Summary:
- Diabetes is a challenge for many people in developed countries because of plentiful food supplies. Problems develop when there is an overconsumption that the body can’t deal with effectively.
- There are 4 major types of Diabetes: gestational diabetes (diabetes during pregnancy), Type 1 diabetes (diabetes that develops in childhood), Prediabetes (precursor to diabetes where blood sugar starts to run higher than normal), Type 2 diabetes (diabetes acquired usually in adulthood).
- Type 2 diabetes is the most common and caused by chronically high intakes of food that cause your body to have a higher level of sugar in the blood than the body can manage. This causes inflammation which causes stress on the cells leading to damage.
- Risk factors that increase your chances of developing Type 2 diabetes are: obesity, a sedentary lifestyle, high blood pressure, poor diet, and smoking
- Diet involves not only the amount of food you eat, but also the type and quality of food you eat. Consuming higher amounts of unprocessed grains, fruits, vegetables, and yogurt instead of processed foods and sugary drinks can decrease your risk.
- Exercise helps to burn more energy and decrease your blood sugar. Exercises that are aerobic such as running, walking, and swimming are helpful for this and should be done at least 5 times a week for 30 minutes a day. In addition, increasing muscle mass through resistance training can help to manage blood sugar. Other types of exercise such as yoga can be helpful as well.
- It is helpful to consult your doctor before beginning an exercise program. If you take medications that manage blood sugar, you may have to adjust them because of exercise.
- Monitor your blood sugars before, during and after exercise (especially in the beginning) to see how exercise affects your blood sugar.
- It’s helpful to keep a snack on hand in case your blood sugar levels are too low. If you do have a low blood sugar event, you may want to wait 24 hours before exercising again since this event increases the risk of having another one in that period.
- Conversely, high blood sugar can be an issue as well and you may need to seek medical attention to manage.
- Be careful with high intensity activities that involve jumping and heavy straining, especially if you have more advanced diabetes.
Introduction:
Diabetes is a challenge for many people in developed countries. Modern conveniences and plentiful food supplies have helped fuel an overconsumption and thus an increased risk and incidence of Type 2 diabetes.
The body attempts to maintain a balance in energy in the body. Your brain, muscles and organs require energy to function. Humans obviously intake food for energy. When the intake and output of energy is equal or relatively equal, then the body functions well.
Problems develop when there is excessive intake of energy and not enough output through activity. The challenge becomes, keeping the body moving enough and the energy intake/ eating healthy enough to not overload the body, so it can maintain a healthy balance.
If you are dealing with diabetes, or concerned about developing diabetes, then it’s important to learn about what diabetes is, risk factors for it, and ways to manage it or avoid it altogether.
What is diabetes?
There are 4 common types of diabetes:
- Gestational diabetes
This type develops during pregnancy in women who have never had diabetes. It usually goes away after the baby is born. However, it can increase your risk of developing type 2 diabetes later in life. (1)
- Type 1 Diabetes
This type of diabetes usually develops in childhood. It is possibly caused by an autoimmune reaction and not by lifestyle. People with this type need insulin everyday to survive. (2)
- Prediabetes
Prediabetes is not actually considered a form of diabetes but is the precursor to developing Type 2 diabetes. It also increases your risk of heart disease and stroke. Many people have prediabetes and are unaware until they get blood tests.
Normal levels of blood sugar are 70-99 mg/dL. Persons with prediabetes typically have levels between 100-125 mg/dL. (3)
- Type 2 Diabetes
Type 2 Diabetes which is the most common form of diabetes occurs when the body is chronically overstressed due to over consuming food. Excess amounts of food (especially foods with high concentrations of sugars) lead to an inflammatory reaction in the body.
This causes issues such as oxidative stress, hyperglycemia, and hyperlipidemia (. Oxidative stress is basically damage to cells. Hyperglycemia refers to high blood sugar concentrations and hyperlipidemia refers to high concentrations of fat in the cells. Hyperlipidemia refers to high levels of cholesterol and triglycerides in the blood (essentially fat concentrations in the bloodstream).
The body is unable to make enough insulin to get the excess sugar into your cells. In addition, the cells stop responding to insulin. This causes excess amounts of glucose to be present in your bloodstream.
Insulin’s job is to regulate the amount of sugar in the bloodstream by moving it into storage in the muscles where it can be used as fuel at a later time. The cells also become resistant to insulin as diabetes progresses.
This causes the body not to function nor repair itself as efficiently as it did when the process was functioning normally.
What are the Risk Factors for Type 2 Diabetes?
The risk factors for diabetes include:
- Obesity
Obesity is an epidemic in developed countries. In fact, one review cited that approximately two thirds of persons are overweight or obese in the United States. (4).
It is one of the most significant contributors to Type 2 Diabetes and is a product of the following risk factors for it. It is linked to other issues as well, such as cardiovascular disease and all-cause mortality (dying from other diseases as well such as cancer, stroke, etc.).
- Sedentary lifestyle
“Move it or lose it” was a popular saying, but an excellent maxim for preventing diabetes. The increase in sedentary jobs and technology fueling video games have made this phenomenon much more common.
Movement is medicine. Numerous studies as well as recommendations by such institutions as the World Health Organization and the National Institute of Health have recommended increasing physical activity to improve health.
There is a burden on the healthcare system associated with this lack of movement. This includes the burden of care when someone has a stroke or heart attack, as well as the medications used to manage the conditions before they become a life threatening emergency.
The current recommendation for adults in the United States is at least 150 minutes to 300 minutes of vigorous aerobic activity per week. Also, it is recommended you do at least 2 days per week of (at least) moderate resistance training. (5)
- High blood pressure
High blood pressure is another common issue that affects many people. It is common for it to coincide with diabetes. They are 2 sides of the same coin when it comes to lifestyle diseases. Hypertension is when the blood pressure stays elevated greater than 120/80 mm Hg.
Some of the mechanisms that occur during diabetes contribute to hypertension. These include oxidative stress and systemic inflammation. Essentially, the two issues have a snowball effect progressively contributing to both. (6)
- Poor diet
Diet tends to tie diabetes and most of the above risk factors together. Excessive caloric intake is associated with obesity, diabetes, hypertension and cardiovascular disease. (6)
This subject will warrant greater detail and will be discussed in the next section.
- Smoking
Smoking is less prevalent today than 20 years ago. However, it is still prevalent in many societies.
How Does Diet Affect Diabetes?
As mentioned above, diet is linked to multiple cardiomedabolic diseases. Diet is a difficult subject in that there are many factors that go into diet. For instance, there is the amount of calories you eat, but there is also the type and quality of food you eat.
For instance, one study found eating a diet rich in whole grains instead of processed foods led to less weight gain and consequently lower blood sugar. In addition, consumption of other foods such as fruit, vegetables, nuts, and yogurt can help to reduce weight gain and decrease the risk of diabetes as well. (7)
In addition to type and quality of food, other subtle factors include the place you live in as well as your financial ability to buy high quality food. For example, those in low and lower middle class income families may have difficulty purchasing high quality, nutrient dense foods. (6)
This makes them have to substitute with highly processed foods that are high in fat and sugar. These foods are cheap, plentiful, and readily affordable.
It’s not just food that can be an issue. Consuming high sugar drinks such as sodas and juices can increase sugar levels and increase your risk for diabetes. In addition, high levels of consumption of alcoholic beverages can also contribute to increased blood sugar. (7)
Diets that are low in carbohydrates tend to show a greater reduction in risk for diabetes. Diets such as the Mediterranian diet, vegan and macrobiotic diets tend to show this same (decreased) risk. These diets tend to be higher in fruits and vegetables as well as fiber that promote better management of blood sugar. (8)
Diet is one of the most important factors in managing diabetes. Starting small and working on one small change can lead to dramatic results. Even just reducing consumption of sugar sweetened drinks and substituting water can make a difference. Or, adding a serving of vegetables at dinner time every day.
How Does Exercise Affect Diabetes?
If diet is the gas for the car, then exercise is how you burn the fuel. Your muscles use energy as fuel to power movement (as well as breathing, heart pumping, basic maintenance or your body functions).
When you increase the amount of movement, more energy is utilized which decreases the amount of excess fuel in the body. This helps to control blood sugar since excess glucose isn’t roaming around the bloodstream.
You may be asking, what type of exercise is best. There have been numerous research studies involving this subject. Aerobic exercise appears to have the greatest effect. This includes running, cycling, walking, Aerobics classes, etc.
Anything that elevates the heart rate and involves repetitive motion for a sustained period of time. These types of activity have been shown to reduce insulin need in the blood and decrease blood markers related to diabetes. (9)
However, if you can increase muscle mass there are more cells that have a greater need for energy as well. Thus, resistance training can be helpful as well to manage diabetes. However, the greatest effect can be seen when combining aerobic and resistance training into your fitness routine. (9)
In addition, other forms of exercise have also demonstrated a benefit at reducing blood glucose levels and have positive benefits at controlling diabetes. (10)
Obviously there is benefit in increasing movement no matter what you do. The main thing is to add activity above what you normally do. Anything that involves moving the body for an extended period of time.
In fact, combining activities into your weekly exercise regimen can help alleviate boredom and provide variety to keep you motivated.
Precautions With Exercise and Diabetes
Exercise (along with diet) is an excellent way to help manage diabetes. However, you will want to consult your doctor before starting an exercise program, as well as during an exercise program.
This is most important if you are taking medications to manage diabetes or if you have other risk factors such as hypertension. Your doctor may have to adjust your medications.
In addition, you will want to monitor your blood sugars before, during, and after exercising. This is helpful to see how exercise affects your blood sugar. Also, taking it before can help you decide if you need food before you exercise (if your blood sugar is too low). (11)
The risk of a low blood sugar (hypoglycemia) incident is possible since exercise helps to lower it. So keeping a small snack on hand can help if it occurs.
Also, it is advised to hold exercise for 24 hours after a hypoglycemic event since it increases the risk of having another event. (11)
Conversely, if your blood glucose is 300 mg/dL or higher (what is termed hyperglycemia), it is advised to hold on exercising as well and seek medical attention if needed to decrease that level. (11)
In addition, caution is recommended for more high intensity activities such as jumping, especially if the risk of developing a wound is possible. Inspecting your feet after higher intensity exercise is advised to be proactive. (11)
In fact, if you have an active foot ulcer, you may want to change to a non-weight bearing activity to avoid worsening the ulcer. Diabetics heal from wounds slower and have an increased risk of not being able to fight off infection
If you have issues with your eyes such as diabetic retinopathy, then avoiding excessive straining where you are holding your breath to push more weight during resistance training is advisable (11)
Diabetes and high blood pressure often go hand in hand. Thus, monitoring your blood pressure is advised as well. Keeping your systolic below 200 mm Hg is a good idea and to keep your exercise exertion low. This will help to decrease the risk of a heart related issue during exercise. (11)
Most people with diabetes will exercise without any issues. However, if your diabetes is not controlled or if you have multiple health problems in addition to diabetes, then participating in a supervised exercise program (such as a cardiac rehab program) may be a better option.
Call to Action
Exercise can be an excellent way to manage diabetes. The current recommendations are to get at least 150 minutes of low to moderate aerobic exercise per week. That could equate to 30 minutes of walking, water aerobics, or biking per day.
If you can’t do that much then start with an amount you can do such as 10 minutes per day. Then each week, gradually add 2 minutes per day until you can increase to 30 minutes per day.
Resistance training is another way to help manage diabetes. It can be traditional weight training or something different such as high intensity interval training. The recommendation is 2-3 days per week.
Start small. Start with push ups for 2 sets trying to get 8-15 repetitions. Also try squats or sit to stands from a chair. Add heel raises and toe raises as well. If you decide to go to a gym, get some instruction on using some machines.
Remember, just doing something is better than nothing. Establish the habit first and then you can grow it. Consistency beats doing a 1 time hour long workout. Have fun and embrace your awesomeness for getting started.