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Hypokinesis and Diabetes

Definitions and Classifications of Diabetes
Symptoms of Diabetes
Diagnostic Criteria for Diabetes
Blood Glucose
Glycosylated hemoglobin (hA1c)   
Other Important Numbers
Educational Links

The focus of this web page is to address the effects of hypokinesis (low physical activity) on diabetes and its contribution to the development of diabetes.  It will also illustrate the many positive effects of physical activity for those with diabetes as well as in the prevention of diabetes.  Diabetes is a complex metabolic disorder with many other necessary aspects of treatment including nutrition and medications, which are beyond the scope of this website.  This site provides links to other educational sites which may offer information on other facets of diabetes care because appropriate treatment of diabetes requires some degree of knowledge of these topics.      

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Diabetes Mellitus or diabetes was first recorded in 400 B.C. and is one of the oldest documented diseases in history 70 .  Diabetes Mellitus actually means "sweet urine" and for centuries the diagnosis was made by tasting the patient's urine for "sweetness".  Fortunately, modern laboratory technology has developed more accurate analysis for the diagnosis of diabetes.  There are various forms of diabetes, which are all characterized by the abnormal metabolism of glucose for energy. 

Normal energy metabolism within the body breaks down the food eaten (mostly carbohydrates) to a simple sugar known as glucoseThe pancreas and liver are able to maintain normal blood sugar levels through a balance of insulin and glucagon secretion while providing the body with fuel.  

Glucose needs the help of the hormone insulin, which is produced by the pancreas, to get inside the cell where it is broken down to give the body energy. Think of the cell as a door and insulin is the key.  Glucose remains outside the door until insulin is present to unlock the door and help glucose get inside.  Simply put, diabetes is a breakdown of this process.

Various classifications of diabetes represent different problems with this process. 

Definitions and Classifications of Diabetes
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A condition in which blood glucose levels are elevated, but are not high enough to be classified as diabetic.  Pre-Diabetes is characterized by insulin resistance. T
he clinical definition of insulin resistance is the inability of a known quantity of exogeneous (injected into the body) or endogenous (within the body) insulin to increase glucose uptake and utilization in an individual as much as it does in a normal population 44.

Type 2 Diabetes
Type 2 diabetes is characterized by abnormal carbohydrate, lipid, and protein metabolism, which is associated with insulin resistance and impaired insulin secretion 24 .  Type 2 diabetes is also known as non-insulin-dependent diabetes (NIDDM).

Type 1 Diabetes
Insulin dependent diabetes mellitus (IDDM) or Type 1 diabetes is an autoimmune disorder, in which the insulin secreting pancreatic beta-cells of the pancreas are destroyed and the patient is then reliant on exogeneous insulin injections to sustain life 26.

Gestational Diabetes
Gestational diabetes is a glucose intolerance of variable severity that is first detected during pregnancy 48.

Common Symptoms and Signs of Diabetes Mellitus
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  • Frequent Urination
  • Fatigue                        
  • Increased Thirst
  • Weakness
  • Rapid/Unexplained Weight Loss
  • Increased Hunger

An estimated that 5 million Americans have diabetes and do not know it.  On average, people have diabetes for seven years before diagnosis. Type II diabetes is preceded by a period of impaired glucose tolerance, which is typically asymptomatic 66. It is recommended that physicians perform a simple test for diabetes at the age of 45 and every year there after. If over age 45 and/or are experiencing some of the symptoms listed above, it may be beneficial to be checked by a physician for diabetes.  Undiagnosed diabetes, and therefore chronic high blood sugars, cause excessive damage to eyes, kidneys, nerves, heart, and blood vessels that can be prevented.  Forty-seven million Americans have been diagnosed with the metabolic syndrome or insulin resistance, which is estimated to only be 60% of the population that currently has the disease 58.

Diagnostic Criteria for Diabetes Links
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Type 2 diabetes

Blood Glucose
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It is important for people with diabetes to monitor blood sugar level using a glucometer.  Keeping blood sugars within healthy ranges  protects long term health and helps the individual feel better as well 71 .  Food, diabetes medications or other medications, exercise, and stress are the things that can effect blood sugar.  A blood sugar below 70 mg/dl is classified as a low blood sugar or hypoglycemia.  It is very important to know the symptoms of hypoglycemia as well as treatment of a hypoglycemic reaction.  Hyperglycemia is when blood sugars go above normal with displaying different symptoms with a very different treatment. 

Glycosylated Hemoglobin (hA1c)
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The glycosylated hemoglobin or hA1c (as it is more commonly known) is a test to examine overall diabetes control.  The results of the hA1c represent average blood sugar for the previous 2-3 months.   An hA1c should be performed every 3-6 months depending on the classification of diabetes, but is recommended by the American College of Endocrinology that it is maintained if possible under 6.5% 1.  Keeping the glycosylated hemoglobin at or below 7% has been shown to minimize long-term complications associated with diabetes 60.

A comparison of blood sugar and corresponding hA1c levels 1.

Blood sugar (mg/dl) hA1c
60 4%
90 5%
120 6%
150 7%
180 8%
210 9%
240 10%
270 11%
300 12%
330 13%

Other Important Numbers
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Numbers to pay attention to include blood pressure which should be under 130/80 mmHg, microalbumin which should be under 30 mg/24 hours, and cholesterol with an LDL cholesterol under 100 mg/dl, HDL cholesterol above 60 mg/dl, and a triglyceride level under 150 mg/dl 1.

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Lack of knowledge about diabetes is a huge problem amongst people living with diabetes. Understanding diabetes and its management may empower patients to make the best choices possible for a long and healthy life living with diabetes. 

Educational websites regarding diabetes: 

National Diabetes Education Program

American Diabetes Association

American Association of Diabetes Educators

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