Exercise offers diabetics surprising benefits

by Rintos Mail features@theborneopost.com. Posted on March 29, 2015, Sunday

SOME may consider exercise a nuisance, a chore, or simply a bore.
But if one has been diagnosed with Type 2 diabetes, one may need to look at physical activity in a whole new light.
Now, exercising has been acknowledged worldwide as a tool to control diabetes.
Just like taking a drug or altering one’s diet, exercise can lower blood sugar on its own even if one does not lose weight.
Although its benefit has been acknowledged throughout the world, exercising is still the most under-used treatment among us here. In fact, exercising has been found to be very powerful in controlling diabetes, a few studies have claimed.
Malaysian Diabetic Association Sarawak secretary Daniel Voon said tai chi is one of the good forms of exercise to control diabetes.
He believes tai chi works in the same way as other mind-body therapies, and there is ample evidence that paying attention to the connection between the mind and the body can relieve stress, combat disease, and enhance physical well-being.
Tai chi has three major components — movement, meditation, and deep breathing.
Voon said he used to do the 18-step tai chi but has stopped due to age.
“I’m 83 now and at my age, the 18 steps are too much for me. I did it for a long time before but stopping as I could no longer cope,” admitted Voon, who has lived with diabetes for 28 years.
He said instead of doing all the steps, he modified some in order to continue with his daily exercise.
He does a few steps for about five minutes before continuing with walking or jogging for another 10 minutes.
“I’m doing exercise every day,” said the former lecturer of the then Batu Lintang Teachers College.
Voon took up tai chi after a bladder operation in 1990. Before that, his fitness regime included swimming and badminton.
“Because I couldn’t swim and play badminton after my operation, I decided to do light exercise. I learnt the 18 steps of tai chi in Tabuan Jaya. They are for the older people like me,” he said.
Tai chi is a gentle exercise with slow, deliberate movements, meditation and deep breathing, believed to enhance physical health and emotional well-being.

Voon shows the normal, pre-diabetes and diabetic readings of blood sugar.

Need for balance
According to Voon, serious tai chi is based on spiritual and philosophical ideas that advocate a need for balance in body, mind and spirit.
“My modified tai chi exercise also suits the older people because we don’t have to run. We just stand and move a little bit but it can still burn glucose if we do it seriously.”
Voon said tai chi could be done in a sitting position, adding that while sitting, one could still move, breathe and meditate, and the movement involved is also a form of exercise.
Tai chi is a Chinese martial art combining diaphragmatic breathing and relaxation with soft, gentle movements. It is considered moderate exercise, previously shown to improve immune system response in contrast to strenuous physical activity which depresses it.
Previous studies have shown tai chi improves respiratory and cardiovascular function while improving flexibility and relieving stress.
Voon said the United States is already introducing tai chi as a health-enhancing activity while a few studies had suggested tai chi could help control diabetes.
According to a University of Florida study, a regular tai chi exercise programme may help lower blood glucose levels, allowing people with diabetes to better control their condition.
Looking at adults with Type 2 diabetes, the study found that participants, following a supervised tai chi exercise programme two days a week,  supplemented with three days of home practice for six months, lowered their fasting blood glucose levels, better managed their condition and improved their overall quality of life compared to those at a much lower level of intervention.
Earlier, two small studies published in the British Journal of Sports Medicine in April 2008, found that tai chi exercises could also improve blood glucose levels as well as the control of Type 2 diabetes and immune system response.
In 2009, researchers at the University of Florida studied 62 Korean women assigned to one of two groups — a control group and an exercise group that began  regular practice of tai chi.
Those who completed the tai chi sessions showed significant improvement in blood sugar control. They also reported increased vitality, energy and mental health.
Voon said tai chi is great for patients who do not like to exercise and those who could not participate in games and sports.
The style and movements of tai chi are very slow, circular and fluid, and this is a good way for patients to think of them.

Voon shows a list of some of the bad effects of diabetes.

Two types of exercise
There are two main types of exercise — aerobic and anaerobic. According to Voon, tai chi belongs to the former.
Aside from tai chi, other aerobic exercises include running, dancing, games and sports whereas anaerobic exercises work the muscles like in weightlifting.
Voon said all aerobic exercises worked better for diabetics as they enhance the entry of glucose into cells, even without insulin, and increase cell metabolism.
“This results in the breakdown of glucose to provide energy, and therefore, the lowering of glucose. This is clearly shown again and again when we measure people’s blood sugar before and after exercise.”
Voon pointed out that exercise and training increased muscle bulk, which in turn increased the utilisation of glucose and further lowered blood sugar.
He said aerobic exercise actually helped burn glucose as it used a lot of oxygen whereas anaerobic exercise did not.
“Therefore the latter does not help diabetics much,” he noted.
Voon also said most Type 2 diabetes came about because the visceral fat or the inner fat was markedly increased where people tended to look overweight and obese.
“When the visceral fat becomes too much, it causes insulin resistance as if one is short of insulin. That’s why, we ask people to keep reducing weight because when the inner fat is reduced, the insulin is better.”
He said insulin opened up cells to the entry of glucose, adding that cells used glucose to metabolise — which then produced energy.
He noted if cells lacked glucose, they might starve and die.
So, if you have diabetes, exercise offers surprising benefits. As it lowers your stress levels, it also lowers your blood sugar level.
The right exercise regime
But how much exercise is right for you?
For diabetics, Voon recommends at least three times a week, each taking about 30 minutes.
Exercise is so important for people with diabetes that the Malaysian Diabetes Association Sarawak branch invites patients in Kuching to join them for aerobic exercise at its premises compound at Jalan Maxwell at 5.30pm every Friday.
For patients wishing to work out on their own, there are many exercises that will benefit them as well such as walking, jogging, tai chi and swimming.
Because anyone can do it almost anywhere, walking is the most popular form of exercise. Thirty minutes to one hour of brisk walking, three times a week is a great and easy way to increase your physical activity.
It is also reported that swimming stretches and relaxes the muscles and doesn’t put pressure on the joints, which is great for diabetics.
For those with diabetes or at risk of developing diabetes, studies show swimming improves cholesterol levels, burns calories and lowers stress levels.
To get the most benefit from swimming, it is recommended that patients swim at least three times a week for at least 10 minutes and gradually increase the length of the workout.
As for dancing, it is believed to be great for the body not only physically as the mental work to remember dance steps and sequences actually boosts brain power and improves memory.
For diabetics, dancing is a fun and exciting way to increase physical activity, promote weight loss, improve flexibility, lower blood sugar and reduce stress.
Voon pointed out that aerobic exercise not only reduces blood sugar but also preserves the heart.
He said during exercise, the heart becomes stronger and exercise markedly reduces the chances of narrowing of blood vessels.
“Exercise not only strengthens the heart but also protects the heart,” he added.

Exercise can control sugar levels which is beneficial for those with diabetes.

Coping with life as a diabetic

by Rintos Mail, features@theborneopost.com. Posted on March 22, 2015, Sunday

Voon takes his blood to be tested and at right inserts the black code key into a glucose meter.

DANIEL Voon was diagnosed with diabetes in 1987 when he was 55 years old.
He has been living with Type 2 diabetes over the past 28 years.
The 83-year-old is very open about his condition — maybe you would be too if you have had the disease all this while.
“I have never been secretive about it. I think the more open you are with people, the better it is. After all, at some point, you might need their help or you may even help to create awareness of the disease among others,” he said.
While it is not the first thing the octogenarian will talk about when he meets someone new, he, nonetheless, is not really worried about telling people if he needs to explain the effects of the disease to them.
After all, he is secretary of Diabetes Malaysia, Sarawak branch.
Voon, a former lecturer at the Batu Lintang Teachers’ Training College — now Teacher Education Institute Batu Lintang Campus — can still remember when he first knew he had a high glucose level.
“One day, in 1987, I went to meet my friend, a doctor, at his home and between our chatting, he suggested I make a random blood test for glucose level. I didn’t hesitate. He gave me the test and found my glucose level at 11.”
The doctor friend then advised him to double check and seek medication.
The blood test at a government clinic (at Jalan Masjid, Kuching) showed an even higher reading. He then asked to be registered as a diabetic patient at the clinic.
“After consultation with the doctor, I began my diabetic control by doing exercise and watching my diet. I had been doing that for five years.
“Later, I found I could not control my condition and asked for oral medication. I tried that for two months but still it was difficult to control, so I tried insulin. Since 1992, I have been dependent on insulin injections,” he revealed.
Not a surprise
Voon said he was not surprised he has diabetes. His mother and his maternal grandmother also had it.
“My grandma went through amputation while my mum had kidney failure. In the 1970s, there was no medication for diabetes, let alone insulin injections. The tips for diabetics at the time were only exercise and diet control.”
Voon said living with diabetes left him with little choice but to change his lifestyle, pointing out that aside from diet control, he had to do regular exercise.
“I have to watch not just what to eat, but also the portion, at every meal.
“To make sure my diabetes is under control, I bought a blood test meter to check my blood pressure and a smart check meter to test my glucose level every day.
“I do random blood glucose tests before going to sleep and fasting blood glucose tests early in the morning after waking up. I have to do it every day to have an idea whether my insulin is working or not.”
Voon has avoided high sugar, high fat, high salt and high carbohydrate food most of the time. He still consumes them but in controlled portions.
“For example, if I take one plate of rice (high in carbohydrates) last time, now I take a quarter plate.”
 
Different diet controls
However, Voon said his diet control may not be suitable for others as it all depends on the individual.
“The personal diet of one diabetic may not suit everybody — there is no one-diet-fits-all formula.”
He said some people could not avoid eating a large portion of rice because they need the energy to work.
“For example, it’s impossible to expect a farmer to eat less rice and take less sugar. These are good sources of energy and the farmers need them to do their work.”
As far as Voon is concerned, regular exercise does help him control his glucose level and blood pressure.
He used to swim and play badminton before undergoing a bladder operation in 1992. Subsequently, he took up health-enhancing exercises such as Tai Chi and walking, but stopped the former when it became too strenuous.
“I made modifications, taking just a few steps to do some exercise at this age. I do my modified Tai Chi exercise maybe for five minutes, then the other exercises like walking and jogging for about 10 minutes.”
Voon suggested that if one feels unwell, it is always better to find out whether diabetes is the cause.
Based on information displayed at the association, among the signs of diabetes are frequent passing of urine, thirst, weight loss, tiredness, frequent skin infections, blurring of vision, dental disease, numbness in the hands or neck, and itching especially of the genitalia.
The chronic complications of diabetes include heart attack, blindness, stroke, kidney failure, damage to blood vessels in legs, foot ulcers or gangrene, impotence, nerve damage and leg amputation.
Diabetes may also sometimes lead to cancer, brain damage, enlarged heart, heart failure, pregnancy complications (large babies), high blood pressure, bad cholesterol, being overweight and obesity.
Better now than later Voon said it is better for one to know now rather than later so that one could learn more about the long-term effects and complications of the disease, and make more lifestyle changes.
“It’s hard to advise people but if you have been diagnosed with Type 2 diabetes, you’d better commit yourself to making gradual changes and putting a healthy and realistic routine together,” he pointed out.
He suggested joining a support group for the knowledge and long-term success.
“The group may offer emotional support to help the diabetics stay motivated and stick to positive lifestyle changes.”
Voon agreed that being diabetic does not mean the inability to live a normal life.
“You can live just as healthy a life provided you have the condition under control. You just have to be more conscious about yourself than the person next to you and learn what your body is telling you, and act on it.”
At 83, Voon still looks healthy — and does not seem to have diabetes. You would not know he is diabetic if he did not tell you.
He believes education on diabetes has been a lifesaver for him and could be for others as well.
“If we have more knowledge about the disease, we are in a better position to control it. Since I was diagnosed with diabetes, I joined the Diabetes Malaysia Association and from my involvement, I have learned a lot on how to control my glucose level. I know the importance of proper dieting and exercise in diabetic control — which I have been doing until today,” he explained.

Voon puts a test strip with his blood into the glucose meter (top) and shows his blood glucose reading.

Two types of diabetes
Type 1 diabetes develops when the insulin-producing cells in the body have been destroyed and the body is unable to produce any insulin.
Type 1 diabetes accounts for about 10 per cent of all adults with diabetes and is treated by daily insulin injections, a healthy diet and regular physical activity.
It can develop at any age but usually appears before the age of 40, and especially in childhood. It is the most common type of diabetes found in childhood.
Type 2 diabetes develops when the insulin-producing cells in the body are unable to produce enough insulin, or when the insulin produced does not work properly (known as insulin resistance). The cells are only partially unlocked and glucose builds up in the blood.
Type 2 diabetes usually appears in people over the age of 40, though in South Asian people, who are at greater risk, it often appears from the age of 25.
It is also becoming more common in children, adolescents and young people of all ethnicities.
Type 2 diabetes accounts for between 85 and 95 per cent of all afflicted people and is treated with a healthy diet and increased physical activity. In addition, medication and/or insulin are often required.
Often, diabetes is caused by poor diet. A lifetime of too much refined sugar and fat will put your body into a state where it is eternally having difficulties dealing with high sugar levels in the blood.

Public invited to free exercise to beat diabetes

Posted on March 20, 2015, Friday

KUCHING: Diabetes Malaysia (Sarawak branch) has embarked on a free exercise programme for the public, says its branch chairman Dr William Voon.
He said the programme was held from 5.30pm to 7pm on every first and third Friday of the month at the Diabetes Resource Centre at Bampfylde Road here.
“The next session will be held on March 20. Participation is free-of-charge. All are welcome.
“A lucky draw will be held at the end of each session to thank the participants,” Dr Voon said here yesterday.
He stressed that with the affluence the country had attained, lifestyle had changed.
“We eat a lot of unhealthy food and adopt a sedentary lifestyle. There have been consequences. Quietly, dreadful illnesses surface and diabetes mellitus is one of them.”
He said diabetes was a silent but devastating condition of insidious onset and by the time it’s diagnosed, the condition has been there for five years.
“What is disturbing is that diabetes, if not properly controlled, leads to blindness, heart attack, kidney failure, leg ulcers and amputation, stroke, impotence and more,” he warned.
Dr Voon said the good news was that with proper control, all these need not happen.
“Proper control means that we have to revert to a healthy lifestyle, which includes healthy eating habits and plenty of exercise. If these two are not enough, then medication may be needed, but not before the first
two.
“We invite all to exercise with us, meet new friends, learn more about diabetes and stay healthier into old age,” he said.
Recently, Dr Voon disclosed that an estimated 21 per cent or almost six million Malaysians were diabetics, making the country among those in the region with the highest number of diabetics.
He said the staggering number of diabetics was due to various reasons, the main one related to food intake (obesity) and lack of exercise.
Dr Voon disclosed that in the past 20 years or so, the trend had been going up.
And it had been declared epidemic in Malaysia as well as throughout the world.
However, he reckoned that the cases in Sarawak could be lesser at 15-16 per cent of its 2.5 million people, due probably to lesser number of people having their health screened.

Read more: http://www.theborneopost.com/2015/03/20/public-invited-to-free-exercise-to-beat-diabetes/#ixzz3f5FTYbH8

A silent killer on the rampage

by Peter Sibon, reporters@theborneopost.com. Posted on March 12, 2015, Thursday

Dr Voon (left) and the secretary of the Diabetes Malaysia, Sarawak Branch, Daniel Voon, speaking at The Borneo Post office in Kuching on Tuesday.

KUCHING: Almost 6 million Malaysians or 21 per cent of the population are suffering from diabetes, placing the country among the highest ranks in the incidence of the disease in the region,
This startling statistic was revealed Dr William Voon, chairman of Diabetes Malaysia, Sarawak Branch to The Borneo Post and Utusan Borneo here on Tuesday.
He said the main reasons for the staggering number of sufferers in the country were poor diet and lack of exercise which led to obesity.
“In the past over 20 years the trend has been going up. And diabetes has been declared a epidemic in Malaysia as well as throughout the whole world.”
He believed the incidence of diabetes in Sarawak could be lower than the national average with 15-16 per cent of the population diabetic.
However, the figure could be misleading as the people in the state were generally reluctant to go for screening, he added.
Dr Voon explained that there are two types of diabetes; namely type one and type two.
Type one diabetics are those who with defects of their pancreas or who suffered from a bout of illness which resulted in the malfunction of the pancreas while type two diabetes which usually occurs later in life is caused by unhealthy lifestyle.
Most people afflicted by diabetes in Malaysia are in the type two category which is preventable.
“The people should be guided away from diabetes so that they would have better life and go for regular checkups,” Dr Voon said.
He disclosed that the Diabetes Resource Centre run by the association located at Maxwell Road here is ready to assist people who need more information on the disease.
“We are also promoting proper diet and healthy lifestyle such as exercise to those who are interested. On top of that we are also ready to reach out to various communities and target groups,” he said.
As diabetes is incurable at present, Dr Voon advised patients not to fall prey to any kinds of food supplements or treatment which claimed to be able to cure the disease.
“But we never know as in the time to come we may get the cure through stem cells, etc,” he said.
“Most impotently, live a healthy lifestyle and prevent oneself from getting obese as it is one of the main causes of the disease,” he said, adding that the people should cut down carbohydrate but more vegetables and protein instead.
Meanwhile, when contacted, State director of Heath Department Datu Zulkifli Jantan confirmed Dr Voon’s statements.
“We have been promoting healthy lifestyle among the people and we are also providing free health screening in our clinics,” he said.
Diabetes Malaysia (Sarawak) has branches in Sri Aman, Serian, Sibu, Bintulu, Limbang and Sarikei.