By 2025 it is predicted that 5 million people will be classed as diabetic in the UK alone!
Lifestyle interventions including nutrition and exercise can be some of the most effective methods of managing this wide reaching condition.
Presenting as one of 2 main varieties, type I and type II (also gestational diabetes affecting pregnant women) diabetes mellitus is the name given to a condition of impaired glucose management that results either from insufficient insulin being produced, and/or from muscle and fat cells becoming progressively resistant to the signalling that insulin is supposed to cause. This results in excess glucose present in the blood which if left untreated can result in issues such as nerve and kidney damage.
Type I diabetes develops when the immune system attacks the insulin-producing beta cells in the pancreas leading to insulin deficiency and the resultant rise in blood glucose known as hyperglycaemia and the onset of diabetes. This is not lifestyle related, but due to genetic or factors outside of an individuals’ control,
Type II diabetes is the most common form today and consists of two main problems: insulin resistance which means that muscle, liver and fat cells do not use the insulin produced by the body correctly meaning that glucose rises and so too do insulin levels and this represents the first stages of type II diabetes, Over time the beta cells of the pancreas become incapable of keeping up with demand and the insulin response to glucose feeding is diminished. Risk factors include (though are not limited to) increased visceral fat stores, poor aerobic fitness and chronic low grade total body inflammation; these tend to be more lifestyle dependent.
In both cases exercise can prove beneficial (as is true for any individual with an underlying condition or not!), but particularly in the early stages of type II or the prediabetic stage. It is estimated that most individuals with prediabetes will have full diabetes within 10 years, but research indicates that risk is reduced by 58% with small changes to lifestyle (such as a meagre 7% weight loss and engagement in 150 minutes of activity per week).
There is also a large body of evidence to support the role that all types of physical exercise play in improving metabolic control in type 2 diabetes and gestational diabetes.
Essentially, people with type 2 diabetes can increase the clearance of glucose from their blood and into cells through exercise as effectively as non-diabetics. Research has largely shown the effects of resistance training are more efficacious than aerobic exercise or diet alone at improving rate of fat loss, body composition change and a decrease in the likelihood of peripheral neuropathic amputations.
The risk of hypo/hyperglycaemia before, during and particularly after training should be fully understood before any form of training is undertaken and as with any person undertaking exercise it should be undertaken at a pace that is comfortable yet still adheres to the principles of progressive overload for maximal results. It must be remembered that many diabetic individuals will be new to exercise, may lack confidence or even a basic level of fitness or may have additional health concerns such as high blood pressure or cardiovascular disease.
Prior to commencing an exercise programme it is recommended to consult a health professional and to carry the necessary items required in the event of a hypoglycaemic episode. It is important to stress that each person will respond differently to exercise and this will also be relative to their particular medication. The individual should carefully self monitor their own response to each new exercise regime and learn how the exercise dose affects the current balance between their blood sugar, drug and insulin interaction and food intake. With careful consideration of these variables, there is no reason why anybody with diabetes should not only undertake exercise, but also be encouraged to partake as the benefits are just so worthwhile. It is important to stress that each person will respond differently to exercise and this will also be relative to their particular medication. The individual should carefully self monitor their own response to each new exercise regime and learn how the exercise dose affects the current balance between their blood sugar, drug and insulin interaction and food intake. With careful consideration of these variables, there is no reason why anybody with diabetes should not only undertake exercise, but also be encouraged to partake as the benefits are just so worthwhile.
Matt Anderson; Personal Trainer from Bournemouth