The Value of Exercise for Diabetes

Diabetes has reached the stage of a widespread epidemic. According to national figures, over three million people in the UK are living with a diagnosis of diabetes. For type 2 diabetes in particular, the key element in management and prevention is exercise. However, this is also the population predominately associated with inactivity meaning major complications arise when they could be avoided with simple lifestyle changes.

With an annual amount of nearly £10 billion spent in the NHS of treating diabetes and diabetes complications, Barbara Young chief executive of leading UK charity Diabetes UK highlights the dangers of poor diabetes management. "The fact that so many of them do not have good control over their diabetes means that unless something changes we face a public health disaster.”

Type 2 diabetes is associated with an inadequate insulin production as well as a resistance to the way muscle and cells of the body respond to it. Insulin is needed to allow the body to respond to fluctuating levels of glucose and poor insulin activity results in high blood glucose levels. If left untreated or unmanaged, complications such as heart disease and cardiovascular problems, kidney disease, nerve damage and even blindness and limb amputation are not uncommon in diabetes patients but they are almost certainly unavoidable.

Recommended Programmes

According to the Department of Health, different levels of activity should be achieved depending on your age.

• For children 5 and younger: Around three hours of activity is recommended once they have reached the walking age.

• For children and young adults: An aim of 60 minutes a day of moderate to vigorous activity should be enough to manage diabetes as well as strengthen bone and muscle.

• For adults and elderly: A minimum of 150 minutes a week should be carried out in the form of moderate to vigorous activity. This can achieved in long sessions or short regular bouts. However, it is important that no more than two consecutive days of inactivity occur.

If you have been diagnosed with prediabetes, a condition of impaired glucose tolerance that almost certainly leads to type 2 diagnosis if left unmanaged, at least two and a half hours of moderate to vigorous exercise should be included into your lifestyle changes to prevent or delay a diagnosis. This should include aerobic exercises such as swimming, brisk walking, bike riding dancing or active sports like tennis. You should also aim for a mixture of both aerobic exercises and resistance activities such as hand weights, weight machines or elastic bands. These strengthen and builds muscles helping to burn more calories and utilise glucose properly but also improves balance and coordination.

Long Term Benefits

The aim with exercise and diabetes management is to improve blood glucose control without the need of medical intervention. Physical activity promotes glucose regulation but also has a positive effect on lipid levels, blood pressure, cardiovascular events and mortality meaning an overall improvement of quality of life is also achieved. The major advantage is that it also helps to manage your weight. With 58% of diabetes attributable to excess fat, maintaining a healthy weight is vital to prevent the onset of diabetes. In addition, if you are already taking insulin to manage you diabetes, starting a programme of healthy eating and exercise may mean you find you are able to lower your dosage as your body is able to deal with fluctuations more readily.

Short Term Effects

When muscle contract, they increase the amount of glucose they take from the blood in order to utilize it as a source of energy. To maintain a healthy blood glucose balance, the liver also increases the amount it produces and so in a healthy person, a balance is achieved when exercising. In a person with type 2 diabetes, there is often an imbalance in glucose regulation leading to an overall decline. However, regular sessions of moderate exercise can be effective in maintaining a steady, non-threatening blood glucose level.

Tips to Maintain Regular Exercise

As mentioned, the majority of people living with Type 2 Diabetes do not engage in regular physical activity. For these people, it’s important not to over-do it but to introduce new types of exercise and activity gradually. Set yourself goals and keep an honest diary of your progress so you are aware of how far your have come. Support and encouragement is also key in ensuring these lifestyle changes are with you long term. Get family and friends involved and participate in group activities. Once you have found something you all enjoy, it will become less of a chore and something you can all look forward to together. According to Young, the key to sustainable changes is support, "by identifying those at high risk of developing Type 2 diabetes, we can ensure they start getting support to make the kind of lifestyle changes that can help prevent it.”