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People with type 2 diabetes developed better blood sugar control if they combined aerobic exercise with lifting weights, according to a recent Canadian study. Researchers split participants into four groups:

• Aerobic exercise only
• Resistance training only
• Aerobic exercise and resistance training
• No assigned excercise

After 22 weeks, hemoglobin A1c levels improved for all three exercise groups but those who got aerobic exercise and also lifted weights had the biggest improvement. There was no improvement in the non-exercise group. An editorial published with the study in the Annals of Internal Medicine says "Doctors should prescribe exercise to all type 2 diabetes patients who are healthy enough to work out".

 Photo courtesy of New York Times 

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My patients with type 2 diabetes realize that blood sugar control, a balanced diet, weight management, regular exercise, and checkups are essential to their overall health. However,  many don't realize that regular care of EVERY part of their body is extremely important  to avoid serious complications.

Here are the  5 biggest concerns:

• Foot infections
• Chronic skin infections
• Gum disease and tooth loss
• Vision problems 
• Heart disease and blood circulation problems

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            In a study  funded by the Juvenile Diabetes Research Foundation, and published in the Sept. 8 ,2008 online edition of the New England Journal of Medicine, researchers found that adults gained substantially better control of their diabetes when using continuous glucose monitoring versus a group using conventional, intermittent blood sugar management. Improved diabetes control was determined by a hemoglobin A1c test, which measures how effective blood sugar  control is over three months.          

Patients on continuous glucose monitoring had a disposable blood sugar sensor placed under the skin. The device used in the study monitored blood glucose about every five minutes. The sensor was worn for a few days and then replaced. A pager-like device displayed blood glucose levels on a continuous basis. Data  was received from a transmitter which had received it from the sensor.

"Getting better control of diabetes using continuous glucose monitoring is almost certainly likely to equate with fewer long-term complications. This will have substantial long-term benefit on quality of life and reduce health care costs", said lead researcher Dr. Roy W. Beck, from the Jaeb Center for Health Research in Tampa, Fla.

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A growing number of overweight American children and adolescents are being diagnosed with chronic diseases once considered illnesses of adulthood.

In addition to the well-known rise in Type 2 diabetes among U.S. youth, children affected by obesity also are suffering from fatty liver disease, hypertension, high cholesterol and sleep apnea.  Concern is mounting because the long-term effect of developing chronic diseases early in life can lead to a slew of health issues.

"The earlier you develop diabetes, the more likely you are to develop complications," says Dr. Paula Butler, chief of endocrinology at Mount Sinai Hospital. "People will be having eye problems early, heart problems early, strokes early and go on dialysis. They will suffer knee and back pain, have sleep problems. They may not be able to work. It affects quality of life."

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A study recently published in the New England Journal of Medicine, followed 3,277 newly diagnosed Type 2 diabetes patients who were asked to tightly manage their blood sugar either through diet restrictions or drugs.

The results show that the group taking insulin had a 15 percent lower risk of heart attack and a 13 percent lower risk of death compared with the group who used diet. The early, intensive approach to blood sugar control amounted to a head start. The researchers call this the "Legacy Effect."

 "These results emphasize the importance of detecting and treating diabetes at the earliest opportunity and the major benefits that can be obtained with good blood glucose control."  said Professor Rury Holman, of Oxford University, who led the study.

Intensive and not-so-intensive approaches to blood pressure were also compared among the diabetes patients in the study. When the study ended, the patients who took the intensive approach were less likely to have died from diabetes, had a stroke or developed diabetes-related complications.

It's not news that controlling blood sugar and blood pressure are musts for managing type 2 diabetes. But the new findings show that doing so promptly and intensively will lead to a lower likelihood of a heart attack as well as a healthier cardiovascular system.

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