Bachillerato

Research review

First Step to Active Health for Diabetes
First Step at ICAA Conference Phil Page and Michael Rogers presented the session “First Step to Active Health for Diabetes” at the International Council on Active Aging Conference 2008 in San Antonio, Texas, in December. This Journal on Active Aging® article gives Page and Rogers the opportunity to share this information with Journalreaders as well. For a brief overview of the recent ICAA event, turn to “ICAA Conference 2008: Delegates share experiences and expand horizons” on page 66. Research supports exercise for older adults with Type 2 diabetes by Phil Page, PT, ATC, MS, CSCS, and Michael E. Rogers, PhD, CSCS, FACSM Diabetes is a chronic disease affecting an estimated 180 million people worldwide, advises the World HealthOrganization.1 In the United States, 24 million people—8% of the population—have diabetes, and the number of individuals with this condition grows every year, increasing 25% in the past 6 years alone2 (see Figure 1 on page 45). In fact, the US Centers for Disease Control and Prevention (CDC) recently estimated that one in 3 (~30%) Americans born in 2000 will develop diabetes in their lifetime.2Today in the US, the disease is more commonly found in men, blacks and Hispanics, as well as individuals in the southeast. Many older adults also live with this condition. In 2007, 23% of adults 60 and older had diabetes, according to CDC.2 The decrease in muscle mass and physical activity with aging are thought to lead to increased diabetes risk in this age group. And the impact on society issevere. Healthcare costs related to diabetes totaled $132 billion in 2002, with more than half those costs attributed to adults over 65.3 Diabetes is characterized by an increase in glucose (sugar) in the blood. Normally, the hormone insulin is secreted by beta cells in the pancreas to remove glucose from the bloodstream, and into

44 The Journal on Active Aging

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January/February 2009

USpopulation with diabetes
40
Millions

30 20 10 0 2002 2005 2008 Projected

although an alarming number of adolescents are now being diagnosed. Fully 90–95% of all diabetes diagnoses are Type 2. There are several ways to assess blood glucose levels, including a fasting blood test, oral glucose tolerance test, and hemoglobin A1c (HbA1c) levels. HbA1c is a monitoring of glucose control over 2–3months based on levels of hemoglobin, a blood protein. Normal levels range from 6.5 to 7. Every one percent increase in HbA1c increases risk of death by 28%,4 while a one percent decrease reduces microvascular complications (which involve small blood vessels) by 37%.5 Recently, a cluster of signs and symptoms have been associated with the development of Type 2 diabetes, including obesity, highblood pressure, and hyperlipidemia (elevation of blood lipids, or fats). This cluster is known as metabolic syndrome or prediabetes, and predisposes individuals to develop Type 2 diabetes. People with Type 1 diabetes are treated with insulin, while those with Type 2 diabetes or prediabetes are usually treated with lifestyle modification, including diet and exercise. (Medication may be prescribed forType 2 diabetes if lifestyle

modification does not control the condition.) Diabetes complications, however, may affect an individual’s ability to exercise. The impact of diabetes on physical health and activity Diabetes causes numerous other chronic conditions such as blindness, heart and kidney disease, and amputation, leading it to be ranked as the seventh highest cause of death in the US.2Heart disease is the leading cause of diabetes-related deaths (68%).2 In addition, 75% of people with diabetes have hypertension, and are at a twofold to fourfold greater risk for stroke2 (see Table 1 below). High glucose levels from diabetes cause many problems in the circulatory system (turn to “Pathology of diabetes complications” on page 50 for details). Major comorbidities of diabetes are...