Diabetes is a major epidemic challenging Australia’s health system. About 280 Australians develop diabetes every day. That’s one person every five minutes! This includes all types of diagnosed diabetes (1.2 million known and registered), as well as undiagnosed type 2 diabetes (up to 500,000 estimated). This article discusses how exercise can help control diabetes and prevent the complications associated with it.
Diabetes is associated with a myriad of complications that affect the feet, eyes and kidneys. Diabetes also affects cardiovascular health. Around 65% of all cardiovascular disease deaths in Australia occur in people with diabetes or pre-diabetes.
The major forms of diabetes are categorised as type 1 or type 2.
Type 1 diabetes accounts for 5-10% of cases. It is an auto-immune condition where the person’s immune system is activated to destroy the insulin-producing cells in their pancreas. Type I diabetes is not linked to lifestyle factors.
Type 2 diabetes accounts for 90-95% of cases. It is a progressive condition in which the body becomes resistant to the normal effects of insulin, and/or gradually loses the capacity to produce enough insulin in the pancreas. It is associated with modifiable lifestyle risk factors, as well as genetics.
There is compelling evidence that Type 2 diabetes is more likely to develop in people who aren’t very active. Therefore if exercise were a pill, it would be the most widely prescribed medicine in the world. The benefits of exercise, especially in relation to diabetes, are undisputed. Obesity, insufficient physical activity and high levels of inactivity are all risk factors for diabetes.
The goal of treatment is to achieve and maintain optimal blood glucose, cholesterol, and blood pressure levels to prevent or delay chronic complications of diabetes. It is possible to achieve blood glucose control by following a nutritious meal plan and exercise program, losing excess weight, implementing self-care behaviours and taking oral medications (although others may need supplemental insulin). When medications are used to control Type 2 diabetes they should supplement lifestyle improvements, not replace them.
Exercise itself has an insulin-like effect that enhances the uptake of glucose to reduce your blood glucose levels, even in the presence of insulin deficiency. So if you eat something sweet it is best to do some exercise, such as going for a walk, to assist your body to regulate the excess sugar. This benefit is maintained for 48 hours after you exercise.
Your exercise should consist of a combination of cardio and resistance/strength training.
Australian guidelines suggest a minimum of 150 minutes of moderate intensity exercise in a week. This is equivalent to 5x 30minute exercise sessions. For better time efficiency, 90 minutes of vigorous physical activity at a higher intensity is equivalent to 150 minutes moderate intensity. However, while vigorous intensities of exercise may be a preferable option for some, for the majority of people at risk of, or with Type 2 diabetes, moderate intensities of exercise may be more appropriate, better tolerated and result in greater exercise adherence.
Exercise should be performed at least three days a week, with no more than two consecutive days without training, to assist your blood glucose management. A good strategy is to take advantage of the acute glucose-lowering effect of exercise by timing the session for approximately one hour after a meal. It is also important to carry a carbohydrate supplement when exercising. in case your blood sugars drop unexpectedly.
On top of cardiovascular fitness exercise, 60 minutes (e.g. 2×30 minute sessions) of strengthening exercise should be completed per week to reduce risk of developing chronic diseases.
At least 250 minutes per week is recommended for those that are overweight, if weight loss is a goal, as this volume of exercise is considered necessary for significant weight reduction. It is important to remember though that any exercise is better than nothing. Even increasing your incidental activity, such as getting up in the TV ad breaks or parking further away from the shops, can significantly improve your health.
Due to the potential risks and likelihood of other health conditions, exercise programs should be designed and delivered by qualified personnel who are trained and experienced to deal with the likely additional considerations.
At Physiotas we hold group diabetes classes to help in developing skills and knowledge to manage your diabetes. The class utilises specialised equipment and the expertise of our Accredited Exercise Physiologists to implement tailored, individualised exercise treatment. The group is suitable for newly diagnosed clients, or clients needing to get back on track with their diabetes control. Participants are also prescribed home exercises, so that the benefits they experience during the program can continue long-term.
Ask your GP about the group diabetes Medicare referral pathway today. This includes an initial consult and eight group class sessions every calendar year, with no out of pocket expense for anyone who has Type 2 diabetes. Or please feel free to call and chat to any of our Accredited Exercise Physiologists at Physiotas.
About the Author:
Kathryn graduated from Queensland University of Technology in 2012 as an Exercise Physiologist. Her clinical interests include neurological rehabilitation, cardiovascular and respiratory conditions, and falls and balance training. She has undertaken further professional development in Parkinson’s disease and is a qualified PD Warrior instructor. She is also one of our group and individual Clinical Pilates instructors.