Educação Física e Esporte

Cevnautas,  os esforçados tocadores das comunidades do CEV vivem consultando boletins e serviços de alerta bibliográficos e de congressos para manter o povo de cada comunidade em dia com as novidadedes. Um dos boletins é o Physical Education News. Tem artigos muito interessantes. A edição de setembro traz o Exercício e Diabetes. Carece de tradução. Colei no fim as referências. Alguma alma generosa e poliglota bem que poderia adotar a tradução.  Por favor, interessad*s escrever direto para laercio@cev.org.br. Os artigos completos da edição de setembro estão no portal, onde tb dá pra assinar digrátis: http://www.pelinks4u.org/

EXERCISE AND DIABETES
Written by: Govinda Allin, student, University of Florida

With the rising advances in science and technology, health has become a widely popular public interest. Tools like the internet provide many opportunities to obtain educational information related to health. People are exploring new ways to stay healthy and everyone has his or her own health philosophy.

As information becomes more accessible, the general concept of health is slowly changing into an all encompassing definition. According to Charles Corbin and Robert Pangrazi “Wellness is a multidimensional state of being describing the existence of positive health in an individual as exemplified by quality of life and a sense of well-being” (1, p7). Many people define health as having two parts: physical and mental. Slowly, through health education, the definition of health is changing and is now encompassing multiple dimensions including these six: environmental, mental, emotional, spiritual, social, and physical.

Daily exercise has been proven to raise self-esteem, create positive social attitudes, increase neuromuscular coordination and physical fitness, and increase cognitive abilities (3). Exercise has been shown to reduce muscle loss from aging, improve bone density, decrease migraine headaches, and improve sleep (2). Exercise is the answer and supports all of these six dimensions of health.

Diabetes Mellitus is a condition in which the pancreas does not produce enough insulin, or the body does not properly respond to insulin (4). Our bodies have the ability to break down the foods we ingest and can convert it to energy. Different complex processes and hormones are used to break down, move, and store food for energy use. One of the key hormones used to break down starches into energy and facilitate storage is insulin (4). Insulin is a transport hormone that moves glucose from the blood into cells.

There are three different types of diabetes. With type 1 diabetes, the pancreas does not produce insulin (4). Type 1 diabetes is usually identified in children and young adults, affecting only about 5-10% of people with diabetes (4). The disease was previously known as juvenile onset diabetes; however, recently, the name has been changed due to the fact that children are now also being diagnosed with type 2 diabetes.

Type 2 diabetes is much more common and is caused from insufficient insulin production or existing insulin being ignored by cells. Insulin transports glucose from the blood into the cells, and if insulin is not recognized by cells the blood sugar levels will rise. If the blood glucose levels are not lowered, then devastating diabetic complications can emerge. Lastly, during around the 28th week of pregnancy women can be diagnosed with a third type of diabetes referred to as gestational diabetes. Women with gestational diabetes must watch their diet to remain healthy so they do not contract type 2 after the pregnancy or harm the health of the baby (4).

Some symptoms of diabetes include frequent urination, excessive thirst, unexplained weight loss, extreme hunger, sudden vision changes, tiredness, very dry skin, slow healing sores, and more infections than usual (5). These symptoms can be explained through different complications occurring in the body due to the high levels of sugar in the blood. People with diabetes can develop atherosclerosis, and eventually, full blown heart disease from the damage of sugar build up in blood vessels (3). People can develop retinopathy, neuropathy, nephropathy, hypoglycemia, and ketoacidosis from diabetes mellitus (3).

Diabetic retinopathy refers to the damage of the retina due to high levels of glucose, leading to vision changes or blindness (3). Diabetic neuropathy is associated with injury to small blood vessels that would otherwise supply blood to nerves. If the nerves’ blood supply is diminished, the nerve cannot function optimally (3). Diabetic nephropathy is a progressive disease caused by angiopathy of capillaries and the destruction of glomeruli in the kidney (3).

Diabetic hypoglycemia is caused when a person with diabetes takes medication to lower their own blood sugar levels. In the process they may not take the correct amount of medicine, or the medication does not match their body’s needs, or they are not eating a proper diet and glucose levels can fall far below the normal level (6). People with Diabetes can obviously also have hyperglycemia which is blood sugar levels that are higher than normal (4).

Diabetic ketoacidosis results from a critical shortage of insulin in the body. The body, instead of using glucose as energy, starts burning fatty acids and produces acidic ketones that enter the blood stream causing a chemical imbalance which can eventually lead to death (6). There is a close link between gum disease, or periodontitis, and diabetes. People with diabetes have to take extra care of their oral health, otherwise gum disease will develop in their mouth, and their teeth will be destroyed (4).

People with diabetes can become subject to anger, stress, or depression. It is important for a person with diabetes to surround him/herself with people that will support him/her and give emotional and mental encouragement.

The exact mechanisms and causes for diabetes mellitus are unknown. Both type 1 and type 2 are partly inherited because people that have relatives with diabetes mellitus have a much higher risk of developing the disease and should take the necessary preventable measures. “The appearance of type 1 diabetes is suspected to follow exposure to an environmental trigger, such as an unidentified virus, stimulating an immune attack against the beta cells of the pancreas (that produce insulin) in some genetically predisposed people” (5). Clinical characteristics such as obesity and lack of physical activity are regarded as the most important risk factors, both independently associated with diabetes and diabetes related co-morbidities” (8).

Diabetes screening is recommended for anyone with any risk factors at different stages of life. As discussed, many medical conditions are associated with diabetes and synergistic effects can occur between the diabetes and the complication. Understandably, people with diabetes must be routinely monitored for complications and promote and incorporate different preventable actions in order to remain healthy.

Because diabetes is a chronic disease, the medical field emphasizes prevention and avoidance of potential future diabetic complications. Treatment for diabetes includes insulin therapy, oral medications, medications to reduce blood pressure, injectable medications, and aspirin, which has be proven to reduce the risk of heart attacks (4). Self-treatments include monitoring blood sugar and ketone levels.

There are many different types of glucose meters from which patients can choose. Together, the physician and the patient should have a discussion about the different types of measurement tools and select the most appropriate tool that fits the patient’s lifestyle. This increases the chance that the patient will regularly use the glucose meter to monitor his/her diabetes on a daily basis. As mentioned earlier, people with diabetes have a significantly high chance to contract periodontitis; therefore, strict brushing and flossing must become a daily activity (4). In certain extreme cases, kidney replacement therapy or pancreas transplants are options; however, due to the complexity of the procedures, results vary and the results are not always a success (4).

Exercise has been proven to significantly increase insulin sensitivity, enhancing the transport of sugar into cells which would lower the blood sugar levels in the body and give a person with diabetes more energy. “With continued moderate exercising your muscles take up glucose at almost 20 times the normal rate. This lowers blood sugar levels” (6 p1). “Research studies have found that moderate weight loss and exercise can prevent or delay type 2 diabetes among adults at high-risk of diabetes” (5 p1). Exercise is arguably the number one key component to preventing and treating diabetes. Exercise improves the body’s use of insulin, burns excess body fat to gain weight control, increases bone density, increases muscle strength, lowers blood pressure, increases HDL and lowers LDL preventing heart disease, increases energy level, and reduces stress and tension which promotes relaxation.

Education is a key aspect for people with diabetes. A person with diabetes must have the desire to learn as much as they can so they can always be prepared for different situations and circumstances. Whether a person has diabetes or not, maintaining a proper diet is a tremendous part of ensuring a healthy lifestyle. There are many resources available with thousands of ideas and food recipes that are healthy and tasty for people with diabetes. Gaining a strong support group to help deal with stressors and give encouragement is incredibly essential. Children can play a very supportive role and positively influence parents who have diabetes (9). Reports were given that children exercised with the parents, shopped for healthy foods, reminded parents what to eat, reminded parents to take medications and assisted with tasks such as taking blood pressure or checking blood glucose levels (9).

If a person with diabetes has friends who have diabetes, they can together become a team and prevent potential complications by maintaining their health and exercising. If diagnosed with the disease it is vital to continue to set goals and continue to have life aspirations for the future. “If you want to live a happy life, tie it to a goal, not to people or things – Albert Einstein” (7). This will avoid depression and will ensure the maintenance of a productive lifestyle.

The ability to dream is crucial to maintaining all six dimensions of health and living a healthy life. “If I do this…I can do anything.” Perseverance is important for any person, and no one should ever give up on his dreams. Lastly, exercise is an amazing, simple behavior that everyone should incorporate into their daily living to help facilitate the maintenance of the six dimensions of health in order to reach a state of peace and wellness.

References

(1) Corbin, Pangrazi, (2001).  Toward a Uniform definition of wellness: a commentary.  President’s Council on Physical Fitness and Sports Research Digest, 3(15), Retrieved at: http://presidentschallenge.org/misc/news_research/research_digests/dec2001digest.pdf

(2) (2009).  Palo alto medical foundation.  Retrieved from http://www.pamf.org/patients/EXERCISE.html

(3) Stopka and Todorovich (2008).  Applied Special Physical Education and Exercise Therapy (5th ed).  Pearson.

(4) (n.d.).  American diabetes association.  Retrieved from http://www.diabetes.org/diabetes-basics/

(5) (2008, December 3).  Diabetes public health resource.  Retrieved from http://www.cdc.gov/diabetes/faq/basics.htm#2

(6) (n.d.).  Diabetes health center.  Retrieved from http://diabetes.webmd.com/default.htm

(7) (n.d.).  Albert einstein quotes.  Retrieved from http://thinkexist.com/quotation/you_have_to_learn_the_rules_of_the_game-and_then/253063.html

(8) Praet, S., & van Loon, L.  (2009).  Exercise therapy in Type 2 diabetes.  Acta Diabetologica, 46(4), 263-278.  doi:10.1007/s00592-009-0129-0.

(9) Laroche, H., Davis, M., Forman, J., Palmisano, G., Reisinger, H., Tannas, C., et al. 
(2009).  Children’s Roles in Parents’ Diabetes Self-Management.  American Journal of Preventive Medicine, 37(6), S251-S261.  doi:10.1016/j.amepre.2009.08.003.

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