Note: This article was originally published in the June 2010 issue
of the Denver publication Community News.
What do a fitness expert, a podiatrist, and a writer have in common? Well, we were all invited to take part in a day-long event at the Colorado Convention Center on March 27th of this year. It was the American Diabetes Association EXPO 2010, aimed at helping attendees learn about diabetes management and prevention. Exhibits and demos included free health screenings, exercise demos, healthy cooking demos, and exhibits featuring the newest products and services for diabetics. The Latino Zone presented all information in Spanish.
In the end, only one of the three of us actually attended the expo. That was Kim Lyons, a former trainer on the TV show The Biggest Loser, who conducted several exercise sessions. Prior to the event, I conducted telephone interviews with both her and Dr. Greg Still, a Denver-area podiatrist who specializes in diabetic foot care and treatment.
Prior to doing the interviews, I received several pages of information from a publicist, Kate F. Boes, about DPN (Diabetic Peripheral Neuropathy) and about Kim Lyons.
Before I tell you more about Kim and her valuable work, here is some general information on diabetes and DPN. Sources were the above-mentioned materials and interviews, emedicinehealth.com, and the websites of the American Diabetes Association, the NIH (National Institutes of Health), and the Mayo Clinic. The following is only a brief sampling of the wealth of information which is available online and in print publications. Some of the statistics are a few years old, as up-to-date ones are not yet available, but they give the reader a good idea of the tremendous impact of this disease.
Some 24 million Americans now have diabetes. Some 57 million more people have pre-diabetes. More than 1.6 million new cases of diabetes are diagnosed every year. In 2006, diabetes was the seventh leading cause of death in the U.S. Slightly more than 23% of Americans age 60 or older have diabetes. Blacks and Hispanics have somewhat higher rates of diabetes than do other ethnic groups. The American Diabetes Association estimates the total yearly cost of the disease to be at least $218 billion (2007 estimate, the most recent available).
In Type 1 diabetes, previously known as juvenile diabetes, the body does not produce insulin. This is an autoimmune disease whose exact cause is not known. Genetics and exposure to certain viruses may trigger it. Only 5-10% of diabetics have this form of the disease.
In Type 2 diabetes, the body becomes resistant to insulin or the pancreas does not produce enough insulin. This type tends to run in families. Risk factors include overweight or obesity, smoking, high blood pressure, high cholesterol, high blood triglyceride (fat) levels, a high-fat diet, heavy alcohol consumption, a sedentary lifestyle (not getting enough exercise), and aging. One out of every six overweight adolescents aged 12-19 has pre-diabetes.
These can include death, heart disease, stroke, blindness, kidney disease and failure, nervous system disease (neuropathy, discussed in more detail below), and amputation. More than 60% of non-traumatic lower-limb amputations, those not due to accidents, are performed on people with diabetes.
Type 1 is usually recognized in childhood or early adolescence. Symptoms are often dramatic and come on suddenly. Diabetic ketoacidosis is characterized by nausea and vomiting. Dehydration and disturbances in blood levels of potassium follow. Without treatment, ketoacidosis can lead to coma and death.
Symptoms include frequent urination, unusual thirst, extreme hunger, unusual weight loss, extreme fatigue, irritability, frequent infections, blurred vision, cuts or bruises that are slow to heal, tingling or numbness in the hands or feet (due to nerve damage), and recurring skin, gum, or bladder infections. However, it is possible to have diabetes but no symptoms. That's only one reason why regular medical checkups are important. Simple blood tests can detect elevated glucose, cholesterol, and triglyceride levels.
The treatment of Type 1 diabetes always involves the daily injection of insulin. For both types of diabetes, regular monitoring and care from a healthcare provider is essential. For Type 2 diabetes, there are several different medications available, which are beyond the scope of this article. Self-care at home would include such things as learning to eat a healthy and consistent diet, striving to lose weight if overweight is a problem, getting regular exercise (any is better than none), drinking less alcohol or eliminating it from the diet, and quitting smoking. Smoking greatly raises the risk of complications from diabetes.
Nerve damage from diabetes falls into several classes, depending on which part of the body is affected. Some of the many body parts that can be affected include the feet, legs, hands, arms, buttocks, digestive system, heart, blood vessels, sweat glands, eyes, ears, and sex organs (resulting in erectile dysfunction and vaginal dryness).
Peripheral neuropathy affects the toes, feet, legs, hands, and arms. It can result in a variety of unpleasant sensations or lack thereof: numbness or insensitivity to pain or temperature, tingling, burning, sharp pains or cramps, extreme sensitivity to touch, and loss of balance and coordination. The symptoms are often worse at night. Not surprisingly, the pain can also result in depression.
Both the material on diabetes that I read and Dr. Still emphasized that proper foot care is of the utmost importance to diabetics. There are several good summaries of diabetic foot care on the Web. The feet need to be frequently inspected and kept clean and smooth. The toenails need to be properly trimmed. Socks and shoes cannot be too restricting, and must fit so as to avoid any irritation of the feet. Calluses, foot blisters and sores may go unnoticed. If these are not detected and treated promptly, infection may spread to the bone, and the foot will have to be amputated. Afflictions of the foot due to peripheral neuropathy can also include hammertoes and collapse of the midfoot.
Fortunately, there are a great many people in this country, medical professionals and others, who want to do their part to educate and care for all those who are either in danger of developing diabetes or who have already done so. Kim Lyons is one of those concerned professionals.
Her present specialty is designing and teaching exercises for those with Painful Diabetic Peripheral Neuropathy, working to help people manage both their pain and daily activities. When one watches her exercise videos and speaks to her (even over the telephone, as I did), it quickly becomes obvious that her good looks and sparkling personality are supplemented by intelligence, hard work, imagination, and a tremendous desire to help others.
Kim attended Colorado State University, where she majored in Human Development. It was when she was working at the front desk at a gym - and struggling with her own weight issues - that she became interested in physical training: first to get in shape and lose weight, and then to help others. She became certified to teach aerobics, then weight training. She attended the National Academy of Sports Medicine and became certified as a personal trainer and nutritionist.
Over the next few years, she won national and international titles in fitness competitions and did fitness modeling. She also worked as a trainer on NBC's hit show The Biggest Loser. She's the author of the popular book Your Body, Your Life (Sterling, 2008). She's been featured on leading broadcast programs and in numerous print publications, including The Today Show, Larry King Live, Woman's World, Muscle and Fitness, and many more. She is currently writing a second book, as well as developing a special training system for people with diabetic neuropathy, one using grip-free resistance bands.
When I was reading all the material about Kim that Kate Boes had sent me, I was very impressed by the fact that someone with all that success and fame would concern herself so deeply with various segments of the population that are usually overlooked, or at least sidelined, by most other trainers. Those are the elderly, the extremely obese, and those with diabetic complications so severe that they can scarcely manage basic daily activities, much less exercise. But it is precisely these people on whom Kim has chosen to concentrate.
The bio sheet I have on her says that she is "unique in bringing in the often neglected emotional coaching that goes hand-in-hand with the workout and nutritional aspects of achieving ultimate health." She strives to help people overcome both psychological and practical barriers to starting an exercise program. She offers simple strategies to help people understand their own potential and to build their confidence.
All of this is quite evident when you view the short, simple exercise videos that you can watch for free online, videos in which she demonstrates gentle, non-strenuous exercises for people with peripheral neuropathy. She radiates kindness and concern.
In the interview, Kim explained to me the most basic concept in her approach to working with people with peripheral neuropathy. No matter how much they hurt, no matter how reluctant they are to even try to exercise, she works with them until she finds at least one part of their body that they can move with no pain, or at least less pain. Once they can do exercises with that body part, once they start to make progress, they are encouraged to go on, to try more. Here is the link to those free "Take the Next Step" videos: http://www.diabetespainhelp.com/nerve-pain-and-diabetes-management.aspx
She has also produced a series of longer commercial videos, the Start Fitness Now series, available on www.Amazon.com.
Kim also gives diet advice and tips on how to work more exercise into your daily life. Suggestions include eating a little protein with every meal (vs. so many carbohydrates), getting more sleep (that helps people lose weight), carrying a hand basket when shopping for just a few items (rather than pushing a cart), standing up while talking on the phone, taking the stairs vs. the escalator at the mall, and walking vs. taking the "people mover" at the airport.
The NIH recommends two common supplements, alpha lipoic acid and evening primrose oil, to relieve symptoms of neuropathy and improve nerve function. The supplement bitter melon can help lower blood sugar. (See swansonvitamins.com for low prices on high-quality supplements.) And Kim agrees with the NIH's strong anti-smoking message. They say that smoking "significantly increases the risk of foot problems and amputation."
In conclusion, I would like to say that this was an very enjoyable writing assignment. I learned a vast amount while writing this article, and hope that it has added to your knowledge, as well.