Tai Chi Chuan and Diabetes

Yang Style Tai Chi Chuan Helps Diabetes Management

Type 1 Diabetes

Diabetes is a serious disease that occurs when the pancreas produces very little or no insulin (Type 1 diabetes), or alternatively, when the body cannot effectively use the insulin (known as insulin resistance) it produces (Type 2 diabetes). Insulin is a substance produced by the pancreas gland that helps process the food we eat and turn it into energy. Insulin regulates blood glucose levels.

Glucose is the principal sugar the body makes that serves as its chief source of energy. Glucose is carried through the bloodstream to provide energy to all cells in the body. Cells cannot use glucose without the help of insulin. Insulin resistance is the diminished ability of cells to respond to the action of insulin in transporting glucose from the bloodstream into muscle and other tissues. The result is an elevated level of glucose in the blood that, if left unchecked can cause a number of serious or life-threatening problems.

Type 2 Diabetes

 

Diabetes affects people from all walks of life and is reaching epidemic proportions throughout the world. In the US alone an estimated 20.8 million people have diabetes. Another 41 million have pre-diabetes, meaning having blood glucose levels that are higher than normal, but are not high enough to be classified (yet) as diabetes. And 1.3 million new cases of diabetes are diagnosed each year. Worldwide, it is estimated that 120 million individuals have the disease and this figure is expected to reach 330 million by 2030.
If diabetes is not well controlled it can cause long-term complications that over time lead to serious damage to many of the body’s systems, especially heart, blood vessels, eyes, kidneys, and nerves. These complications include retinopathy (the result of long-term accumulated damage to the small blood vessels in the retina), neuropathies (damage to nerves in the hands, arms, feet, legs, organ system, etc.) and nephropathy (kidney damage). Diabetics also face increased risks of heart disease, high blood pressure (twice as common in diabetics as in non-diabetics), strokes (mortality rates from this disorder are three- to five-times higher in diabetics) and peripheral vascular disease (damage to blood vessels).

diabetic complications

Good diabetes management is not only about lowering glucose levels, but also about the overall reduction in the risk factors for diabetic complications. This requires lifelong care and management. Studies have shown that many complications of diabetes can be prevented or delayed through effective management of the disease. This includes lifestyle measures such as a healthy diet, physical activity, and the avoidance of being overweight.
Although diabetes is an incurable, chronic disease, it is treatable, and the long-term complications are preventable. A successful life plan for diabetes is dependent on several factors. Three of the most essential are developing a lifetime eating plan, engaging in some form of physical activity, and attainment of an ideal body weight.

This article solely focuses on the effects and benefits of exercise on diabetes management. More specifically, the article takes a closer look at the benefits of including Traditional Yang Style Tai Chi Chuan as part of a diabetes treatment plan.

But a word of caution. Although there are two major types of diabetes (type 1 and type 2) the information presented in this article is more general in nature and does not target a specific type. The reality of how exercise affects blood glucose levels in each is complicated. Depending on the status of your condition and any diabetes-related complications you may have, you might have to take some extra precautions before making any changes in your activity level. Diabetes can cause health problems that can make certain types of exercise unsafe. The practice of Tai Chi is safe for those with either type of diabetes. It is incumbent on readers to do their homework relative to their type of diabetes before developing an exercise strategy. Each exercise plan has to be tailored to the individual. For most people, however, the benefits of exercise outweigh the risks.

Physical activity: An important tool for managing diabetes

Physical activity is a key factor in leading a healthy lifestyle and reducing the impact of diabetes on our health. Staying active is a very important part of diabetes management.
The interplay between exercise and diabetes is a critical one. Besides improving your overall fitness, exercise can also help you manage your blood sugar levels, control your weight and improve your cardiovascular health. Exercise also helps reduce the harmful effects of stress on glucose levels.

Exercise helps control diabetes by:

  • Improving the body’s use of insulin.
  • Improving muscle strength.
  • Burning excess body fat, helping to decrease and control weight (decreased body fat especially around the waist results in improved insulin sensitivity).
  • Increasing bone density and strength.
  • Lowering blood pressure.
  • Lowering ‘bad’ LDL cholesterol and increasing ‘good’ HDL cholesterol.
  • Improving blood circulation and reducing the risk of heart disease.
  • Increasing energy levels and enhancing work capacity.
  • Reducing stress, promoting relaxation, and releasing tension and anxiety.

Tai Chi: an important part of a diabetes management plan

What has Tai Chi got to do with diabetes? Studies have shown Tai Chi to have beneficial effects on cardio-respiratory fitness; muscular strength, balance, and peripheral circulation, while reducing tension and anxiety. All these factors help minimize the complications of diabetes.
According to the American Diabetes Association, a comprehensive physical activity routine includes three kinds of activities: aerobic exercise, strength training, and flexibility exercises.

The practice of Tai Chi meets all three criteria.

Several studies suggest that Tai Chi is a form of aerobic exercise that can improve aerobic capacity. For example, two separate studies conducted by the Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital and National Taiwan University, College of Medicine, Taipei, Taiwan, concluded that “Tai Chi Chuan is an aerobic exercise and suitable for participants of different ages and gender to improve their functional capacity.” One study goes on to say that “Our data substantiate that Tai Chi Chuan is aerobic exercise of moderate intensity, and it may be prescribed as a suitable conditioning exercise for the elderly.”
In the study, “Tai Chi: physiological characteristics and beneficial effects on health” conducted by the Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Tai Chi is classified as a “moderate intensity exercise that is beneficial to cardiorespiratory function, immune capacity, mental control, flexibility, and balance control; it improves muscle strength and reduces the risk of falls in the elderly.”
Muscles are the major “users” of circulating blood sugar. Since we lose muscle with age, rebuilding it with strength training is very important for older adults with diabetes. Tai Chi is a weight-bearing activity that involves lifting or pushing your own body weight as well as shifting weight from one leg to the other. As the muscles of the legs contract and relax during form practice, they use glucose for energy. Improving muscle strength improves the body’s use of insulin.

The benefits of Tai Chi practice in diabetes control

Long-term regular practice of Tai Chi – for 30 to 60 minutes most days of the week – can provide a variety of benefits in the control of diabetes. Among them are:
Better blood sugar control – Regular practice of Tai Chi can improve blood sugar control in type 2 diabetes. As muscles contract and relax during exercise, they use sugar (glucose) for energy. To meet this energy need, the body taps into sugar supplies in the blood during and after practice, reducing blood sugar level. In addition, improved insulin sensitivity means the body requires less insulin to escort sugar into the cells, which also reduces blood sugar level.
Effective stress management – When you have diabetes, stress can significantly affect your ability to control the disease. Stress can alter blood glucose levels either directly or indirectly. When stress occurs, increasing stress hormones (the body’s fight-or-flight response) may directly alter glucose levels by making a lot of stored energy (glucose) available to cells. Insulin resistance inhibits the body’s ability to let the extra energy into the cells, so glucose piles up in the blood.
Stress can also affect your blood glucose levels indirectly. People under stress are less likely to take proper care of themselves as they should. They may forget about the regular routine of their diabetes care plan that helps them control their blood glucose levels. When someone with diabetes is “stressed out,” they may exercise less or skip exercise altogether, eat more often and/or eat less healthy foods. In general people who are under stress may be more focused on the thing that is stressing them and less likely to be focused on managing their diabetes.
Although you can’t completely remove stress from your life, the regular practice of Tai Chi provides a means to counteract the effects of stress on blood glucose levels. Tai Chi invokes the body’s relaxation response by bringing together 3 powerful stress relieving techniques into one practice. These include breathing, muscle relaxation, and meditation. Reducing stress through the regular practice of Tai Chi will help to better manage glucose levels.
Control of emotional eating
– Often, our dietary choices are based on our state of stress and anxiety. Emotions can be triggers that produce a reaction in us that makes us want to eat. Thus, we end up eating for reasons that have nothing to do with nourishment.
Emotional eating is a problem for someone with diabetes that makes it more difficult to keep blood sugar levels under control. Practicing Tai Chi is a healthy way to deal with emotions that can trigger overeating. Instead of responding to stress or disappointment with unplanned, uncontrolled eating, relax, breathe and practice the form until the cravings subside. Tai Chi offers a major advantage as an alternative to emotional eating: It’s enjoyable, and can be practiced almost anytime and almost anywhere.
Better weight control – Being overweight is the number one risk factor for type 2 diabetes. Excess weight can alter how your body responds to insulin. And it can also lead to other health problems, such as heart disease and high blood pressure that can significantly complicate your diabetes. Maintaining a healthy weight is crucial when you have this disease. Even a modest weight loss (5-10 percent) can substantially reduce insulin resistance and help control or even stop progression of type 2 diabetes in people with the condition.
With regular practice, Tai Chi burns calories, which helps you to lose weight or maintain a healthy weight. In addition, through the practice of Tai Chi (as with most exercise), one doesn’t feel as hungry, thus you eat less. And through the reduction of stress, you may tend to not only eat less, but better, by making better food choices.
Improved blood circulation – Diabetes often leads to peripheral vascular disease that inhibits a person’s blood circulation. With this condition, there is a narrowing of the blood vessels that frequently leads to significantly decreased circulation in the lower part of the legs and the feet. Poor circulation contributes to diabetic foot problems which can affect balance and stability in walking.
Tai Chi can improve circulation, especially in the arms and legs, where people with diabetes typically have problems. During Tai Chi practice the stretching and relaxation of the body helps to improve and restore muscle functions and improve blood circulation. Tai Chi practice helps to stretch and relax the muscles and promote blood circulation by decreasing the muscle tension which inhibits blood flow. The increase in the relaxation of the blood vessels helps to open, stretch and strengthen the capillary system within the body. Tai Chi is also easy on the feet where many of the problems associated with poor circulation exist and has been proven to be effective in improving balance and mobility.
Reduced blood pressure – Having diabetes increases your risk of developing high blood pressure and other cardiovascular problems. High blood pressure is an important risk factor for the development and worsening of many compli¬cations of diabetes, including diabetic eye disease, blood vessel damage, stroke, heart attack and kidney disease.
Having a normal blood pressure is as important to managing diabetes as having good control of your blood sugars when it comes to preventing diabetes complications. Tai Chi has long been recognized as being effective in reducing high blood pressure. Tai Chi techniques improve the body’s strength and flexibility, teach one how to relax mentally and physically, and show how to better manage stress reactions such as muscle tension, rapid heart rate, constricted breathing, and anxiety.
As mentioned earlier in this article, Tai Chi brings together the 3 powerful stress relieving techniques of breathing, muscle relaxation, and meditation. These techniques are as applicable to reducing blood pressure as they are to the control of glucose levels. The practice of Tai Chi will help control high blood pressure as it contributes to greater general health and well-being.
Diabetes can strike at any age, but your risk for developing the disease increases as you age. Although diabetes is a potentially life-threatening condition, people with well-managed diabetes can expect to live healthy lifestyles.
There is no cure for diabetes. However, it is almost always manageable, either with diet and exercise alone or with the addition of regular medical treatment. Diet and exercise also are key to reducing risk. If you are diagnosed with diabetes, you can cut by half or more your risk of developing many of the associated complications such as kidney disease and neuropathy by following an intensive glucose management regimen.
Successful diabetes management is based on a simple and powerful promise: Make small changes, get big results. If you already have diabetes, make Tai Chi practice a priority in your diabetes management plan. If you do not have diabetes, make Tai Chi practice a priority in your’ preventive health and wellness program. Either way, you will reap the numerous health benefits that a consistent practice routine provides. Taking good care of your diabetes today means avoiding other health related problems from the disease in the years to come.

mgyang04.jpg Tai Chi is not the only form of exercise for people with diabetes, nor should it be considered a treatment by itself. A healthy eating plan, adhering to medication, stress control, as well as a safe exercise routine recommended by qualified health professionals are the cornerstones of diabetes self management.
Tai Chi is cost-effective and facilitates a lifestyle of health-related behavior practices such as good posture, healthy breathing and relaxation. You get the benefits from Tai Chi through practice. But it takes commitment. By taking control of your own health, you can enjoy the benefits of graceful aging well into your old age. It’s never too late to start. Once learned, Traditional Yang Style Tai Chi Chuan is a treasure that will last you a lifetime ….. a long lifetime.
Explore the power within you to change your life!.

By William W. Wojasinski, Director. Louisville Center

Excerpted from The Journal of the International Yang Style Tai Chi Chuan Association. Number 20. fall 2006. p13-15

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