There are many preventable diseases still plaguing our medical community today. These diseases are responsible for large morbidity rates, high amounts of unnecessary health care spending and increased risk of secondary illnesses like cancer. Diabetes is on of those diseases! It can be prevented and even reversed through diet and exercise but it continues to affect more that 22 million Americans each year. Take a few minutes to read through the next few paragraphs and learn about Diabetes, the prevention and the treatment.

Diabetes, What Is It?

Diabetes mellitus is defined in terms of the function of the hormone insulin.

Definition: a decrease in the production, release and / or effectiveness and action of insulin.

This short video, “Diabetes Made Simple”, provides a great visual and break down of the basic information regarding diabetes.  It explains how the hormone insulin helps blood sugar get into the muscle and fat cells to provide vital energy to each cell. Without energy, our bodies can not function properly. Starved cells start to die, decreasing our ability to heal. To compound the problem, sugar starts to pile up in the blood stream and can cause other issues like damage to nerves and blood vessel walls.

 

There are two major reasons this happens;

Type 1: There is not enough insulin being produced. Type 1 diabetes is more uncommon, affecting only about 5% to 10% of all patients. The absolute deficiency in blood insulin release is likely due to an immune response causing the destruction of pancreatic insulin secreting beta cells. Type 1 diabetic patients are almost always dependent on insulin medications and should consult a doctor or an exercise professional  to prescribe and monitor exercise.

Type 2: There is too much sugar being consumed and dumped into the blood stream for the insulin to keep up with. Type 2 diabetes patients have an increase in blood sugar levels due to a condition called insulin resistance where cells stop responding to the insulin that is there. The main objective for treating this type of diabetes is to increase insulin sensitivity to help the existing insulin to work with cells. This can be done by regulating the amount of blood sugar through diet and improving cell activation through regular exercise. Exercise also helps decrease excess abdominal fat, a leading cause of type 2 diabetes.

The American College of Sports Medicine explains that “Type 2 diabetic patients gain health and fitness benefits rather quickly once an exercise program is initiated. Perhaps the most beneficial aspect is the improved insulin sensitivity that is reported with exercise training. Which can result in lower medication requirements and greater control of blood glucose levels.  In addition if body fat is reduced, as may occur from the indirect effect of exercise, further increase in insulin sensitivity are found.”

Medical Complications of Diabetes

  • Poor healing time leading to higher incidence of minor cuts and scrapes becoming infected

  • Blindness due to nerve damage to the optical nerve

  • Kidney failure due to damage from excess sugar and efforts to filter it out

  • Diabetic Neuropathy: Nerve damage in fingers and toes causing numbness resulting in foot ulcers

  • Amputations: Combination of poor healing and neuropathy causing irreparable damage to toes and feet

  • Diabetic Dislipidimia: Lower “good” cholesterol and increased “bad” cholesterol levels

  • Increased risk of heart attack and stroke: Increased artery disease due to damage in blood vessels caused by excess sugar and higher triglyceride levels

Exercise as Medicine

There are plenty of studies that show how exercise increases insulin sensitivity, decreases blood sugar and decreases abdominal fat. It is well documented that exercise can reverse the effects and complications of type 2 diabetes and MAY REDUCE YOUR NEED FOR MEDICATIONS. Here are some exercise recommendations to get you started:

  • Cardiovascular Exercise:

    • Recommended for diabetic patients who are cleared to exercise

    • Frequency: 5-7 days a week for a combined 30-60 minutes each day (at least 10 minutes at a time)

    • Intensity: Moderate = 60-80 % of maximal heart rate

    • Mode: Increases insulin sensitivity by increasing circulation, decreasing belly fat and improving body composition

  • Resistance Training:

    • Recommended for diabetic patients who are cleared to exercise, without complications and with controlled blood glucose levels

    • Frequency: 3 x a week at 3 sets of 8-10 reps using 8-10 multiple joint exercises for all muscle groups

    • Intensity: Moderate = 60-80 % of maximal load

    • Mode: Increases insulin sensitivity by increasing muscles uptake of blood sugar

  • Stretching:

    • Recommended for diabetic patients who are cleared to exercise

    • Frequency: Every day, hold each stretch for a combined amount of 60 seconds (4 sets of 15 second holds)

    • Intensity: Low to moderate; hold until you feel a stretch, relax into it with out bouncing

    • Mode: Improves circulation and mobility, decreases nerve compression to decrease risk of future injury

Exercise Safety With Diabetes

  1. Keep emergency stores of glucose close by

  2. Exercise with a buddy in case you need help administering emergency glucose

  3. Wear a medical ID

  4. Always take your medications as directed by your doctor

  5. Check your blood sugar often (before, during and after exercise, and any time you feel “low” or “high”)

  6. Do not exercise if blood sugar is below 100 mg/dl or above 250 mg/dl with ketosis

  7. If blood sugar is low, use the rule of 15: eat 15 grams of carbohydrates and wait 15 minutes to retest (Find out what 15 grams of carbohydrates looks like HERE)

  8. Start any exercise program slow, progress slow and be consistent

  9. Practice good hygiene by showering and cleaning your extremities after exercise to reduce the risk of infection

  10. Thoroughly check your extremities for wounds or sores that are not healing, keep them covered and clean, report them to your doctor regularly

  11. Exercise in the morning instead of in the evening; exercise in the evening is cautioned because it can cause hypoglycemic conditions later at night while sleeping

Additional References

Check out these websites for more information on Diabetes and Exercise

  1. American Diabetes Association Position on Fitness

  2. Center for Disease Control and Prevention Diabetes Home

  3. American College of Sport Medicine “Diabetes and Physical Activity”

  4. American Heart Association “Cholesterol Abnormalities in Diabetes”