jackson, Biloxi, Gulfport, Diamondhead, Kosciusko and Hattiesburg, about the importance of the exercise component in managing type 2 diabetes. Despite the debilitating nature of the complications of diabetes, Dr. Bouldin offers hope to everyone who has diabetes, prediabetes or who is at high risk of developing the disease.
“One of the most important public health messages that I can communicate is that while diabetes has reached a crisis level in our nation today, with a few important lifestyle changes it is actually one of the most easily managed and prevented chronic diseases,” notes Bouldin. “It is crucial to diagnose the disease early and to develop a management plan to prevent its dangerous progression. At Diabetes Care Group we take a comprehensive approach to address weight, proper nutrition, exercise and monitoring of blood sugar, blood pressure, and cholesterol.”
Rx for Regular Physical Activity
“An initial assessment tells us where the patient is in terms of how much physical activity he or she is getting. From there we work with them to set goals for starting a regular exercise schedule that is appropriate for their physical condition – basically a prescription for exercise.”
According to Bouldin, “If a person has not been getting regular physical activity, we have to start where they are with a program that is safe for their physical condition and go from there. If they are resisting exercise we use goal setting with motivation and rewards, along with feedback on their progress. We help them understand the benefit of exercise, weight control and good nutrition to the overall management of their diabetes.”
Dr. Bouldin revealed some astounding facts about how diabetes can be controlled and even prevented. With moderate exercise such as walking 150 minutes a week and the loss of 7% percent body weight, a person diagnosed with prediabetes can prevent the development of type 2 diabetes 60% of the time. You can split up the intervals as you please – that’s just 30 minutes a day 5 days a week, for instance. And, according to the results of a study from the Diabetes Prevention Program, when the diabetes drug Metformin is taken to help prevent diabetes without regular exercise, it is only half as effective as exercise alone.
How to Get Started
For those who want to increase their level of activity to help manage their diabetes and benefit their overall health, there are steps that should be taken to insure that it is an enjoyable and safe experience. There are a few simple things you can do to help prevent injuries, dehydration, and hypoglycemia when exercising. If you have never been active or haven’t been active for a while, start slowly. If you feel unsure about your health, talk to your health care team about which activities are safest for you. Your health care provider’s advice will depend on the condition of your heart, blood vessels, eyes, kidneys, feet, and nervous system.
1. Warm up for 5 minutes before starting to exercise, and cool down for 5 minutes after. Your warm up or cool down should be a lower intensity than the rest of your time exercising. This helps get your blood flowing and warms up your joints.
2. Avoid doing activity in extremely hot or cold temperatures. Choose indoor options when the weather is extreme.
3. Drink plenty of water before, during, and after activity to stay hydrated.
4. If you feel a low blood sugar coming on, be ready to test for it and treat it. Always carry a source of carbohydrate with you so you’ll be ready to treat low blood glucose.
5. If exercising for an extended period (more than an hour or two), you may want to have a sports drink that provides carbohydrates. Be careful to check the nutrition facts. You may need to water down the drink so that you don’t have too much, which can cause your blood glucose to spike.
6. Wear a medical identification bracelet, necklace, or a medical ID tag that identifies you as someone with diabetes in case of emergency, and carry a cell phone with you in case you need to call someone for assistance.
7. Activities should be energizing but not overly difficult. Use the “talk test” to make sure you are not pushing yourself too hard. If you become short of breath and you can’t talk, then slow down.
8. Take care of your feet by wearing shoes and clean socks that fit you well. Shoes with silica gel or air mid-soles are a good choice for weight-bearing activities like walking because they are built to reduce stress on your feet and joints. Choose socks that are made out of a material that reduces friction and pulls moisture away from your skin.
9. Carefully inspect your feet before and after activity for blisters, redness, or other signs of irritation. Talk to your doctor if you have a foot injury or a non-healing blister, cut, or sore.
10. Stop doing an activity if you feel any pain, shortness of breath, or light-headedness. Talk to your doctor about any unusual symptoms that you experience.
Marshall J. Bouldin, M.D., is the Chief Medical Officer of Diabetes Care Group and cares for patients at its center in Jackson. He was formerly Chief Medical Officer of the Delta Health Alliance, and was also Associate Professor of Medicine at the University of Mississippi Medical Center, where he founded and directed the UMMC Diabetes and Metabolism Center and the Delta Diabetes Project. Dr. Bouldin received his bachelor’s degree from the University of Mississippi, and an M.D. degree from Johns Hopkins University. He served his residency in internal medicine at the University of Virginia.
Additional Sources: The American Diabetes Association and the Mississippi State Department of Health.