In a Facebook post that went viral, 18-year-old Madeline Milzark wrote, “Diabetes isn’t your piece of cake… or anything you see coated with sugar… Diabetes is a whole ton of people who fight for their lives every single day and go to bed not sure if they’re going to wake up the next morning.”
The American Diabetes Association estimated that nearly 30 million Americans have diabetes today. A population of 86 million also has pre-diabetes across the country. Dr. Kris Berg described diabetes as an “epidemic condition in the United States.” He recently retired from a 45-year career with the University of Nebraska at Omaha (UNO) as Professor of Health, Physical Education and Recreation.
Twenty-five years ago, he started a program -- “Special Exercise for Life and Fitness (SELF),” -- for people with Type 1 and Type 2 diabetes. “The patients kind of understood their unique problems and medicines including insulin and sulfonylureas. They knew that exercise could lower blood sugar, but there was nowhere they could go in the community,” said Dr. Berg.
The Birth of “Special Exercise for Life and Fitness (SELF)”
As a trained exercise physiologist, Dr. Berg used to give lectures on diabetes around Omaha, Nebraska. Eventually, he decided to bring people in and show them what to do to meet their needs, instead of just talking about it. The SELF program was born as a result.
“We facilitate people’s blood glucose management and improve their overall health in the program,” Dr. Berg explained. “We measure blood sugar levels of the participants before and after the exercises and give them guidance on whether or not they need medication. If they have low blood sugar, we have glucose available to them.”
The blood sugar level monitoring supports diabetes patients to exercise safely. Patients are trained to do a good complement of all-around movement patterns and exercises that combine endurance with strength, speed, power, balance and coordination. Dr. Berg and his team would identify individuals whose blood sugar levels were not well-regulated, and advise them to stop training to avoid ketoacidosis.
Research-based Exercise Programs
Years after its initial implementation, Dr. Berg expanded the SELF program to cover other chronic conditions including arthritis, obesity, hypertension, and Parkinson’s disease. As the program was developed with evidence based on research, area physicians and people in the community who were aware of the program began to refer others to join.
Then in 2002, Dr. Berg participated in a research study with colleagues at the University of Nebraska Medical Center (UNMC), investigating if a strength and weight-training exercise program could prevent osteoporosis in breast cancer survivors. About a decade following the research, he launched a course called “Strong Bones.” Open enrollment is available to residents in the community who are age 60 or above at a cost of $54 for three months (with parking). Class meets twice a week for an hour and 15 minutes.
Dr. Berg said that participants are trained like an athlete, “but we tone it down so it’s proportional to their capacity” in an interview a few years ago. He also thought that exercise is medicine, and that “we all have the potential. We just have to make it a priority.”
“Researches show that exercises in general is neurorestorative, and it slows many conditions, whether it’s ALS or Parkinson’s,” Dr. Berg elaborated. “Even after one of these conditions evolves in people, exercise still seems to be somewhat restorative in nature. I’m not saying exercise is the cure. Nonetheless, it seems to be an important part of the treatment regimen.”