Thursday, December 12, 2002

Using exercise to control diabetes

Published in the Current

A diabetic himself, Brad Smith knows the value of exercise to people living with diabetes. Smith, who runs the Right Fitness Studio on Route 1 in Scarborough, used November’s status as American Diabetes Month to begin a program educating diabetics about the impact exercise can have on their lives and to teach non-diabetics about the disease, which affects 17 million Americans.

There are two types of diabetes, numbered one and two, both involving too much sugar in the blood. Type 1 diabetes is a condition in which the body’s immune system attacks the pancreas, resulting in the production of no insulin
at all. Insulin regulates the level of sugar in the blood by moving excess blood sugar into the cells of the body. People with Type 1 diabetes typically are diagnosed at an early age, and require daily insulin injections throughout their lives.

Type 2 diabetes occurs when the pancreas fails to produce enough insulin, or cells resist the effects of insulin. The first stage of attack, said Smith, who is an exercise physiologist, is for a diabetes patient to increase physical activity and change his or her diet. Medication can also make a person more receptive to insulin. A last resort is insulin injections.

“The first line of defense is a healthy lifestyle,” Smith said. That’s true even for non-diabetics. The U.S. Department of Health and Human Services estimates that 16 million people have a condition called “pre-diabetes,” in which their blood sugar levels are elevated, but not high enough to qualify as diabetics.

And Smith said there are more young people diagnosed with Type 2 diabetes than in the past. “Everything is super-sized, ” Smith said, referring not only to large fast-food servings, but dishes at all types of restaurants and even foods in supermarkets. He also said children see their parents involved in sedentary lifestyles, and continue that pattern as they grow up.

For diabetics, as for many people, exercise can be troublesome.

Exercise changes how the body uses blood sugar, and modifies its demand for insulin. People with Type 1 diabetes, Smith said, may need to eat when they don’t want to eat, to prevent their blood sugar from being too low. Or they may have to stop exercising for a time.

“It can be frustrating for someone who’s trying to lose weight,” he said.

And for someone seeking weight loss, high-impact sports may be too hard on already stressed joints like knees and ankles, Smith said. Diabetes increases the risk for cardiovascular disease and kidney failure and is the leading cause of blindness in people between the ages of 20 and 74.

Teens who have to sit out during sports because of diabetes may be more susceptible to eating disorders and depression, due to feelings of lack of control over their own bodies.

Smith said exercise can help minimize those health risks in all people, and help people deal better with their diabetes. “Diabetes doesn’t have to hold you back,” he said.

He offers clinics for diabetics who want to learn more about ways they can exercise safely, including tips on aerobic exercise and using weights. Smith, a Type 1 diabetic since he was eight years old, is hoping he can make a connection to diabetics in the area.

“I understand the physical and psychological things that go with (diabetes),” he said.

He also understands the value exercise can bring to a diabetic’s life. He recently completed the Maine Marathon. He did have to do some things differently from most runners, checking his blood sugar level every three or four miles and bringing along fast-acting sugars, like juice, in case he needed to boost his blood sugar level.

Smith said some people with diabetes or other health issues may feel intimidated to join a conventional gym, so he offers work in small groups and one-on-one coaching to meet individual goals.

He encourages people to find exercise they enjoy, whether it is walking with friends or a regular workout using exercise equipment or weights.

“It’s all about balance,” Smith said.