Addressing the Diabetes Epidemic

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Estimates by U.S. government are that two out of every five Americans will develop type 2 diabetes. This increases the lifetime risk of type 2 diabetes to 40 percent for both men and women. The financial cost of diabetes was $174 billion in the United States in 2007 and will significantly surpass this amount by 2015. As a healthcare clinician you are likely to encounter many patients that have diabetes and its associated diseases.

40 percent of the men and women in the United States will develop type 2 diabetes during their lifetime. ~CDC

Healthcare clinicians are being called upon by health officials to address this public problem. Obesity, inactivity and high sugar foods together are the leading cause of type 2 diabetes. Physical therapists are in a unique position to involve their diabetic patient in a program that will improve their blood glucose levels. A 2010 research study demonstrated that a combination of aerobic and resistive exercise was more affective that aerobic or resistive exercise performed separately for lowering HbA(1c) levels in type 2 diabetic patients. A 2011 meta-analysis demonstrated that structured exercise training that consists of aerobic exercise, resistance training, or both combined is associated with HbA(1c) reduction in patients with type 2 diabetes. Structured exercise training of more than 150 minutes per week is associated with greater HbA(1c) declines than that of 150 minutes or less per week. Encouraging your patient to exercise, integrating both appropriate aerobic and resistive exercises will improve the sensitivity of the muscle receptors to insulin. Encouraging your patient to make better food choices, including avoiding sugary drinks, refined flour and processed foods and eating higher fiber whole foods and monitoring their body weight/BMI, the patient will see improvements in the status of their diabetes. As physical therapists we are in a unique position to make a difference. No other profession spends 45-60 minutes 2-3 times per week and has as much ‘say so’ about their patients’ exercise/activity habits and can advise on a healthy BMI and encourage improved food choices.

My next entry will address how to get more fiber into your diet. One of the secrets to weight loss!

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Jeff Gilliam PT PhD, OCS: is a weight loss specialist, who has studied extensively in the areas of health behavior, exercise physiology and nutritional biochemistry at the University of Florida. Jeff has taught a course at the University of Florida called ’Research Applications to Obesity and Weight Loss’. He has also taught courses for the DPT program at UF in Health Promotion and Wellness’ and ‘Evidence Based Practice III’. He has presented on a national level on topics related to diseases related to obesity and changing behavior to facilitate a healthy lifestyle. His PhD research was in the area of effective behavioral interventions for obesity and its associated diseases. He is founder of Physicians’ Choice for Weight Loss, a successful lifestyle/weight loss program, which can be found in over 50 clinics in the eastern US. He currently is clinical director of ReQuest Physical Therapy (Gainesville, Florida) and incorporates his lifestyle/weight loss program into his patients’ physical therapy to help them achieve their healthiest body weight. Jeff Gilliam is an Orthopedic Certified Specialist through the American Board of Physical Therapy Specialties

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