I originally thought the subject of diabetes was covered too much, but it’s too important to overlook. It’s a disease that’s responsible for so many medical issues today. Even the severity of COVID-19. And yet, it’s one we have so much control over.
A decision to consume a poor quality diet of too much sugar and too many carbohydrates can lead us down this path. Of course for some, it’s genetic (type 1). But for most, it’s about choices.
Takeaways That Won’t Fail You
- Exercise is “medicine” for those with type 2 diabetes.
- Sugar does nothing good for us. Keep it in check (What you eat and your blood sugar).
- Blood sugar must be monitored closely for those with type 1 diabetes during exercise.
- Eating well is more important for diabetes than exercise. But exercise is still super important.
- A lifelong exercise program and a healthy diet can prevent the onset of type 2 diabetes.
The essential information on diabetes
I know this is ad nauseam, so here’s the usual scoop on diabetes which I feel obligated to include:
- Either your body does not recognize the insulin your making or
- Your body doesn’t make enough insulin
Either way, your blood sugar soars and wreaks havoc on most of your organs.
What does insulin do?
Think of insulin as a bulldozer that pushes sugar, amino acids, and fatty acids from your bloodstream into the cells requiring energy. It has a lot (and I mean a lot) more functions. But for the sake of this article, let’s stick with the bulldozer analogy.
Regardless, when there’s an issue with insulin, glucose regulation is botched and the metabolism of other nutrients is hindered.
The difference between type 1 and type 2
I mentioned previously that either your body does not recognize the insulin you’re making or our body doesn’t make enough insulin.
- Type 1 diabetes (Insulin-Dependant Diabetes Mellitus) is when the pancreas is no longer able to produce insulin. This individual requires shots of insulin to metabolize blood glucose. This type is generally genetic or caused by other abnormalities and has nothing to do with a poor diet.
- Type 2 diabetes (Non-Insulin Dependent Diabetes Mellitus) accounts for 90-95% of all diabetes cases. It’s when our cells no longer respond to insulin (insulin resistance). There could also be a lower level of insulin production on top of the resistance for some individuals.
I feel compelled to mention that another term regarding diabetes has been coined. It’s called type 3 diabetes. It’s a situation where the excess insulin is causing issues with your neural tissue. More to the point, it’s one of the many potential culprits for Alzheimer’s disease.
You can read more about it in my article The Relation of Diet, Exercise, Stress, and Alzheimer’s Disease.
What are the symptoms of Diabetes?
Hyperglycemia can elicit many symptoms. The following list incorporates both common and less common symptoms. They are in no particular order. And some are short term while others are long term.
- Depression has been associated with type 2 diabetes
- Unusually thirsty
- An unusually high amount of urination
- Ketoacidosis (not to be confused with ketosis)
- More susceptible to infections
- Blurred vision
- Retinopathy (long term)
- Renal failure
- Capillary damage in the appendages (this can lead to tissue death and amputation)
The hormone “Insulin”
Insulin is responsible for energy metabolism after we’ve eaten a meal. It signals specific enzymes to increase glucose uptake in the muscles and liver and increases the production of glycogen and fatty acids. It also influences the production of stored fat (lipogenesis) by promoting the entry of glucose into adipose tissue (fat) and inhibits the use of stored triacylglycerols (fat).
That last statement is important. If insulin levels are constantly elevated, our metabolism becomes inefficient at burning fat as an energy source.
Again, a good analogy for insulin is to picture the hormone as a big bulldozer, which not only pushes substances into cells but also blocks many substances from exiting the cell.
What’s happening physiologically when someone has diabetes?
Now that we better understand the effects of this “bulldozing” hormone, we’ll apply it to diabetes. Regardless of the type, the bulldozer (insulin) is powerless in pushing glucose into cells in a person with diabetes, which causes hyperglycemia (elevated blood sugar).
Prolonged hyperglycemia begins a chain of events (osmotic diuresis, water and electrolyte loss, dehydration, hypotension, hemoconcentration and decreased renal and cerebral blood flow). These issues can lead to a coma or death.
Individuals with type I diabetes must inject insulin daily to prevent hyperglycemia and be careful not to induce hypoglycemia (too much insulin and not enough glucose).
Type II (non-insulin-dependent) diabetes is typically caused by excessive food intake and a lack of exercise. In time, receptor cells in peripheral tissues down-regulate, becoming insensitive to excessively high levels of insulin. There’s a picket line in front of the bulldozer!
Type II diabetes can be prevented by incorporating fitness and sensible dietary habits early in life.
How do we test for Diabetes
Typically, your annual fasting blood work will determine if you need additional screening for diabetes. If you’re found to have a fasting blood sugar greater than 110 mg/dL, your doctor may order a glucose tolerance test.
This test measures fasting glucose, followed by a sugary drink. Then blood is drawn at regular intervals to see how quickly blood glucose drops. If blood glucose is still equal to or greater than 140 mg/dL after two hours, then it’s a sign of diabetes. Labs and doctors use several different protocols, but in the end, all the glucose tolerance tests are fairly cut and dry.
If your initial annual fasting glucose test is equal or greater than 126 mg/dL on two occasions, it’s an automatic diagnosis of diabetes.
How does exercise help people with type 2 diabetes?
Exercise is important for anyone with diabetes. But it really helps those with type 2 diabetes. It helps patients:
- Control weight
- Improve insulin sensitivity and glucose tolerance
- Decrease blood pressure
- Bring about a healthier mental outlook and
- Reduce cardiovascular risk factors
Exercise also reduces the effects of those hormones that counter-regulate insulin by finding different bulldozers (hormones) to push glucose into the cells for utilization. Epinephrine is one such hormone that helps regulate blood sugar during exercise.
It is important to monitor both pre- and post-exercise blood glucose levels to be safe. Also, packing a snack while exercising outside or away from home prepares patients for times when they feel poorly.
Regular exercise from a young age through adulthood can help minimize the risk of ending up with diabetes. Yet again, one more reason to adopt a lifelong exercise plan.
Is there a difference between cardiovascular training and strength training with diabetes?
Both strength training and cardiovascular exercise improve the following aspects:
- Better glucose tolerance
- Reduced atherosclerosis risk
- Increased insulin sensitivity
- Decreased blood pressure
- Improved cardiovascular fitness (duh)
It’s worth noting that many individuals with type 2 diabetes are also obese. In my experience, if they don’t exercise, it’s best to start simple. A light, slow-paced strength training program in combination with walking is good. Gotta crawl before you walk, right!
Regardless, both strength training and cardiovascular exercise improve diabetes in different ways. This is why I recommend doing both to help improve the symptoms of both type 1 and type 2 diabetes.
Exercise for insulin dependant (type 1) diabetics
It must be noted that exercise can introduce another problem for individuals with diabetes. If one is insulin-dependent, injects insulin, eats, and then exercises, adjustments may be necessary to prevent hypoglycemia.
Exercise induces absorption of glucose, which is a double whammy if one has already used insulin. This is one reason I have always kept apple juice in my studio for clientele.
If you have type 1 diabetes, I’m certain you already know this fact!
Do Diabetics have a hard time building muscle?
Yes, if insulin levels are not properly controlled. If insulin levels are kept in check, then there should be no issues. Why?
Well, the muscles also require insulin to absorb amino acids. If there’s turmoil for this process, we’ll not be able to absorb the building blocks for muscle building. This is not a good situation.
What’s more important, food intake or exercise?
Food intake. What we consume has a far greater influence on our metabolism than exercise. This is not to say that exercise is not important, because it is. In fact, Turner states, “Exercise is medicine for people with type 2 diabetes.”
But, regulating your carbohydrate intake is of the utmost importance regardless of the type of diabetes you might have.
Excess calories of any type of macronutrient is also an issue
This article is not about how to manage your food intake if you have diabetes. So, if you are diagnosed with diabetes, please take the time to learn everything you can about eating healthy. It could save your life.
The financial impact of diabetes
I covered this in more detail in my article 13 Easy Steps to Eating Healthy on a Budget [Definitive Guide].
But it’s no secret or surprise that the financial impact of diabetes and obesity is enormous to the medical system. And we all pay more for our healthcare because of the added expense.
What are some solutions to diabetes?
If you have either type of diabetes, the following points are important:
- If you don’t already, add an exercise program that incorporates both strength training and cardiovascular exercise.
- Keep your carbohydrate intake in check. The fewer carbohydrates the better depending on your goals.
- Avoid adding too many excess pounds to your frame.
- Monitor your blood sugar yearly if you’re not diabetic.
- Also, if you’re not diabetic, look for signs listed above that you may be developing diabetes.
I really like Turner’s comment that “exercise is medicine for type 2 diabetes.” But sadly, too many of us don’t exercise and eat too much sugar (or too many carbohydrates). This not only encourages the onset of diabetes, but it also puts a massive financial burden on the medical/insurance industry. That cost is passed on to us.
So, I can’t stress it enough, exercise and a healthy meal plan are super important in the prevention or management of diabetes.
References & Resources
Physical Activity/Exercise and Diabetes, American Diabetes Association, Diabetes Care Jan 2004, 27 (suppl 1) s58-s62
Diagnosis and Classification of Diabetes Mellitus, American Diabetes Association, Diabetes Care Jan 2010, 33 (Supplement 1) S62-S69.
Sheri R. Colberg, Ronald J. Sigal, Jane E. Yardley, Michael C. Riddell, David W. Dunstan, Paddy C. Dempsey, Edward S. Horton, Kristin Castorino, Deborah F. Tate, Physical Activity/Exercise and Diabetes: A Position Statement of the American Diabetes Association, Diabetes Care Nov 2016, 39 (11) 2065-2079.
Sheri R. Colberg, Ronald J. Sigal, Bo Fernhall, Judith G. Regensteiner, Bryan J. Blissmer, Richard R. Rubin, Lisa Chasan-Taber, Ann L. Albright, Barry Braun, The American College of Sports Medicine and the American Diabetes Association: joint position statement executive summary, Exercise and Type 2 Diabetes, Diabetes Care Dec 2010, 33 (12) 2692-2696.
Thomas D, Elliott EJ, Naughton GA. Exercise for type 2 diabetes mellitus. Cochrane Database of Systematic Reviews 2006, Issue 3.
Golden SH, Lazo M, Carnethon M, et al. Examining a Bidirectional Association Between Depressive Symptoms and Diabetes. JAMA. 2008;299(23):2751–2759.
Nicolas Musi, Nobuharu Fujii, Michael F. Hirshman, Ingvar Ekberg, Sven Fröberg, Olle Ljungqvist, Anders Thorell, Laurie J. Goodyear, AMP-Activated Protein Kinase (AMPK) Is Activated in Muscle of Subjects With Type 2 Diabetes During Exercise, Diabetes May 2001, 50 (5) 921-927
Nicolucci, A., Balducci, S., Cardelli, P. et al. Relationship of exercise volume to improvements of quality of life with supervised exercise training in patients with type 2 diabetes in a randomized controlled trial: the Italian Diabetes and Exercise Study (IDES). Diabetologia 55, 579–588 (2012).
Turner, G., Quigg, S., Davoren, P. et al. Resources to Guide Exercise Specialists Managing Adults with Diabetes. Sports Med – Open 5, 20 (2019).