Type 2 Diabetes and Exercise

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What is Type 2 Diabetes Mellitus?

Diabetes is a chronic disease in which the body is unable to effectively maintain a normal level of glucose in the blood. Glucose is a sugar which is converted into energy in the body and is one of the main sources of energy that the body uses during exercise. There are different types of diabetes, such as type 1 diabetes, type 2 diabetes, and gestational diabetes. Of these types, Type 2 Diabetes Mellitus (T2DM) accounts for around 90% of all diabetic cases. T2DM is a disease which occurs over a long period of time and is caused by both genetic factors and particular lifestyle factors such as inactivity and poor diet. The insulin resistance which leads to T2DM occurs through the pancreas not producing enough insulin, or by the body becoming less effective at using the insulin produced. This results in an abnormal amount of amount of glucose in the blood.

Causes of Type 2 Diabetes Mellitus

T2DM has a strong genetic disposition, so having immediate family member with T2DM increases your risk of being diagnosed. Poor lifestyle factors increases your risk of being diagnosed with T2DM. These lifestyle factors include inactivity/sedentary lifestyle, poor diet, high blood pressure, older age, and excessive adipose tissue around the waist (high waist circumference). While it usually affects older adults more than younger people, more and more younger people are being diagnosed with T2DM due to poor lifestyle factors.

Fortunately, T2DM can be delayed or even prevented by changing the risk factors mentioned above. Maintaining a healthy weight and waist circumference, sticking to a healthy diet, and being physically active can prevent or delay T2DM in up to 58 % of cases.

Type 2 Diabetes Mellitus and Exercise

Exercise has many benefits for improving the health status of individuals living with T2DM. Regular exercise can reduce weight, lower blood pressure, and reduce excess adipose tissue around the stomach and waist which reduces the risk of comorbidities associated with T2DM. Regular exercise also alters how our muscles react to the glucose in the bloodstream, becoming more receptive to the glucose for hours after exercise. Both aerobic and resistance training has been shown to improve insulin action, blood glucose control, and fat oxidation and storage in muscle.

Those who are diagnosed with T2DM have an increased risk of other health issues compared to those who do not have T2DM. these health issues include heart disease, hypertension, hyperlipidaemia, and kidney disease. Regular exercise helps to reduce the risk of these comorbidities in people with T2DM.

Insulin and glucose production in type 2 diabetes: Insulin (green dots) is produced in the pancreas, and acts with glucose (blue dots) to regulate energy in the body’s cells.

Types of Exercise for Type 2 Diabetes Mellitus

There are various forms of exercise that are recommended to prevent or improve the risks of T2DM. Some recommended types of exercise include:

Increasing your incidental physical activity level can also improve your health. This can be achieved by reducing your sedentary time (avoid sitting down for long periods) taking the stairs instead of a lift, increasing your daily steps etc.

Recommended Exercise for Type 2 Diabetes Mellitus

It is recommended to complete 150-300 minutes of moderate intensity exercise per week, or 75-150 minutes of vigorous intensity exercise per week. This roughly averages out to 15 to 60 minutes of physical activity per day, depending on this intensity of the exercise. Even a small amount of exercise is better than no exercise. If these guidelines are too challenging for you initially, set a goal to do some form of physical activity (walking, gardening etc.) for 5-10 minutes a day, and slowly increase when you can. It is recommended that aerobic exercise (walking, cycling, swimming, running etc.) should be completed at least 3 times per week of at least moderate intensity. Resistance/strength exercise training should be completed 2-3 x weekly on non-consecutive days.

Considerations for Exercise and Type 2 Diabetes Mellitus

Although exercise is beneficial for the management and prevention of T2DM, it is vital to ensure exercise is delivered correctly to avoid complications from T2DM. While exercising, the muscles require an increased amount of glucose as energy for the increased workload. This can lead to hypoglycaemia (low blood sugar levels) if not managed correctly. To avoid hyperglycaemic episodes while exercising, it is recommended that you have a good source of carbohydrates prior to exercising to avoid the drop in blood glucose levels. Depending on the duration and intensity of exercise, you may require some additional carbohydrate source during or after exercise as well. This is especially important for type 2 diabetics who are insulin dependent.

An increase in blood glucose levels during exercise is possible with high intensity exercise but is less common that hypoglycaemia. This can occur with high intensity bouts of exercise as the body responds with an exaggerated release if glucose to keep up with the demand, and this can continue to rise after the exercise is ceased due to poor insulin control.

Monitoring your blood glucose level before and after exercise will allow better management and less risk of these high or low glycaemic episodes from occurring.

At Inertia Health Group we run Group Diabetes exercise classes as well as individual exercise sessions to help you with the management of your diabetes care.