Type 2 Diabetes and Exercise
Type 2 diabetes is the most common form of diabetes making up to 90-5% of cases according to the Centre for Disease Control (CDC). It develops slowly over a period of time making the subtle onset of symptoms difficult to pick up and while T2DM can develop at any time the average age of onset is 45 years of age, but drops to 35 years in ‘at risk populations’. The slow onset also means that many people, as high as 25% of suffers, are unaware of the condition until symptoms become more significant.
- 25% of sufferers are unaware
- 90-5% of diabetes sufferers are Type 2
In T2DM the pancreas produces insulin, a hormone that helps store and use glucose but if the body’s cells do not respond to this insulin they fail to take up the blood glucose which is needed to power the cell. In response, the pancreas produces more and more insulin to try and manage the blood glucose levels, leading to overloading and damage and the eventually reduction in insulin production.
- by the time of diagnosis, between 50-70% of insulin producing cells in the pancreas have been lost.
If blood glucose levels become high the body cannot work efficiently, the glucose isn’t transported into the cell and the energy available for the cells to work drops. The blood becomes thicker which places more stress on blood vessel walls and the heart has to work harder. The reduced availability of energy to cells also leads to a variety of complications depending on the role of the cells, from nerve tissue, intestinal cells, the cells within the eyes or cell involved in healing injury.
T2DM results from genetic and environmental factors with the risk increasing with lifestyle factors including:
- high blood pressure
- poor diet
- low physical activity levels &
Symptoms for T2DM can include:
- constant thirst
- reduced sensation to the fingers and toes
- slow healing cuts
- low energy levels
- blurred vision
- increased weight
- headaches &
- increased passing urine.
Complications of Type 2 Diabetes
T2DM can effect many organs and results from the destruction of the small blood vessels with an associated disruption of blood supply leading to peripheral vascular disease (PVD)and peripheral neuropathy causing the loss of sensation, poor healing, loss of vision, poor kidney function and poor absorption in the intestine.
These complications resulted in diabetes being associated with 1 million hospital admission in 2015-16.
PVD and Peripheral Neuropathy leads to poor healing and infection, making diabetes the leading cause of amputations. In 2015-16 there were 5000 lower limb amputations with men making up 75% of cases and those aged over 65 making up 62% of cases.
This has obvious implications on mobility and independence.
Importance of avoiding and cuts to the extremities, taking care with routine nail care often requiring the attention of a skilled podiatrist and using protective equipment such as gloves when gardening or working with tools to avoid scratching or jamming the fingers.
Diabetes Related Deaths
Of the million hospital admissions in 2015, reports ranged from 15740 -16400 deaths being linked to the effects of diabetes.
How Diabetes Effects the Organs and Body Systems
Heart & Circulatory System:
Peripheral vascular disease and the destruction of the small blood vessels means that more volume is held in the larger blood vessels, increasing blood pressure. The effect of high blood sugar also thickens the blood making it harder for the heart to pump around the body. The increased load and increased blood pressure lead to increased risk of stroke and heart attack.
The kidney is effected by the increased blood pressure but is also forced to work harder to excrete the excessive glucose (high blood sugar) and stabilize the blood content.
High levels of blood glucose levels over a long duration of time can cause damage to small blood vessels in the eyes and organs and can also effect the optic nerves. Over time, if small blood vessels in the retina become damaged, fluid or blood can leak and lead to retinopathy, and other eye conditions such as glaucoma. Symptoms may include blurred vision, difficulty with balance as the eyes and inner ear give the brain conflicting information, difficulty reading and increased sensitivity to glare. It is important to have regular eye exams if you have T2DM or high blood sugar levels.
Diabetes can also lead to gastrointestinal problems. One in particular is gastroparesis, a delayed emptying of the stomach contents leading to bloating, abdominal pain, nausea and vomiting. This is caused due to a reduced sensitivity of the intestinal nerves, similar to that experienced with peripheral neuropathy. The reduced blood flow to the intestines can also lead to malabsorption of nutrients from food.
So why is it important to exercise with T2DM?
Everyone benefits from regular exercise and for people with T2DM exercise plays a role in the management of the condition.
Exercise cannot reverse damage to pancreatic cells that leads to decreased insulin, however, exercise increases and improves the way muscles response to insulin. When exercising, muscles provide a pathway for glucose uptake into the cells and out of the blood without the need for insulin. This means that if you are insulin resistant glucose can leave the blood and be used for energy and reduces the long term effects of ugh blood sugar on cells generally.
Exercise can also make insulin more effective as resistance reduces during muscle contraction and glucose can be used.
Exercise also has benefits on heart health, body fat and body composition, mood and energy levels.
So what type of exercise should you be doing?
Before exercising speak to your Doctor and an Physiotherapist on the best way to start.
It is recommended to perform a combination of strength training and cardiovascular exercises. 30-60 minutes of moderate intensity exercise is recommended every day, however start slow with 10 minutes at a time and build up gradually.
Resistance or strength training is effective for developing lean muscle mass which uses large amounts of glucose when contracting, so the more lean muscle mass we have, the more blood glucose is being consumed.
Exercise provides a secondary pathway for reducing the amount of glucose in the body!
Moderate intensity aerobic exercise improves blood glucose levels and insulin action. As aerobic exercise is performed over a more substantial period of time it is effective at helping to reduce blood glucose levels. Therefore a combination of aerobic and resistance training is most effective for diabetes management.
A combination of resistance and aerobic exercise helps to control blood sugar levels and also improves the effect of insulin.
If you would like help in managing your diabetes and it’s complications or to prevent the development of Type 2 Diabetes if you have a strong family history or the risk factors mentioned give us a call or book now.