Two of the biggest risk factors for Type 2 Diabetes (T2DM) are physical inactivity and poor diet, hence why T2DM is often called a lifestyle disease. Increasing your physical activity and eating a balanced diet will not only decrease your risk of developing T2DM, it is also frequently used as a treatment method (depending on the stage of T2DM – always seek medical advice).
What is T2DM?
Someone with T2DM has defects in their insulin pathway leading to hyperglycaemia (high blood sugar levels). Let’s look at a simplified version of the Insulin and Glucose pathway:
1. Levels of blood glucose increase; typically due to food consumption. The amount of blood glucose will depend on the type of food consumed.
2. The pancreas responds by releasing a corresponding amount of insulin into the blood stream. Higher blood glucose levels = more insulin. Lower blood glucose levels = less insulin.
3. Insulin receptors on the outer surface of muscles detect insulin and activate pathways within the muscle – the key substance we want to activate is GLUT4.
4. GLUT4 travels up to the surface of the muscle, it then ‘opens the door’ and allows glucose into the muscles.
5. The muscle cells can then use glucose as their energy source.
For most people with T2DM the problem lies at step #3. The insulin receptors are no longer reacting to the insulin that the pancreas is pumping out; if they don’t respond then GLUT4 can’t be activated and glucose can’t get into the cells – that means no energy for the muscles!
However, exercise has an amazing ability to bypass the need for insulin receptors, it can allow our bodies to jump straight to step #4 by activating GLUT4 and allowing glucose into cells. Whilst doing this, exercise also increases the rate at which we use glucose, thereby decreasing blood glucose levels further.
What sort of exercise is best?
To put it simply – the type you enjoy the most and will therefore stick to. If you’re new to exercise, start off simply and slowly. You might just aim to go for a short walk every day and gradually increase the duration and intensity. I would love to be able to write more in this section about what sort of exercise should be performed however there are considerable precautions that need to be taken when exercising and programs need to therefore be designed on a case-by-case basis. That’s not to say that people with T2DM should be scared of exercising, quite the opposite actually.
People with T2DM need to work in consultation with their GP, dietitian and exercise physiologist to ensure they are engaging in the best and safest exercise program and diet. When it comes to exercise, diabetics will often fatigue earlier and require longer recovery then those who are otherwise healthy. It’s also important to be aware of kidney and cardiovascular health as this can be affected by T2DM. There are also considerable risks due to hypertension (high blood pressure), retinopathy (the eyes), autonomic neuropathy (heart rate, body temperature regulation etc) and peripheral neuropathy (nerves at the feet).