P H Y S I C A L T H E R A P Y N E W S
Predicting Insulin Resistance in Diabetes Patients:
Can Your Physical Therapist Play a Role?
Diabetes is a serious disease that afflicts 23.6 million people throughout the United States, equivalent to 7.8% of the total population. The complications associated with diabetes are severe and multifaceted, affecting the heart, blood vessels, kidneys, eyes, skin, and many other organs. Diabetes is far from a small problem and efforts to understand those at risk for the disease can go a long way toward disease management and prevention.
Insulin, a hormone released by the pancreas, is required of the body in order to utilize blood glucose (sugar) for energy. In type 2 diabetes, insulin is either not produced in high enough amounts by the body, or the body’s cells become resistant to the insulin produced. Hence, insulin resistance has long been considered a predictor of type 2 diabetes, and can occur years prior to development of the disease.
One of the well known risk factors for type 2 diabetes (the most common type) is physical inactivity. As such, physical activity level has been studied by researchers to determine its predictive ability in identifying those at risk for the disease, specifically those at risk for insulin resistance. Early identification of those at risk for insulin resistance can provide a significant head start on management of the disease, or preventing it altogether.
A research study published in the November 2008 issue of Physical Therapy looked at the role that physical therapists might play in the early identification of those at risk for insulin resistance. Primarily recognized for their role as rehabilitation professionals, physical therapists are also heavily involved in health promotion and disease prevention. Their expertise in the area of fitness assessment provides physical therapists with an opportunity to identify persons “at risk” for diseases that often accompany physical
inactivity, such as diabetes.
The study focused specifically on the ability of a group of physical fitness measurements (readily available to physical therapists) to predict insulin resistance. The study looked at 151 persons that had one or more risk factors for diabetes, and measured both the actual level of insulin resistance (using lab testing), as well as a number of physical fitness measurements (body composition, muscle strength, muscle endurance, flexibility, and cardiopulmonary endurance). The results of the tests were then statistically analyzed in order to determine if there was a relationship between actual insulin resistance, and the results of the physical fitness measures. That is, without performing lab testing for actual insulin
resistance, could the results of the physical fitness measures reasonably predict insulin resistance?
The study found that there was indeed a predictive relationship between a number of the physical fitness measures and actual insulin resistance in the participants. This study indicates that among other well known roles, your physical therapist may also be able to play a key role in the early identification of risk of insulin resistance – information that could change, or save a life.