Thursday, May 30, 2024

Managing diabetes with physiotherapy

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Diabetes manifests as a metabolic disorder primarily caused by defective insulin secretion, impaired insulin utilisation, or both. Individuals with diabetes typically exhibit elevated plasma glucose levels compared to non-diabetic individuals, potentially leading to metabolic disturbances and various diabetic complications including nephropathy, neuropathy, retinopathy, foot diseases, and gum diseases. India ranks second globally in terms of diabetic prevalence, with 74.9 million cases projected to increase to 124. 9 million by 2045 among individuals aged 20–79 years. While pharmacological treatments have traditionally been the mainstay of diabetes management, their adverse effects, including heart failure, increased fracture risk, bladder cancer, and weight gain, often outweigh their benefits. Consequently, there is a growing emphasis on non-pharmacological approaches to diabetes management, with physiotherapy emerging as a cost-effective, customisable treatment option for individuals with pre-diabetes, early type 2 diabetes mellitus (T2DM), and advanced cases with multiple complications.

Is Physiotherapy Effective in
Managing Diabetes
Consistent engagement in physiotherapy can yield significant benefits for individuals living with type 2 diabetes, particularly among older adults and those with multiple comorbidities. Physiotherapy intervention operates within two primary domains: preventing the progression of symptoms and effectively managing existing diabetic symptoms.

How Physiotherapists can Help Manage Diabetes?

Physical therapists play a crucial role in assisting individuals with diabetes in participating in safe and effective exercise programs, leading to lower blood sugar levels. They focus on improving mobility, enhancing daily activities, and alleviating pain. Moreover, physical therapy treatments expedite the healing process of diabetes-related skin issues.

Assessment and Personalised Treatment
Physical therapists evaluate patients’ blood glucose records and examine their skin for wounds. Additionally, they conduct comprehensive assessments of patients’ strength, flexibility, endurance, balance, and skin sensation, particularly in the feet. Based on these findings, they design tailored treatment plans to address specific needs and challenges.

Improving Mobility
Physical therapists employ specific activities and treatments to restore normal movement, starting with passive movements performed by the therapist and progressing to active exercises and stretches for self-practice.

Building Strength and Flexibility
Through targeted exercises, physical therapists help patients regain strength gradually and safely. They also address muscle tightness by teaching gentle stretching techniques to improve flexibility.

Enhancing Endurance and Balance
Rebuilding endurance and balance is essential to prevent falls and facilitate daily activities. Physical therapists guide patients through exercises to improve endurance and restore coordination.

Walking Assistance and Pain Management
If needed, physical therapists adjust footwear and may introduce supportive inserts to enhance walking comfort. They also provide techniques to manage chronic pain effectively, utilising various treatments and technologies while prescribing safe exercises.

Blood Sugar Control and Wound Healing
Prescribed exercise programs aid in lowering blood sugar levels, contributing to better glucose control. Additionally, physical therapists apply dressings and treatments to expedite the healing of wounds, offering guidance on foot and skin care to prevent complications.
Home Exercise and Recovery Goals
Physical therapists educate patients on strengthening, stretching, and aerobic exercises for home practice, tailored to their needs. They collaborate with patients to set recovery goals aligned with activity objectives, ensuring a safe and efficient rehabilitation process.

Physiotherapy stands as a valuable ally in the holistic management of diabetes. By addressing mobility issues, enhancing strength and flexibility, and promoting overall wellness, physical therapists play a pivotal role in empowering individuals with diabetes to lead healthier, more active lives. Through personalised assessment and targeted interventions, physiotherapy offers a multifaceted approach to diabetes management, helping individuals navigate the complexities of their condition with confidence and resilience.

(The author, Tamilarasu Kumarappan, is the Chief Physiotherapist at JNI.)

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