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Advocacy and Research

November is American Diabetes Month

By Riva Preil

November marks American Diabetes Month, and is therefore an appropriate time to discuss Diabetes Mellitus (DM). DM was first described in an Egyptian manuscript in 1500 BCE as a disease associated with increased urination (polyuria), and in fact the very name “diabetes,†which means “to pass through†was first used by the Greek Appollonius of Memphis in 230 BCE due to this trademark of the disease. The other two primary symptoms of DM are increased thirst (polydipsia) and increased hunger (polyphagia).

Normally, when a person eats carbohydrates, complex sugars are consumed, digested, and broken down into simple sugars (ex. glucose) which are sent to the bloodstream. Glucose is transported to the body cells where it is absorbed and metabolically broken down through cellular respiration in the mitochondria of the cell. This process produces ATP, or energy, and enables us to function. Insulin, produced in the pancreas, is vital in this process- it allows for normal transport of glucose into the cell. However, with DM, a person experiences hyperglycemia, increased blood sugar levels due to interference of glucose transport into the cells (to be discussed further- stay tuned for next blog).

There are generally two reasons for this abnormality: either the beta cells of the islets of Langerhans in the pancreas are not properly producing insulin (Type 1 or Insulin Dependent DM) OR the insulin is being produced, however the person has developed an insulin resistance (Type 2 or Non-Insulin Dependent DM), thus preventing glucose from entering the cells. In addition, a third type of diabetes known as gestational diabetes may develop in some pregnant women. It is associated with decreased insulin secretion thereby interrupting with glucose transport into the cells. The prevalence of gestational diabetes is 2-5% of all pregnancies, and it usually spontaneously resolves after childbirth. There is a correlation between gestational diabetes and future development of Type 2 DM. In fact, approximately 20-50% of women who experienced gestational diabetes while pregnant eventually develop Type 2 DM.

—FAQ

Frequently Asked Questions

Pelvic Floor Disorders and Treatment

What is pelvic floor dysfunction and why does it happen?

Pelvic floor dysfunction is extremely common and occurs when the muscles, tissues, or nerves of the pelvic floor are weakened, tightened, or injured by trauma, chronic strain, or overuse. Pelvic floor disorders can result from traumatic injury such as a fall, from sporting activity, surgery, or childbirth. They can also happen from more chronic issues, such as infection or chronic inflammation such as endometriosis. Pelvic floor disorders can be a consequence of poor alignment or posture, overuse, or improper movement. The pelvic floor muscles surround the urethra, rectum, vagina and prostate; therefore, if there is a dysfunction in these muscles it can result in urinary, bowel, or sexual dysfunction in people of all ages.

Who should I see to get a proper diagnosis?

Many healthcare providers don’t assess – or don’t know how to assess – the pelvic floor muscles and nerves, so it’s important to get a proper diagnosis from a practitioner who specializes in pelvic floor dysfunction and pelvic pain. Too often patients tell us that they’ve been to 10 different doctors and healthcare providers and their symptoms have not improved, or have worsened. Find a specialist right away and get on the path to healing as quickly as possible.

Why do healthcare providers miss (or misdiagnose) pelvic floor dysfunction?

Long story short, the medical practice is divided into areas of the body: Urology. Orthopedics. Gynecology. But the body itself doesn’t have walls; every system interacts with everything else. Sometimes providers are so laser-focused on what they treat that they miss the whole picture. 

As more and more research emphasizes the importance of physical therapy as part of a complete treatment regimen, more and more physicians are learning how to recognize and treat pelvic floor disorder. In the meantime, if you’re not getting relief from your current treatment, make an appointment with a pelvic floor specialist to learn more.

How does pelvic floor dysfunction affect sex?

Pelvic floor muscles have a huge impact on sex. Muscles that are shortened or tight and are unable to elongate will not allow for good blood flow into the genitals. This can result in pain, weaker erections, diminished sensation, inability to orgasm, and even decreased lubrication. Pelvic floor PT can help with these issues by enhancing blood flow and improving muscle function. 

How can pelvic floor dysfunction cause bloating?

Pelvic floor dysfunction, a condition characterized by the inability to correctly relax and coordinate pelvic floor muscles, can significantly contribute to bloating due to its impact on gastrointestinal functions. When these muscles are not functioning properly, it can impact the ease of emptying and make it difficult for your body to pass stool and gas through the intestines. This obstruction leads to an accumulation of waste and gas in the gastrointestinal tract, causing bloating and abdominal discomfort.

Is it true there’s internal massage?

There can be. We do perform internal soft tissue mobilization of the pelvic muscles that are inside your pelvis and are accessible only through the vagina or rectum. We never do internal treatment without your consent and understanding.

What makes someone a pelvic floor PT vs a regular PT?

All pelvic PTs get additional training in pelvic floor internal treatment through continuing education and at our clinic. 

We pride ourselves on the level of training we provide, not just at the beginning but throughout the time our therapists spend at Beyond Basics. We know that learning is a life-long process.  We also provide additional training in physiology of the GI system and urinary system as well as sexual health and function and nutritional training. Most PT programs and schools do not provide the depth and breadth of knowledge that we provide all our PTs at Beyond Basics.

Get help now from a pelvic floor therapist.

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