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Dr. Ravinder Kumar

The journey of Dr Kumar”s academics started from (CAEHS) and continued to accomplish his higher education from the most reputed Physiotherapy department of Post Graduate Institute (IAMR) & ICRI (Cranfield University) U.K.

Diabetes !

 

More than 51 million people of India are afflicted with diabetes, and the figure is likely to touch 80 million by 2030. It is no wonder then, that India has been tagged as the ‘Diabetes Capital of the World.

Physiotherapists treat a wide range of conditions and injuries. Many people believe that physiotherapists only treat sports injuries and help rehabilitate patients after surgery. While this is a big part of what physiotherapists do, they also help in a number of other ways that you might not have expected.

Diabetes carries a heavy burden for patients, the healthcare system and society. Over the next decade, diabetes rates will rise from population growth, an aging population and declining mortality rates. However, diabetes can be prevented, treated, controlled, and the risk lessened via various health and lifestyle interventions including physiotherapy. Physiotherapists can assess, diagnosis, treat, and manage musculoskeletal (MSK) manifestations and complications of type 2 diabetes. They can also counsel patients and provide advice on appropriate and effective exercise, physical conditioning, and active, healthy living.

 

Types of Diabetes :-

Type 1 Diabetes Mellitus (T1DM or 'Juvenile Diabetes')

Type 2 Diabetes Mellitus (T2DM or 'Adult-onset Diabetes')

 

Diabetes facts :-

Physical activity is a crucial intervention to prevent and manage type 2 diabetes. Thirty minutes of moderate physical activity/day plus a 5-7% reduction in body weight cuts type 2 diabetes risk by 58% (and 71% for those over age 60).
The benefits of physical activity in people with type 2 diabetes includes improved glycemic control, reduced cardiovascular complications and a 30-50% reduction in mortality.
Supervised physical activity programs are more effective than general exercise counseling, home based exercises, or flexibility exercises.
Complications or co-morbities including cardiovascular disease, obesity, joint pain, neuropathies, skin breakdown, and amputation present barriers to regular physical activity.

 

Diabetes Nerve Disease(Neuropathy) :-

Diabetic nerve disease (neuropathy) is the damage caused to the nerves of the body due to high blood sugar levels from diabetes. Those who have long term, uncontrolled high sugar levels are at high risk of developing weak nerves in all the vital organs of the body (Autonomic Neuropathy) like brain, heart, stomach, bladder, intestines, lungs etc. When the extremities, especially the leg and foot nerves are affected, it is calledPeripheral Neuropathy

 

Symptoms :-

  • Loss of sensation in toes, feet, arms and legs; you may not feel the pain if you have a small blister or cut and may find it difficult to distinguish between hot and cold temperatures;
  • Very few contraindications
  • Deep pain in feet and legs;
  • Tingling and burning sensation in arms and legs;
  • Sluggish digestion causing diarrhoea, constipation and bladder problems;
  • Sexual problems – difficulty in achieving and sustaining erection long enough to complete the sexual act (erectile dysfunction) in men; vaginal dryness and inability to achieve orgasm in women;
  • Changes in skin colour;
  • Fast heart rate;
  • Sudden drop in blood pressure when you stand up after sitting or lying down;
  • Dizziness and nausea.
 

Recommended Tests :-

Diabetic Peripheral Neuropathy: Filament test and Biothesiometry to detect nerve damage in early stages;

 

How Do Physiotherapists Help in Treating Diabetes? :-

Did you know physiotherapists can help with type 2 diabetes?

Seeking the help of a physiotherapist may not be your first thought if you have diabetes, but you may be surprised to learn what physiotherapists can do to help you manage the disease.

Physical activity helps manage diabetes by improving glycemic control and reducing cardiovascular complications. But getting started is not always easy or straightforward. People with diabetes often have other conditions like cardiovascular disease, joint pain, skin breakdown, nerve pain (neuropathy) or leg ulcers that can make physical activity challenging.

Physiotherapists Treatment in helping patients with diabetes :

Prescribing a safe and graduated exercise program: if you are overweight, have joint pain or cardiovascular disease it’s important to start with medically supervised exercises that consider these complications. A physiotherapist can provide suitable activities that are safe and gradual.

Providing specific treatment for joint pain: if you have knee, back or foot pain that limits your mobility, a physiotherapist can assess the problem and determine if a specific rehabilitation program will help the joint pain and allow you to get moving again.

Assisting with pain management: if you suffer from nerve pain caused by diabetic neuropathy, the physiotherapist can assess if electrical stimulation, desensitization or targeted exercises will help manage the pain.

Educating you on good footwear: a physiotherapist can assess and advise you on appropriate footwear if you have ulcers or blisters on your feet and show you how to adjust your walking technique to reduce pressure on the feet.

Providing skin and wound care: some specialized physiotherapists can help if you suffer from leg ulcers. Physiotherapists involved in wound care can debride the wound, apply compression bandaging to help circulation, consider if electrical stimulation or laser therapy will help, and provide advice on appropriate exercises and activities.

Health promotion - Support diabetes prevention including physical activity and healthy eating programs for all ages, removal of high sugar foods/drinks from schools, adequate food labeling, and smoking prevention and cessation.

With a strong medical background, physiotherapists work closely with physicians and other health-care providers involved in your care. Many physiotherapists do not require a doctor’s referral. To find a physiotherapist that treats diabetes, click here.

 

Eat low fat foods like :-

Dairy and dairy-like products: Low-fat (1%) or fat-free (skim) yogurt, cottage cheese, or milk Sorbet, sherbet, gelatin ices, and low-fat or fat-free frozen yogurt Fish, meat, and poultry: Egg whites or egg substitutes; Crab, white fish, shrimp, and light tuna (packed in water); Veal, chicken and turkey breast (without skin), and lean cuts of other meats (look for "loin" in the name) – braise, roast, or cook them without adding fats; Extra lean ground beef such as ground round, or ground turkey breast (check the labels)

Veggie burgers; Grains, cereals, and pastas; Hot (oatmeal or grits) and cold cereals (except granola types); Low-fat crackers; Soft tortillas – corn or whole wheat; Toast, English muffins, or bagels with jelly or honey (no butter); Pretzels, soda crackers, or plain breads; Fruits and vegetables

Fruits and fruit juices, applesauce; Vegetables and vegetable juices (again, watch out for fat in sauces you may add)

Snacks and sweets: Danish pudding and fruit pie fillings; Vanilla wafers and ginger snap cookies.

Gelatin; Angel food cake; Puddings made with skim milk

Baked chips, tortilla or potato; Low-fat microwave popcorn; Hard and jelly candies

Broth type soups with a vegetable base; Sauces, pudding, or shakes made with skim milk; Salsa

Light margarine and mayonnaise; Reduced-calorie or fat-free salad dressings

• Eat high fiber and small amounts of fruit

• Eat 5-6 small meals throughout the day. Eating small meals puts less demand on pancreas

 

Diabetic Foot and Wound Healing & Hyperbaric Oxygen Therapy (HBOT)

Sometimes, foot ulcers and non-healing wounds result in gangrene and may necessitate amputation of limb..

Treatment Procedure

• Hyperbaric Oxygen Therapy (HBOT) which refers to using pressurized pure oxygen to treat conditions such as wounds that won't heal in patients with diabetes or radiation injury.