There's still a social stigma associated with diabetes, a disease affecting approximately 1.8 million Australians. This blog is designed to raise awareness of this disease and gives you an idea of an exercise program to manage diabetes. If you have diabetes though, it is important to consult with your health professionals about management strategies that are specific for you.
Type 2 diabetes mellitus (T2DM) represents 85-90% of all cases of diabetes. Screening and achieving an early diagnosis of the condition is essential to prevent further development and minimise chronic complications from diabetes.
What Is Diabetes?
Diabetes is a serious complex condition affecting an individual’s entire body. Diabetes mellitus is a group of metabolic diseases characterised by chronic hyperglycaemia which results in defects with insulin secretion, insulin action, or both. This is also known as insulin resistance (see below) which results from a combination of genetic and environmental factors.
Insulin is primarily responsible for uptaking glucose (or sugar) in the body. With a condition such as diabetes, you will have elevated blood sugar levels as a result of this insulin resistance occurring within the body. While there is a genetic predisposition to the occurrence of T2DM there are also several risk factors that increase the likelihood of it occurring, such as:
obesity
family history (genetics)
physical inactivity
poor dietary habits
high blood pressure.
Impact on Health
Diabetes has many long-term effects which can include damage to large and small blood vessels, which can ultimately lead to several vascular issues such as strokes or heart attacks; along with issues involving kidneys, eyes, feet and even nerves. However, there is some good news! The risk of these long-term effects happening can be reduced through a tailored management approach. This means that regular screening, exercise and diet management.
Importance of Exercise for Diabetes Management
So what’s the best strategy to manage this condition and what can my physiotherapist do for me? Exercise!
This is typically one of the first management strategies for individuals that have newly been diagnosed with Type 2 diabetes along with diet and behaviour modifications. Current evidence suggests that exercise, whether aerobic, resistance training or a combination of both, will help to facilitate improved glucose regulation. We recommend combining High Intensity Interval Training (HIIT) with strength training for the best of both worlds.
Evidence reveals that glycaemic (amount of glucose in the blood) control is one of the main measures for T2DM and many studies have postulated that aerobic exercise improves glycaemic control primarily through increasing insulin sensitivity. Additionally, elevated glycated haemoglobin (a protein in red blood cells with glucose attached) levels are predictive of the vascular complications that may occur with having diabetes. Exercise has also been shown to reduce glycated haemoglobin levels both alone and in conjunction with dietary interventions.
Further, resistance/strength training can improve glycaemic control by regulating glucose through an increase in muscle mass and by increasing glucose transporters within the body to aid glucose uptake into cells.
What Exercises Should I do?
The Australian physical activity guidelines recommend at least 30 minutes of moderate intensity physical activity a day and to gradually build up the duration and intensity of exercise. This could include simple activities such as walking, swimming, running or a resistance training program.
Stationary Bike:
1. Begin with a 5-minute warm up at a low intensity.
2. Continue with a 40 second low-moderate intensity (e.g 2 resistance on the bike - this is your resting resistance).
3. Complete a 20 second sprint at a moderate-high intensity (e.g 5 resistance on the bike).
4. Return to your 40 second low-moderate intensity speed and resistance.
5. Repeat for 5-10 rounds
A similar principle can be adapted to a rower or any other piece of cardio equipment that you would prefer.
The above circuit is just one of the many ways to incorporate a 15-20-minute HITT session into your day. However for some people, moderate or intense exercise is not suitable, including some sort of light aerobic exercise may be a great alternative such as Pilates, yoga, light walking, lawn bowls or even taking healthier options such as walking up the stairs instead of taking the lift.
For a more individualised program, book a session with your physiotherapist or give us a call (3061 7128) and we will happily provide you with a tailored training regime.
Blog and videos by UQ Physiotherapy student undertaking clinical placement, supervised by principal physiotherapist, Winnie Lu.
Principal Physiotherapist
Souths United Football Club Physiotherapist
References
Asif, M. (2014). The prevention and control the type-2 diabetes by changing lifestyle and dietary pattern. Journal of education and health promotion, 3, 1-1. doi:10.4103/2277-9531.127541
Kharroubi, A. T., & Darwish, H. M. (2015). Diabetes mellitus: The epidemic of the century. World journal of diabetes, 6(6), 850-867. doi:10.4239/wjd.v6.i6.850
Kirwan, J. P., Sacks, J., & Nieuwoudt, S. (2017). The essential role of exercise in the management of type 2 diabetes. Cleveland Clinic journal of medicine, 84(7 Suppl 1), S15-S21. doi:10.3949/ccjm.84.s1.03
Strasser, B., & Pesta, D. (2013). Resistance training for diabetes prevention and therapy: experimental findings and molecular mechanisms. BioMed research international, 2013, 805217-805217. doi:10.1155/2013/805217