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EXERCISE AS TREATMENT FOR TYPE 2 DIABETES
Type 2 diabetes or ‘adult onset’ is characterised by insulin resistance (with or without insulin secretory defect). This condition arises from a combination of genetic and environmental factors. Despite there also being a strong genetic component, lifestyle factors including high blood pressure, insufficient physical activity, overweight/obesity and poor diet are all major contributors to an increased risk of developing this condition. Modification to these risk factors is often very successful in the early management and prevention of type 2 diabetes. Type 2 diabetes can be managed with a combination of any of three treatments- diet, exercise and medications. Ideally, diet and exercise should be modified before enlisting the use of medications.
Exercise is important for diabetes for several reasons including:
Improving blood glucose control
Increasing insulin sensitivity
Decreasing blood pressure, weight and other risk factors
Decreasing the risk of co-morbidities such as cardiovascular disease, retinopathy, neuropathy and nephropathy (that are related to uncontrolled blood glucose)
Very few people would argue that regular exercise doesn’t provide benefits. For diabetics, or at risk of developing diabetes in the future, exercise is particularly important in the control of blood glucose and ensuring a healthy life. Many diabetics are even able to decrease their dependence on medication to manage their condition. In addition, for those taking insulin- exercise will also assist the insulin to work more effectively. The reason exercise works so well is that it allows glucose to be taken from the blood into skeletal muscle without the need for insulin- non-insulin-mediated glucose uptake (thus decreasing the reliance on insulin). A single bout of exercise is successful in ensuring an immediate lowering of blood glucose, although the degree to which this occurs is dependent on the intensity and duration of the exercise. This comes about through an increase in muscle glucose utilisation. Even several hours after this exercise, the amount of non-insulin-mediated glucose uptake is increased and increased insulin sensitivity (i.e. the body is more receptive to insulin therefore it is able to do its job better) can last for up to 72hours!
Exercising as a diabetic does hold some risks if your blood glucose is not well-controlled as there is a chance that your blood glucose could drop too far given the increased uptake of glucose as a result of the exercise. This is why it is important to get advice about where to start from an accredited exercise physiologist (AEP). Exercising under the guidance of an AEP will ensure that special consideration is given to monitoring your blood glucose throughout and after your exercise- guaranteeing that any signs of hypoglycaemia or hyperglycemia are identified and accounted for immediately. AEPs are also trained to be able to take into the account the affect that any medication you are on will have on your performance and response to exercise- they will monitor you carefully to ensure that any response you get to exercise is appropriate for YOU. Lastly, their knowledge extends to all co-morbidities and conditions associated with your diabetes including retinopathy, neuropathy, cardiovascular disease, nephropathy and any other musculoskeletal, cardiorespiratory or metabolic conditions that you may be experiencing.
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