How Diabetes Impacts Your Health and Injury Recovery

Diabetes and cardiovascular disease (CVD) are closely linked, with diabetes being a significant risk factor for heart attacks and strokes due to chronic hyperglycaemia, inflammation, and associated metabolic disturbances.

How Diabetes Contributes to Cardiovascular Disease

1. Chronic Hyperglycaemia
   Elevated blood sugar levels damage blood vessels over time, leading to atherosclerosis (hardening and narrowing of arteries).
2. Insulin Resistance
   Common in type 2 diabetes, it worsens metabolic syndrome, which includes high blood pressure, high cholesterol, and obesity—all risk factors for CVD.
3. Increased Inflammation
   Diabetes triggers chronic low-grade inflammation, accelerating plaque build-up in arteries.
4. Lipid Abnormalities
   Diabetics often have high levels of LDL (bad cholesterol) and triglycerides and low levels of HDL (good cholesterol), increasing CVD risk.
5. Hypertension
   High blood pressure, common in diabetes, puts additional strain on the cardiovascular system.
6. Diabetic Cardiomyopathy
   Prolonged diabetes can damage heart muscle independently of coronary artery disease.

How We Diagnose Diabetes in the UK

Diabetes is diagnosed using several key tests:

• HbA1c Test – Measures average blood glucose over the past 2-3 months. A reading of 48mmol/mol (6.5%) or higher indicates diabetes.
• Fasting Plasma Glucose Test – A fasting blood sugar level of 7.0 mmol/L or higher suggests diabetes.
• Oral Glucose Tolerance Test (OGTT) – After fasting, blood sugar is measured before and two hours after drinking a glucose solution. A level of 11.1 mmol/L or higher confirms diabetes.
• Random Blood Glucose Test – A random blood sugar level of 11.1 mmol/L or higher suggests diabetes.

For more information, visit Diabetes UK.

How Diabetes Impacts Healing Times

Diabetes slows down the healing process due to:

• Poor Circulation – Reduced blood flow limits oxygen and nutrient delivery to wounds.
• Nerve Damage (Neuropathy) – Loss of sensation makes injuries go unnoticed, worsening infections.
• Immune System Impairment – Higher glucose levels weaken immune responses, increasing infection risks.

This makes wound care essential, particularly for foot ulcers and pressure sores.

If you have an injury and you suffer from diabetes, then your recovery will take longer.  This is simply a direct correlation to your reduced circulation.  It is therefore important to tell your physiotherapist you have diabetes and make sure you adjust your expectations accordingly.  Be patient and you will still recovery successfully and fully.

Role of Orthotics in Diabetes Management

People with diabetes, especially those with peripheral neuropathy, often develop foot ulcers and pressure sores due to loss of sensation and poor circulation. Orthotics can help by:

• Reducing Pressure Points – Custom orthotic insoles distribute weight evenly, preventing excessive pressure on any single area.
• Improving Balance and Stability – Proper arch support reduces the risk of falls, which is especially important for individuals with neuropathy-related balance issues.
• Enhancing Comfort – Cushioning in orthotics reduces foot pain and discomfort caused by nerve damage.

A study in the Journal of Foot and Ankle Research found that custom orthotics significantly reduced the occurrence of pressure sores in people with diabetes. Regular use of orthotics, along with proper footwear, can prevent complications and enhance mobility. For further guidance, visit Diabetes UK.

At Optimal Physio we provide gait analysis with leading technology that involves a force plate so we can accurately measure the pressure points in your foot and prescribe personalised solutions to reduce your risk of pressure sores. Contact us for more information about our orthotics or click here. 

Physiotherapy and Diabetes Management

Physiotherapy interventions have been extensively studied for their effectiveness in managing diabetes and its complications. Below are key findings from recent research:

Physical Activity and Diabetes-Related Complications

A meta-analysis found that high levels of physical activity reduce the risk of CVD, mortality, and microvascular complications in individuals with diabetes (PubMed).

Types of Exercise Recommended

1. Aerobic Exercises – Improves cardiovascular fitness and glycaemic control. Examples: Cycling, brisk walking, swimming, jogging.
2. Resistance Training – Builds muscle strength and improves insulin sensitivity. Examples: Weightlifting, resistance bands, bodyweight exercises. This is absolutely essential for all diabetics.
3. Flexibility & Balance Exercises – Reduces fall risk. Examples: Yoga, Tai Chi.
4. High-Intensity Interval Training (HIIT) – Short bursts of exercise with rest periods. Effective for cardiovascular health (PubMed).

How to Reduce or Reverse Type 2 Diabetes Through Nutrition

Type 2 diabetes is a condition that develops when the body becomes resistant to insulin or when the pancreas fails to produce enough insulin. While it is a chronic condition, research has shown that it can be managed and even reversed through lifestyle changes, particularly diet. In this article, we will explore how modifying your nutritional habits can help reduce or reverse type 2 diabetes.

1. Prioritise Whole, Unprocessed Foods

One of the most effective ways to control blood sugar levels is to base your diet on whole, nutrient-dense foods. These foods have a lower impact on blood glucose and help improve insulin sensitivity.

• Vegetables: Leafy greens, cruciferous vegetables (broccoli, cauliflower, cabbage), and non-starchy vegetables should be the foundation of your diet.
• Healthy Proteins: Include lean meats, fish, eggs, tofu, and legumes to help stabilise blood sugar levels.
• Healthy Fats: Avocados, nuts, seeds, and olive oil provide essential fatty acids that support metabolic health.

2. Reduce Intake of Refined Carbohydrates and Sugars

Refined carbohydrates and sugars are among the biggest contributors to insulin resistance. Cutting back on these foods can drastically improve blood sugar levels and insulin function.

• Avoid Sugary Beverages: Soft drinks, fruit juices, and energy drinks cause rapid blood sugar spikes.
• Minimise Processed Foods: White bread, pasta, pastries, and other refined grain products lead to blood sugar fluctuations.
• Opt for Whole Grains: Brown rice, quinoa, and whole oats have a lower glycaemic index and provide sustained energy.

3. Increase Fibre Intake

Fibre helps regulate blood sugar levels by slowing digestion and promoting gut health. Aim for at least 25–30 grams of fibre per day.

• Best Sources of Fibre: Beans, lentils, chia seeds, flaxseeds, whole grains, and vegetables.
• Benefits: Fibre-rich foods promote satiety, reduce sugar cravings, and enhance insulin sensitivity.

4. Embrace a Low-Carb or Mediterranean Diet

Studies show that low-carb and Mediterranean diets can help reverse type 2 diabetes by improving insulin sensitivity and promoting weight loss.

• Low-Carb Approach: Reducing carbohydrate intake to 50–100 grams per day can lower blood sugar levels and improve metabolism.
• Mediterranean Diet: Rich in fish, nuts, olive oil, and vegetables, this diet has been linked to better blood sugar control and heart health.

5. Practice Intermittent Fasting

Intermittent fasting (IF) has been shown to help with insulin sensitivity and weight loss.

• How It Works: IF involves restricting food intake to specific hours of the day, such as an 8-hour eating window (e.g., 12 pm–8 pm) and a 16-hour fasting period.
• Benefits: Fasting allows the body to reduce insulin levels, burn fat, and improve metabolic function.

6. Stay Hydrated and Limit Alcohol Consumption

• Water is Key: Staying hydrated helps regulate blood sugar and flush out excess glucose.
• Limit Alcohol: Excessive alcohol can cause blood sugar fluctuations and liver stress.

7. Monitor Your Blood Sugar and Adjust Accordingly

Tracking blood sugar responses to different foods can help you identify what works best for your body.

• Use a Glucose Monitor: Regularly check fasting and post-meal blood sugar levels.
• Adjust Diet Accordingly: Reduce or eliminate foods that cause large spikes in blood sugar.

8. Supplement Wisely

Certain supplements may support better blood sugar control:

• Magnesium: Improves insulin function.
• Berberine: A natural compound that has been shown to lower blood sugar levels.
• Cinnamon: May improve glucose metabolism.
• Protein: Helps build muscle when combined with strength training.

9. Maintain a Healthy Weight

Losing as little as 5–10% of body weight can significantly improve insulin sensitivity and reduce the risk of complications.  Muscle mass is where we store insulin within the boy.  The more muscle we have the easier it is to control our blood sugar levels.  As a result strength training is more important than cardiovascular exercise and should be prioritised for those suffering from diabetes.

Using Stimpod for Peripheral Neuropathy Relief

Peripheral neuropathy is a common complication of diabetes, causing pain, numbness, and balance issues due to nerve damage. One promising treatment is the Stimpod NMS460, a neuromodulation device that stimulates nerve repair and reduces pain.

✔ Pain Reduction – Stimpod uses electromagnetic pulses to target damaged nerves, helping to relieve chronic pain.
✔ Nerve Regeneration – It promotes nerve healing by improving communication between nerves and muscles.
✔ Improved Balance & Function – By enhancing nerve signals, Stimpod may help restore sensation in the feet, reducing the risk of falls.

For those struggling with diabetic neuropathy, Stimpod offers a non-invasive, drug-free option to improve comfort and mobility.

Optimal Physio is the first clinic in Scotland to offer this treatment which is not available on the NHS.  It is cutting edge technology from America and it can help the nerve recover. Get in touch for a free trial session to see if you would qualify for this treatment.

Conclusion

While type 2 diabetes is a complex condition, it can often be managed—and in some cases, reversed—through smart dietary choices. By focusing on whole foods, reducing refined carbs and sugar, increasing fibre, and maintaining a healthy weight, you can take control of your health and improve insulin function. Consistency and a long-term approach to nutrition are key to achieving sustainable results.

Exercise is a cornerstone of managing diabetes and CVD by improving insulin sensitivity, lowering inflammation, and enhancing cardiovascular health. Regular exercise, along with a healthy diet, significantly reduces complications and improves quality of life.

For more information, visit Diabetes UK.