World Diabetes Day – Lori Ryan AEP

Diabetes is one of the biggest chronic diseases impacting Australians to date. Approximately 1.8 million Australians are living with diabetes (all types), with a total annual cost to Australia’s health care system of $14.6 billion. There are multiple types of diabetes including Type 1, Type 2, and gestational diabetes.

Type 1 vs. Type 2 Diabetes

Type 1 diabetes occurs when the immune system destroys cells in pancreas which produce insulin. It is an autoimmune condition which is not linked to modifiable lifestyle factors, there is no cure, and it cannot be prevented.

Main points:

  • The pancreas fails to produce insulin
  • One of the most common chronic childhood conditions
  • Onset is rapid and symptoms are obvious
  • Symptoms can include excessive thirst and urination, unexplained weight loss, weakness, fatigue, and blurred vision
  • The disease is managed by the insertion of an insulin pump or through injecting insulin shots multiple times per day to regulate blood glucose levels

Type 2 diabetes can occur due to multiple causes including the pancreas not producing enough insulin and/or the cells in the body fail to respond effectively to insulin (insulin resistance). While Type 2 diabetes (T2D) does have a strong genetic link, unlike type 1 diabetes, T2D is preventable through modifiable lifestyle factors.

Main points:

  • Is diagnosed when the pancreas does not produce enough insulin (reduced insulin production) and/or the insulin does not work effectively and/or the cells of the body do not respond to insulin effectively (known as insulin resistance)
  • Usually develops in adults over the age of 45 years but is increasingly occurring in younger age groups including children, adolescents, and young adults
  • Is more likely in people with a family history of type 2 diabetes or from particular ethnic backgrounds
  • For some, the first sign may be a complication of diabetes such as a heart attack, vision problems or a foot ulcer
  • Is managed with a combination of regular physical activity, healthy eating, and weight reduction. As type 2 diabetes can be progressive, many people will need oral medications and/or insulin injections in addition to lifestyle changes over time.

Type 1 diabetes accounts for 10% of all diagnoses while Type 2 diabetes makes up 85% of diagnoses. Recent statistics also suggests that gestational diabetes is on the rise.

Complications of Diabetes

Diabetes is a complex condition which affects a large majority of bodily systems due to the poor regulation of glucose in the blood.

  • Those with diabetes are four times more likely to suffer heart attacks or strokes
  • Diabetes is the leading cause of preventable blindness caused by diabetic retinopathy
  • Kidney failure is three times more common in those with diabetes
  • Amputations are fifteen times more common in those with diabetes. This is often caused by peripheral neuropathy which results in wounds being addressed to late and infection spreading to the bone
  • More than 30% of those with diabetes suffer with mental health conditions

Exercise is not only effective at treating the pathophysiology of diabetes, but also at managing the complications such as reduced cardiovascular disease, metabolic syndrome, renal health, and neuropathies.

Exercise and Diabetes

Exercise can play a significant role in helping to regulate blood glucose levels in both type 1 and type 2 diabetics. This largely occurs through what is known as the Glucose Transporter 4 or Glut-4 system which essentially means that instead of glucose remaining in the blood, it is transported from the blood into the muscles to be used as an energy source during exercise.

For those with Type 1 Diabetes (T1D) and Type 2 Diabetes (T2D), exercise can help to improve full-body insulin sensitivity, which essentially means the body requires less insulin to process glucose. It can also help to regulate blood glucose levels. While exercise is a vital part of the management of diabetes, it is important to also consider the timing of food in relation to exercise, time of day, and the intensity and duration of the exercise as these factors are all known to impact blood glucose levels as well.

The following are the acute effects following a single bout of exercise:

  • Immediate lowering of blood glucose levels (dependent on the intensity and duration of exercise)
  • Increase utilization of glucose in the muscles (reduces glucose in the blood)
  • Non-insulin-mediated glucose uptake (can result in requiring less medication to control blood glucose levels)
  • Lasting increased insulin sensitivity which can last up to 72 hours

Diabetes is a complex chronic disease affecting many of the body’s functions. Exercise is a vital part of the management of this condition; however, it must be delivered in a safe and effective manner to avoid complications such as those listed above as well as hyper- or hypoglycaemic episodes. For those managing this condition, having an Accredited Exercise Physiologist on your management team will help you to safely implement an exercise program specific to you and to educate you on the guidelines around exercising with Diabetes.