holistic healing

Web Exclusive: Working with diabetic Pilates clients

Collin Reynolds

Type I Diabetes:
Also known as juvenile diabetes, type I can actually be contracted at any age, often following one of two conditions: a virus or a pregnancy. In the first case, after a person gets a virus, the white blood cells attack the beta cells of the pancreas, which produce insulin. In the second case, during pregnancy, a mother's pancreas can get overly taxed, causing her to require extra insulin until delivery. Many of these women later contract diabetes, resulting from damage to the beta cells. Type I diabetics must take insulin every day for the rest of their lives, in very specific amounts to balance their digestive systems.

Type II Diabetes:
Also known as adult onset diabetes, type II happens mainly to people in middle age or later. Though their bodies still produce insulin, a type II diabetic's cell walls have become resistant to insulin, resulting in the inability to create energy from food. These adult diabetics have to get in shape, and may need to loose some weight, or they may end up needing to take insulin, just like type I diabetics.

Conditions to Watch For

You'll want to find out specific information about your diabetic client's condition in order to work as effectively and safely as possible.

Hypoglycemia, or low blood sugar
: Especially with insulin dependent diabetics, determine if the person has a history of low blood sugar, because this will affect their Pilates performance. Symptoms of hypoglycemia include light-headedness, weakness, instability, shakiness and headache and can cause unconsciousness if not treated immediately.

Hypoglycemic diabetics should consult their physicians when starting a new exercise program. They should always have some sort of quick acting carbohydrate snack with them when working out, and they should also bring their blood glucose meter to check blood sugar a half-hour before and after exercising.

Hypoglycemia typically manifests itself in a pattern in diabetics. To ensure that the client doesn't have a blood sugar dip during a class or lesson, determine the person's hypoglycemic pattern. If the client tends to get hypoglycemia at the same time every day, then pick a time during which blood sugar tends to run more normal.

Hyperglycemia, or high blood sugar:
If a diabetic suffers from hyperglycemia, a common condition to both type I and type II, then determine the clients' hyperglycemic pattern (as with hypoglycemia, above) and ask how long the problem has existed. Symptoms include severe thirst and hunger, negative mood, dry skin, excessive urination, blindness or compromised eyesight and weight loss and can lead to coma and death if left uncontrolled.

If the client experiences high blood sugar periodically, then determine the pattern and schedule sessions when levels tend to run more normal. As with hypoglycemic clients, have these clients consult their physicians before starting and bring their blood glucose meter to check levels a half-hour before and after exercising.

If blood sugar exceeds 250 before a workout, then do low impact exercise, because adrenaline actually makes blood sugar climb even higher.

If a client has had high blood sugar consistently for even a few months, then it may have already done damage to their body, affecting the nerve or kidneys or even causing blindness. Make sure your client doesn't have one of these conditions, and require a doctor's examination if he or she hasn't had one in the past six months.

If your client has one of diabetes' long term effects, then consult with a physical therapist if necessary to come up with appropriate modifications.

Keeping Clients in Balance

Diabetic clients should watch for blood sugar, weight and appetite changes, because any significant alteration of a diabetic's life pattern will affect medication dosages.

The client should check blood sugar four to five times per day, and record the numbers, along with amounts and types of food eaten, and any kind of excessive activity, like exercise, that explains blood sugar fluctuation. The client's doctor should study these records frequently, especially if patterns change, because insulin dosages may need to reflect these changes. (For example, if a diabetic's insulin absorption increases as a result of exercise, then significantly less insulin will be needed to stabilize blood sugar levels.)

Posture Protocols

Though posture, fitness level and age will range tremendously among diabetic clients, they all share a common weak spot: the pancreas and its nerve endings in the low thoracic spine. From this central weakness radiates a pattern of common postural imbalances and muscular restrictions.

The compromised pancreas and nerve endings tend to create misaligned shoulder blades, forwardly rotated shoulders, weak and overly extended lats and triceps, a tight restricted chest, forward head position and splayed ribs. Exercises that engage, strengthen and stretch the upper spine, shoulders, chest and neck will help bring the body gradually into a natural alignment.

Meditational and mind/body sequences and cues actually help diabetics as much as intensive exercise. High levels of stress hormones escalate blood sugar levels, so focusing on relaxation can help improve their health.

Collin Reynolds is a diabetic and the co-owner of Vitality Studio, a Pilates studio in Philadelphia.