Significance of Diabetes Mellitus in Rehabilitation

Physical therapists and occupational therapists may help reinforce the importance of patient compliance during pharmacologic management of diabetes mellitus. Therapists can question whether patients have been taking their medications on a routine basis. Regular administration of insulin is essential in preventing a metabolic shift toward ketone body production and subsequent ketoacidosis, especially in patients with type 1 diabetes. In addition, therapists can help explain that adequate control of blood glucose not only prevents acute metabolic problems but also seems to decrease the incidence of the neurovascular complications. 

Finally, rehabilitation specialists can encourage patient compliance in the nonpharmaco-logic management of their disease. Therapists can emphasize the importance of an appropriate diet and adequate physical activity in both type 1 and type 2 diabetes. Therapists may also play an important role in preventing the onset of diabetic foot ulcers and infection by educating the patient in proper skin care and footwear. 

Problem/lnfluence of Medication. Exercise produces an insulinlike effect that is, it lowers blood glucose by facilitating the movement of glucose out of the bloodstream and into peripheral tissues. Because insulin also lowers blood glucose, the additive effects of insulin and exercise may produce profound hypoglycemia. As a result, a lower dosage of insulin is usually required on days that involve strenuous activ- 

The islet cells of the pancreas synthesize and secrete insulin and glucagon. These hormones are important in regulating glucose uptake and use, as well as in other aspects of energy metabolism. Problems in the production and effects of insulin are typical of a disease known as diabetes mellitus. Diabetes mellitus can be categorized into two primary forms type 1 diabetes, which is caused by an absolute deficiency of insulin, and type 2 diabetes, which is caused by a decrease in peripheral insulin effects, combined with abnormal insulin release. 

Devendra D, Eisenbarth GS. Immunotherapeu-tic approaches to prevent, ameliorate, and cure type 1 diabetes. AmJ Ther. 2005 12 481-490. 

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