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Cardiac Rehab Program physicians
Cardiac Rehab Program physician Dr. Michael Sarin (L) makes it his mission to educate program participants, including Charles Reynolds, about diabetes prevention. (Photo: UHN)

Charles Reynolds is going head-to-head with diabetes – and he's determined to win the battle. 

After a blood test revealed that he's pre-diabetic, which means he's at a higher risk of the disease that causes a build-up of sugar in your blood, and, in turn, further health complications, he adopted a healthy eating, exercise and medication regimen to ward it off. 

"The key to staying healthy was learning how to ask my doctors the right questions," says the 77-year-old.

It's a skill Charles says he picked up as a participant of Toronto Rehab's Cardiovascular Prevention and Rehabilitation Program – a six-month program that helps people with heart disease improve their health and fitness. 

Weekly sessions include a half-hour educational class, to support a participant's understanding of their condition, followed by an hour-long exercise component. 

"Here, I'm made to feel like I can do something about my diabetes risk," Charles says. "I'm encouraged to take control, learn about my health, and be a real partner in my care."

The connection between diabetes and heart disease may not seem obvious, but the two go hand-in-hand.

The factors that lead to heart disease also increase your risk of diabetes: insufficient physical activity, poor eating habits, and being unfit, to name a few. 

And last week, in honour of World Diabetes Day, the cardiac rehab staff held a five-day event to raise awareness and promote positive action. 

'Pre-diabetes is just diabetes in training' 

Each year, about 2,000 participants attend cardiac rehab at Toronto Rehab's Rumsey Centre.

Many, like Charles, are living with pre-diabetes – when blood sugar levels are higher than normal, but not quite enough to be classified as diabetic. 

The catch? Pre-diabetes is a symptomless stage, which means those who have it might not even know. 

"Pre-diabetes is just diabetes in training," says Dr. Michael Sarin, Program Physician & Diabetes Educator for Cardiac Rehab and the Diabetes Exercise and Healthy Lifestyle Program.

"Within seven to 10 years, almost 50 percent of people with pre-diabetes may develop the disease if they don't follow lifestyle recommendations, such as eating right and exercising." 

According to Diabetes Canada, 11 million Canadians are living with diabetes or pre-diabetes. That's one in three of us.

Take a simple test 

Capitalizing on their captive audience, the rehab team asked each participant to complete one simple task, upon arriving for their weekly rehab session: Fill in a quick questionnaire, to determine if they're at a low, medium, or high risk of prediabetes or diabetes. 

Questions related to age, family history, ethnicity, and other factors. 

"If a participant learned that they were at medium or high risk, we were able to educate them on how to take that information and speak to their family doctor about it," explains Dr. Sarin. 

Questions that put control in the hands of a patient include, "A risk assessment revealed that I'm at a higher risk for diabetes. Would you mind doing a blood test to confirm how high my risk is?" And, "What action do I need to take now, to prevent developing diabetes?" 

Charles says that asking why his medication matters has encouraged him stay on schedule, while being taught how to read labels has made healthy eating easier.

Go for a walk 

One key way to keep diabetes at bay is to lower your blood sugar through exercise. 

To illustrate how far fitness can take you, the team measured the distance each participant travelled during their weekly session, by walking, cycling, rowing or on an elliptical machine, and added the number together.

Collectively, participants travelled about 500 miles – the distance from Toronto to Quebec City.

"It was a pleasure to participate in this activity, and see how information can be put into continuous, effective action," Charles says.

"But it was also an opportunity to show appreciation for the efforts of the staff and volunteers who put the program together."

Dr. Sarin believes that finding novel ways to engage participants brings benefits that reach beyond Rumsey's walls. 

"We see every participant as an advocate for a healthy lifestyle," says Dr. Sarin. "When we heighten their awareness, they spread our message to the community."

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