Walking
Found To Help Diabetics Live Healthier
Study Shows Increased Life
Span
Individuals with diabetes
will probably live longer simply by strolling, a new report in the Archives
of Internal Medicine indicates.
An analysis of 2,900 adults
who had diabetes for an average of 11 years found that even two hours
of walking weekly reduced the risk of death by 39 percent.
Included in that reduction was a 34 percent
decrease in risk of death from cardiovascular disease, to which diabetics
are particularly prone.
Not
Just Healthier, But Living Longer
"This is the first study to look
at a nationally representative sample of people with diabetes,"
says Dr. Edward Gregg, an epidemiologist with the Centers for
Disease Control and Prevention (CDC), who conducted the analysis
and prepared the report.
"Other studies have found that people
are less likely to get new diseases if they walk, but we found that
walking will increase the length of life once people have diabetes,"
Dr. Gregg says.
This is particularly important, Dr. Gregg
adds, because of the incidence of the disease.
"Diabetes is one of the most common
chronic illnesses; the ratio in people 60 and older is one out of five
or one out of six," he explains. "But even though the disease
increases the risk for death, most people with diabetes will go on to
live for a long time.
"So one of the key things to do is
improve the quality of life, and walking will increase the length of
life once people have diabetes," Dr. Gregg says.
According to the National Institute
of Diabetes and Digestive and Kidney Diseases (NIDDK) and the
American Diabetes Association:
Diabetes affects an estimated 17 million
people in the US (90 to 95 percent have type 2 diabetes). Of these individuals,
11.1 million have been diagnosed, but 5.9 million are unaware they have
the disease.
For the analysis, Dr. Gregg and his colleagues
at the CDC used data from the 1990-1991 National
Health Interview Survey (NHIS) to look at the mortality rates
for 2,896 diabetics who had been sick for an average of 11 years. Their
average age was 59. In an eight-year follow up, 671 of the participants
died, 316 of those deaths were heart disease related.
Study
Takes a Close Look at Exercise Patterns
Looking at the health interviews that
were conducted in the early 1990s, including self-reports of exercise
among all the participants, the scientists found that those diabetics
who walked for at least two hours weekly had a 39 percent lower death
rate from all causes and a 34 percent lower death rate from heart disease
compared to those who did not walk.
Among those who walked between three and
four hours a week, the benefit was even higher, with a 53 percent lower
death rate from cardiovascular disease. Walking any longer than that
did not result in further benefit, however, the study points out.
Dr. Frank Hu, a diabetes specialist at
the Harvard School of Public Health who wrote an editorial that accompanied
the study, says the CDC study confirms that walking
is an important part of treating diabetes.
"Lifestyle modifications remain a
cornerstone for diabetic management," Dr. Hu says. "We have
very strong evidence that walking and other types of activity can go
a long way in reducing mortality and cardiovascular complications from
diabetes. Walking is as effective as medicines - probably more effective,
because walking has no side effects."
Always consult your physician for more
information.
Treatment
for Diabetes
Specific treatment for diabetes will be
determined by your physician based on:
- your age, overall health, and medical
history
- type of diabetes
- extent of the disease
- your tolerance for specific medications,
procedures, or therapies
- expectations for the course of the disease
- your opinion or preference
Treatment may include:
type 1 diabetes
Persons with type 1 diabetes no longer produce insulin, and they must
have insulin injections to use the glucose they obtain from eating.
Persons with type 1 diabetes must give
themselves insulin every day. Insulin can either be injected, which
involves the use of a needle and syringe, or it can be given by an external
or internal insulin pump, insulin pen, jet injector, or insulin patch.
Extra amounts of insulin may be taken before meals, depending on the
blood glucose level and food to be eaten.
Insulin cannot be taken as a pill. Because
it is a protein, it would be broken down during digestion just like
the protein in food. It must be injected into the fat under the skin
for insulin to get into the blood. The amount of insulin needed depends
on height, weight, age, food intake, and activity level. Insulin doses
must be balanced with meal times and activities, and dosage levels can
be affected by illness, stress, or unexpected events.
type 2 diabetes
Although persons with type 2 diabetes may continue to produce adequate
insulin for some time, their bodies can become incapable of using it.
This syndrome is know as insulin resistance, and may indicate the need
for oral medications that can help stimulate the pancreas to release
insulin or optimize the body's ability to use the insulin secreted.
Diet and exercise can often bring blood
glucose levels down to normal. When these measures are no longer enough,
the next step is the addition of medications that lower blood glucose
levels.
There are many considerations a person
with diabetes must take in order to properly manage his/her condition.
Always consult your physician for more
information.
Online
Resources
American
Diabetes Association
American
Heart Association
Centers
for Disease Control and Prevention (CDC)
Diabetes
Care
Healthier
US.Gov
National
Diabetes Education Program
National
Heart, Lung, and Blood Institute (NHLBI)
National
Institute of Diabetes & Digestive & Kidney Diseases (NIDDKD)
National
Institutes of Health (NIH)
|
August 2003
In
This Issue:
Walking
Found To Help Diabetics Live Healthier
Not
Just Healthier, But Living Longer
Study
Takes a Close Look at Exercise Patterns
Treatment
for Diabetes
Statins
Slash Heart Disease Risk for Diabetics
Online
Resources
Other
Resources:
Find
a St. John's Mercy Physician
Diabetes
Services at St. John's Mercy
Diabetes
Health Information
St.
John's Mercy Classes and Programs
In
Other Diabetes Health News:
Statins
Slash Heart Disease Risk for Diabetics
Supporting
statins' growing status as the aspirin of the 21st century, a new
study shows this medication can slash the risk of strokes, heart
attacks, and other cardiovascular problems in diabetics - even if
they do not have high cholesterol.
The study, reported in
the medical journal The Lancet, found giving these
cholesterol-lowering drugs to people with diabetes cut their risk
of heart and vessel trouble by about 25 percent.
The benefits of lowering
cholesterol were strong for both those with the blood sugar disease
but no warning signs of cardiovascular illness and those whose "bad"
cholesterol fell in the accepted normal range.
That is not surprising,
the researchers say, because very few people in industrialized countries
have "normal" cholesterol.
"We've all got levels
that are too high, and this study demonstrates that absolutely unequivocally,"
says research leader Dr. Rory Collins, of the University of Oxford,
England.
An estimated 100 million
people worldwide have diabetes, putting them at increased risk for
heart attacks and strokes.
If each of them were to
take statins routinely, Dr. Collins says, as many as 1 million of
these life-threatening events could be prevented each year.
"The logical conclusion
is to think about statins in the way we think about aspirin,"
Dr. Collins says. "Now we've got unequivocal evidence that
in people at high risk [for heart and vessel disease], by lowering
their cholesterol we will lower their risk, irrespective of how
low their cholesterol is to begin with."
Dr. Collins' group compared
the effects of routine statin use and no therapy in more than 20,000
Britons. Of those, roughly 6,000 had diabetes - mostly the adult-onset,
or type 2, form of the condition - while the rest had varying degrees
of blocked arteries but no blood sugar problems.
Half the volunteers were
given 40 milligrams a day of the drug simvastatin, sold as Zocor®
by Merck & Co., which helped fund the study. Half were given
a placebo, or inactive pill.
Over the next five years,
601 diabetics taking the statin suffered a first-time heart attack
or stroke, or required procedures to correct vessel blockages. The
figure was 748 in the group on placebo - a difference of 22 percent.
For those who had already had one of these events, the cholesterol
drug significantly reduced their chances of suffering a repeat attack.
In the 2,900 diabetics
without blocked blood vessels at the start of the trial, the reduction
was even greater: 33 percent fewer people in this group developed
heart or vessel problems.
And, among diabetics with
low-density lipoprotein (LDL), the dangerous form of cholesterol,
that was not high, taking the daily statin dropped their risk of
developing cardiovascular trouble by 27 percent compared with those
on placebo.
Dr. Collins says the benefits
of the drug persisted even in diabetics with LDL counts of 80 milligrams
per deciliter of blood, a figure generally thought to be excellent.
"Our hypothesis was
that irrespective of where you started in terms of your LDL cholesterol,
lowering it by the same absolute amount - an average of 40 milligrams
per deciliter - should reduce the risk of [heart and vessel problems]
by the same proportion," Dr. Collins says.
Always consult your physician
for more information.
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