Diabetes and Paralysis: Are You at Risk?

Addressing Risk Factors Through Healthy Eating, Exercise and Electrical Stimulation

Diabetes and healthy eatingFirst the good news: If you have paralysis, chances are you are going to live a long life. The bad news? A long life means you’ll be at risk for all of those common medical complications that come along with aging — including developing diabetes.

According to Dr. Kevin McCully, director of the Exercise Vascular Biology Laboratory at the University of Georgia’s Department of Kinesiology, there’s one important reason you might be at a greater risk for developing diabetes: you use a wheelchair.

“The lack of physical activity is a key risk factor,” he says, but that’s not the only reason.

People who use wheelchairs often have limited control over their food choices and have an unhealthy diet.

McCully estimates that diabetes is nearly three times more prevalent in someone who is paralyzed versus someone who is able bodied.

“Importantly, people who are disabled are more likely to suffer negative health consequences related to obesity than nondisabled people who are obese,” McCully says.

So, getting control over diabetes is even more important for those who use wheelchairs.

Stimulating the Muscles

Exercise is a great way to reduce weight and thereby lower the risk of diabetes. However, people with paralysis who do not have the use of their legs must work their arms, which is a bit of a problem.

“Arm and shoulder injuries are very common in people with spinal cord injuries due to overuse and to exercising with their arms above their heads, much like a football linemen commonly has shoulder injuries from blocking with their arms out above their heads,” explains McCully. “It is important to be very careful with arm exercise as a shoulder injury could very seriously limit the independence of a person in a wheelchair.”

McCully and other Shepherd Center researchers have found a solution to this issue: electrical stimulation.

The theory is that increasing the size of and endurance in the leg muscles helps the muscles use more sugar from the blood, thereby reducing the risk for diabetes.

In fact, McCully’s current research is determining whether it’s better to increase muscle size or muscle quality or if both are in fact needed.

Participants in this study do either an assisted weightlifting exercise in which leg weights are used to lift 40 times a day, two times per week, or electrical stimulation with a commercial stimulator six times a second for 30 minutes, three times per week. After four months, researchers evaluate the participants' ability to use glucose.

Currently electrical stimulation is recommended only for people with partial paralysis.

“With complete paralysis, the stimulation is not considered to be worth the effort,” McCully says. “Our experiment is testing whether electrical stimulation training has enough health benefits to be recommended for everyone with a spinal cord injury who has paralyzed their leg muscles. This assumes there aren't other medical reasons that would make the stimulation unsafe, but our study could lead to new guidelines on how to help people with spinal cord injuries remain healthy and avoid expensive healthcare treatments.”

What Can You Do to Lower Your Risk?

Even if you’re not a candidate for electrical stimulation, getting daily exercise can do a lot to improve your weight and regulate glucose. Make healthier food choices and figure out a way to incorporate low-fat food and plenty of fruits and vegetables — especially dark leafy greens, beans, peas and whole grains — into your meal plan.

A Diabetes Prevention Program study showed that people at high risk for type 2, or adult-onset, diabetes could delay and possibly prevent the disease by losing 5 to 7 percent of total body weight through regular exercise and healthy eating.

If you have trouble preparing your own food, an occupational therapist might be able to show you some kitchen modifications and tools to help you be more independent in the kitchen. You might also enlist the aid of a nutritionist who can show you how to plan and prepare healthier versions of your favorite dishes.

Electrical stimulators are available but require a doctor’s prescription. McCully warns that doctors might not approve the purchase of an electrical stimulation device for someone with a complete spinal cord injury.

To find out more about McCully’s work, visit Facebook and the Exercise Vascular Biology Laboratory's Web site. You can also contact McCully via e-mail.

To find out about diabetes prevention, visit the Centers for Disease Control and Prevention's Web site on diabetes.

About the Author

Elisha Bury is the editor of The Mobility Project. She can be reached at consumer@hmemediagroup.com.