Diabetes is considered the oldest disease in human history. It affects the way the human body handles glucose. Despite the disease having prevalence in any age group, research indicates that older people, for long excluded from control trials regarding its treatment and the associated conditions, are more prone to it than younger ones. According to the American Diabetes Association (ADA) (2014) report, about 25% of Americans aged 60 years and above live with the disease. The report further acknowledges that aging is the primary cause of the epidemic. Older adults with the disease are more prone to both acute and chronic cardiovascular and micro-vascular complications. Due to the heterogeneity of the health status of the older adults, it is difficult to ascertain a standard intervention approach that fits the entire population range. Thus, this research paper explores and designs an exercise program and prescription for older adults with diabetes. However, a brief overview of the types of diabetes causes, and symptoms would all be necessary for this research and as such are briefly discussed.
Causes of Diabetes Mellitus
Usually, the pancreases secrete a hormone known as insulin. It converts glucose in the body that is available in the foods we consume into energy. Whenever the cells fail to use the hormone as required, a medical phenomenon referred to as insulin incidence sets in. Initially, the pancreas secretes more insulin in an attempt to get the glucose into the concerned cells. However, it eventually fails to stand it, and as a result, sugar starts to accumulate in the blood stream instead as is the case with type II diabetes. [“Write my essay for me?” Get help here.]
It is worth noting, however, that the condition arises as a result of a combination of causes. These include Genes, extra weight, and metabolic syndrome to name a few. According to Joslin Diabetes Center (JDC) (2016), genetic history makes some people more susceptible to the disease than others. The different bits that DNA contains explain why some people in a certain family lineage stand at a more risk of getting the disease than others. Overweight is another possible cause of the disease. It stems from the fact that it leads to conditions that result in resistance to insulin. This is the reason attributed as to why type II diabetes affects both adults and children with obesity. Moreover, diabetes can also result from metabolic syndrome. Those people that sustain insulin resistance happen to live with several conditions such as extra fats, high blood pressure, high glucose levels in the blood and high cholesterol.
Research has also established that too much of glucose from the liver causes diabetes. When the blood sugar is low, the liver responds by secreting more glucose to counterbalance the condition. After meals, particularly containing high levels of carbohydrates, the blood sugar level escalates, necessitating the liver to reduce the secretion of glucose (Postic et al., 1999). In the case where people experience a breakdown in the communication between cells, the process of insulin secretion is affected giving rise to diabetes. It could be as a result of wrong signals or failure to pick messages correctly. Additionally, if the there is a breakdown in the beta cells, they send out the wrong amount of the hormone throwing off blood sugar, thus, predisposing people into getting the disease. In the entire analysis above, it should be noted that high blood glucose (that is characteristic of Diabetes Mellitus) is detrimental to cells.
Diabetes Mellitus Types
Diabetes is categorized into two; type I diabetes and type II diabetes. In the first case, the body immune system damages the cells responsible for the secretion of insulin, and ultimately, eliminating the production of the hormone in the body. It accounts for about 5% of the people living with diabetes.
Type II diabetes is not limited to age as it can set in at any stage of human development cycle. However, it becomes more prevalent as one transit from adulthood to old age. In children, this kind of diabetes seems to be on the rise too of late. It accounts of up to 95% of the people suffering from the disease. Here the body fails to use insulin correctly as required resulting into insulin resistance. As the condition worsens, the pancreases secrete a decreasing amount of insulin, resulting into insulin deficiency in the body. According to Olokoba et al. (2012), the type II diabetes mellitus is solely due to genetics and lifestyle factors. The later factors include sedentary lifestyle, physical inactivity, generous consumption of alcohol and cigarette smoking. Notably, obesity contributes 55% of type 2 diabetes incidences.
These types of diabetes differ from symptom manifestation. In type I diabetes, it starts either at childhood or at intermediate stages just before adulthood. The sudden symptoms compel the sufferers to seek medical attention because of an abrupt manifestation of high blood sugar symptoms. On the converse, in the type II diabetes, an individual may not necessarily portray symptoms before diagnosis. The disease shows up in mostly in adulthood. However, there are increasing cases of children diagnosed with the disease currently.
The two types of diabetes are similar in the manner that they both increase the sufferers’ chances of experiencing serious complications. However, it is much easier to monitor and manage the disease if the resultant complications can be prevented and contained. If this is not the case, diabetes can lead to kidney failure and blindness. As well, the disease continues to be the critical risking factor of heart disease, foot amputations and stroke. The type II diabetes predisposes patients to the risks of other complications long-term and short-term, often leading to premature deaths. The increase in mortality and morbidity rates in type II diabetes is due to the commonness of this kind of disease. This is because the disease has insidious onset coupled with late manifestation of the accompanying symptoms. As Olokoba et al. (2012) points out, it is even worse in low-income countries such as those in Africa, Latin America and some parts of Asia. According to JDC (2016), diabetes mellitus affects approximately 20.8 million Americans annually. While 1.5 million of them are diagnosed and are in total awareness of the disease, 6.2 million represent undiagnosed cases, hence unaware of their situation regarding the disease.
The Role Physical Exercises Play in Decreasing Medical Conditions
Overall, physical activities have several benefits to the skeletal health in the entire age spectrum, besides the general benefits to the body. Regular exercise is a vital part of managing diabetes when it is coupled with proper diet, taking medications according to prescriptions, and handling stress adequately according to Haskell et al. (2007). While the human body remains active, it increases the cells’ sensitivity to insulin, making it work more efficiently. These cells help in removing the glucose from the bloodstream leveraging a mechanism that is independent to that of insulin as one engages in physical excises. In other words, exercising regularly helps the body in lowering the blood glucose and hence, improving the body’s ability to handle sugar levels. Regular physical activities assist in reducing blood pressure as well as cholesterol levels in the body, burning calories necessary in either losing or maintaining body weight among a myriad of other benefits.
The contemporary research asserts that consistent decrease in muscle and strength fitness with age can be preventable in part if individuals always engage in regular physical activities. As people grow older, insulin sensitivity decreases partly due to lack of physical exercises. Lowering the rate at which one participates in physical activities predispose a significant number of people to the type II diabetes. Recent surveys regarding physical exercises training are involving older patients to identify whether this can improve their fitness conditions (ADA, 2004). The report indicates that patients do well with adequate training which as well boosts their metabolic responses. Additionally, maintaining quality levels of fitness leads to less cases of chronic vascular diseases, hence improving the quality of life.
The structured approach, as described by ASCM, gives particular recommendation regarding the frequency, type, duration and intensity of the necessary physical activities (Haskell et al., 2007). This approach currently captures lifestyle to enhance healthy lives. However, it recommends that diabetes mellitus patients should participate in a thorough evaluation using appropriate diagnostic survey. While doing this, the examination should examine for the possibilities of both macrovascular and microvascular to isolate compromising situations that can aggregate while engaging in an exercise program. As a result, this would necessitate the establishment of areas of concern, allowing one in designing an exercise prescription at individualized levels, which can help in minimizing risk to the patient.
Mainly, for older adult diabetes, they need to engage in several counseling sessions since there are some factors to be considered in implementing an exercise prescription. Patients are supposed to attend at least twice in such meetings and fill the activity assessment form as required in that matter. ASCM recommends that it is important to identify the physical status of the patient (Haskell et al., 2007). Then, the patient should be assessed for the potential necessity and cardiovascular pre-exercise testing to avoid mishaps while one engages in the program. The first counselling should seek to review the assessment form, with more focus on physical examination and the history of the patient. Equally, important, it should give room for identifying the performance goals of the person. The second session would help in reviewing the exercise prescription at an individualized level. [Need an essay writing service? Find help here.]
By examining an exercise assessment form, it would be easier to identify the levels of the physical activity. They include pre-contemplator, contemplator and active people. The first case categorizes people who do not have the intention of starting and do not necessarily exercise. The second instance identifies them as either to have considered beginning participating in the program or they have infrequently attend it. The active individual, on the other hand, has either achieved or near achieving the activity standards.
ACSM Recommendations for Old Adults
As ACSM recommends that both muscle-strengthening and aerobic activity are vital for healthy aging. It suggests that older adults can at the minimum achieve the best health benefits by engaging in the activity for two and half hours of aerobic activity at moderate intensity (for example brisk walking) every week on top of muscle-strengthening activities minimum two days a week. If the action involves aerobic activity of vigorous intensity, then old adults should engage in the program for 75 minutes. Additionally, they should participate in muscle-strengthening activities minimum two days per week. Alternatively, ACSM suggests that one can have the combination of the above discussed activity in addition of at least four days per week (Haskell et al., 2007).
Furthermore, for increased activity with an aim of obtaining additional health benefits, ACSM recommends that five hours of aerobic activity of moderate intensity is ideal if done weekly on top of muscle-strengthening activities done in two days every week. A patient can achieve this through a two-hour-and-half engagement in an aerobic activity of vigorous intensity weekly coupled with two-day muscle strengthening activities every week. Alternatively, one can obtain maximum benefits of physical activity by a combination of the two approaches plus two-day muscle-strengthening activities weekly.
Each recommended activity has specific requirements that one has to conform. With that in mind, creating an activity plan helps in addressing each activity. That would ensure that patients of different levels of diagnosis use the recommended physical activity that may not end up causing more harm. For instance, patients sustaining chronic conditions need a plan that incorporates prevention and treatment. Additionally, the exercise program should help them in gradually and progressively increasing physical activity as it may seem necessary as time advances as particular conditions of ACSM recommends (Haskell et al., 2007).. During the counselling session, physicians should encourage older adults to engage in sufficient physical activity on a weekly basis, ensuring they meet additional exercises as required regarding the specific goals and needs. For example, old adults can achieve the recommended minimum level of activity if they participate in several but short-lived physical activity. Patients should individualize their functional abilities through participation in a combination of different approaches as long as right the recommendation for a particular activity prevails.
Examples of muscle-strengthening and aerobic activities include callisthenic exercises, bicycle riding, dancing, swimming, walking and jogging among others. Intercepting warm-up and cool-down activities allow muscles to regain energy. Patients should self-monitor their activities regularly coupled with re-evaluation of the activity plan in analyzing improvement in their abilities. With that, they could be able to predicate if they should reduce or increase the physical activities so as not to overwhelm body abilities. Moreover, the old adults should be able to tell if they can increase their activity level or modify their diet as an approach to maintaining a healthy body weight (Buchner, 2009).[Click Essay Writer to order your essay]
Physical activity plays a significant role in promoting health and disease prevention. ACSM recommends that the time, frequency and intensity of the exercise entirely depend on the pre-exercise evaluation results. The previous discussions have shown that type II diabetes epidemic has a close association with the decreased activity levels, leading to increased obesity prevalence. Engaging in physical activity, thus, is a critical component of preventing and managing type II diabetes. Frequent exercising lowers the chances of the disease by improving the metabolic abnormalities as it could be easier to count an earlier progression of insulin resistance that leads to impaired sugar tolerance (ADA, 2004). For type I diabetes more emphasis should be focused on therapeutic remedies adjustments. This allows participating in physical activity safely in line with the patient’s goals and desires.
American Diabetes Association. (2003). Physical Activity/Exercise and Diabetes. Diabetes Care, 27(Supplement 1), S58-S62.
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Haskell, W. L., Lee, I. M., Pate, R. R., Powell, K. E., Blair, S. N., Franklin, B. A., … & Bauman, A. (2007). Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Circulation, 116(9), 1081.
Olokoba, A. B., Obateru, O. A., & Olokoba, L. B. (2012). Type 2 diabetes mellitus: a review of current trends. Oman Med J, 27(4), 269-273.
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