Frozen Shoulder and Leg Muscle Disability for Older Diabetes

Frozen Shoulder and Leg Muscle Disability for Older Diabetes

Physical inactivity is the second most important risk factor in developed countries, after tobacco smoking. It increases total mortality, doubles the risk of cardiovascular diseases, diabetes and obesity, and substantially increases the risk of high blood pressure, lipid disorders, colon cancer, osteoporosis, depression and anxiety.


Diabetes affects more than 70 million women in the world. This figure is projected to double by 2025. Diabetes can lead – in addition to CVDs - to blindness, nerve damage, kidney failure, foot ulceration and amputation. recent study shows that even modest regular physical activity and dietary changes can prevent more than half of the cases of non-insulin dependent diabetes.An increase in the prevalence of type 2 diabetes among youth has been particularly alarming aspect of this epidemic, but the diabetes epidemic in developed countries affects the entire age range, and the greatest absolute increase and total numbers of diabetes cases are actually occurring among the elderly.

The capacity of the human body to make use of muscle strength peaks between ages 20 and 30 and from there on steadily declines with age, most significantly between ages 50 and 60.Physical activity is especially important for older adults because it can lower the risk of heart disease or heart attack, lower blood pressure, control diabetes, and help maintain healthy weight level. It is never too late to start an exercise program.

Researchers suggested that skeletal muscle, which makes up ~40% of the body mass, is the major tissue involved in glucose metabolism and an important site of insulin resistance in obesity and type 2 diabetes. Glucose transport and uptake are diminished in skeletal muscle in type 2 diabetes.The reduced muscle glucose uptake has been estimated to account for ~55% or even up to ~100% of the decrease in whole body glucose disappearance during clamp compared to healthy individuals.

These numbers are, however, calculated from leg muscle glucose uptake and extrapolated to the whole muscle mass, based on the assumption that glucose uptake is similar in upper and lower body muscles. The hypothesis is that the insulin resistance in TYPE 2 is primarily located in the leg muscles.In conclusion this study has shown that glucose clearance and insulin sensitivity are relatively preserved in arm muscles in type 2 diabetes, and that in both CON and TYPE 2 arm muscle glucose clearance is higher compared to leg glucose clearance.

At age 70, males are usually capable of exerting about 80 % and women around 65 % of the maximum muscle strength of young people aged 20.These changes are the result of reduction in the size and number of muscle cells. Leg muscle strength is particularly important in walking, negotiating stairs and maintaining general mobility.Indeed, for older people with diabetes, the threat of loss of independence due to progressing cognitive and physical decline may be of greater direct concern than the clinical progression of diabetes complications.

frozen shoulder, also called adhesive capsulitis, is an inflammatory condition that causes limited, or reduced motion range of motion in the shoulder joint. It can be caused by injury or disease. Pain results in decreased motion in the joint, which then lead to stiffness. Risk factors for frozen shoulder include diabetes, stroke, accidents, lung disease, and heart disease. The condition is uncommon in those under 40 years old, except in impact injuries.Nerves and joints can be damaged leading to pain, tingling, or reduction of sensation or reflexes in the legs or arms. In some cases, the muscles become abnormally weak. The person becomes less sensitive to insulin, which sometimes results in type 2 diabetes.

Frozen Shoulder, also called shoulder capsulitis, is common complication of poorly controlled diabetes. Sufferers first notice this when they try to put on t-shirt or reach for something in the back seat of their cars while sitting in the front seat. Although this condition affects both shoulders, it is usually much more severe on the dominant side.Frozen Shoulder is probably caused by glycosylation of protein in the fibers of the tendons that attach muscles to the shoulder.

Elderly people with type 2 diabetes have an accelerated loss of skeletal muscle strength compared with their counterparts without diabetes, Korean and US researchers report in the current issue of Diabetes Care.

Lead investigator Dr. Seok Won Park told Reuters Health that elderly adults with diabetes lose leg muscle strength about 50 percent faster than their peers without diabetes, which may explain the two-fold higher risk of physical disability in diabetics.

To investigate the changes in muscle mass and strength in community-dwelling older adults with or without type 2 diabetes, Park of Bundang CHUniversity, Sungnam, and colleagues studied datfor 1,840 subjects between 70 and 79 years old. Of this group, 305 had type 2 diabetes.

Leg and arm muscle mass and strength were measured at study entry and 3 years later. The diabetic group showed statistically significant greater declines in leg muscle mass than did the subjects without diabetes. Leg muscle strength and maximum leg muscle strength per unit of muscle mass also declined more in the diabetics.

The researchers observed no between-group differences in changes in arm muscle strength and quality.

Park and colleagues also noted however that the approximate "50 percent more rapid decline in the knee extensor strength in older adults with diabetes was not accounted for by greater loss of leg muscle mass."

These and other findings, suggest that diabetes may cause functional impairments in the muscular function of the legs that are not necessarily accompanied by the loss of muscle mass.

Type II (maturity-onset) diabetes usually occurs after the age of 40 and is strongly associated with obesity. Glucose tolerance deteriorates with increasing age. Regular moderate exercise appears to reduce the risk of developing Type II diabetes in both normal and obese middle-aged people.Later-stage diabetes is associated with many disorders (such as blindness and neuropathy which can lead to the amputation of extremities), each of which has its own substantial impact on function and quality of life.

Regular, moderate physical activity can delay functional decline and reduce the onset of chronic diseases in both healthy and chronically ill older people. Healthy people can engage in most forms of physical activity as long as they do not involve excessive exertion. From the age of 50 onwards, the benefits of regular physical activity can be most relevant in avoiding, minimizing and/or reversing many of the physical, psychological and social hazards that often accompany advancing age. greater degree of physical activity can help to prevent many of the negative effects of aging on functional ability and health. Regularly active individuals are less likely to withdraw from society and are more likely to actively contribute to social life. Leg muscle strength is improved through walking and cycling, and this contributes to reduced risk of injury
from falls among older people.

Always warm up the shoubler before engaging in physical activity. It is better to exercise gently to strengthen the muscles. Finally, heat treatments or ultra-sound treatments have been found to be beneficial in helping to loosen the shoulder and providing some relief for pain.Physical therapy helps you regain muscle strength and teaches you ways to move safely with weak or paralyzed muscles.

Studies have shown that increased levels of physical activity are associated with reduced incidence of coronary heart disease, hypertension, non-insulin-dependent Type 2 diabetes, colon cancer, depression and anxiety.The older people become, the more they need regular exercise. It helps prevent bone loss (reducing the risk of fractures) and reduces the risk of dozens of diseases associated with aging. It also increases muscle strength and may improve balance and coordination, which can reduce the likelihood of falling. It also increases the ability for basic living, making it easier to carry grocery bags, get up from chair and take care of household chores. Being physically active is real key in maintaining quality of life and independence.

Exercise also helps to protect us from some of the normal effects of aging, such as:

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