Diabetes Mellitus is a condition that results from the dysregulation of blood sugar (aka blood glucose). Blood sugar is controlled by insulin, a hormone that is produced by the pancreas, which is responsible for pulling the digested nutrients from the blood stream into your cells after a meal. While insulin directly promotes the storage of carbohydrates, it also indirectly promotes the storage of fats. There are three types of diabetes: type 1, type 2, and gestational diabetes. Type 1 usually occurs early in childhood as a component of genetics and is a result of the pancreas not functioning properly. The prevalence accounts for about 5% of the diabetic population and people are required to be on insulin for life. Type 2, which accounts for the majority of the diabetic population, usually occurs in adulthood and is a result of poor lifestyle choices. However, due to the lifestyle choices of a traditional Western Diet, more children every year are being diagnosed with type 2 diabetes. Gestational diabetes physiologically mimics type 2, but only occurs during pregnancy for women. Gestational diabetes can increase the risk of diabetes for the child as well as the mother later in life.
While the primary outcome of diabetes is poor blood sugar control, the physiological impacts can be different across the types of diabetes. Because they do not produce any insulin, type 1 diabetics typically lose weight if their diabetes is not controlled because their cells go into starvation mode. Type 2/gestational diabetes, on the other hand, results in weight gain if uncontrolled because the pancreas does produce insulin, but the person becomes insulin resistant. Thus, some nutrients are still being absorbed.
The primary focus of this article will be on type 2 diabetes, and subsequently gestational diabetes, and will discuss how exercise can help manage diabetes. It is one of the few chronic diseases that can be managed, dare I say reversed, through lifestyle change. While nutrition is extremely important for management, it is only half of the equation and exercise is equally important.
- Supports Insulin Sensitivity & Weight Management
Regardless of type of exercise, physical activity promotes energy expenditure. By increasing your activity, one can create a caloric deficit and control weight. Research has shown that there is a high correlation between weight and insulin sensitivity. Thus, if one decreases fat mass, insulin sensitivity can improve.
You may be asking, which exercise is better for diabetes, cardio or resistance training? The answer is that both of them are effective and combined training is more effective than either one alone.
To get slightly more granular within cardio/aerobic training, it has been demonstrated that high intensity interval training (HIIT) is equivalent or even MORE effective than steady state cardio-based training. While this may be perceived as a harder workout, there is an added benefit of being a timesaver and not having to spend a long time exercising.
In the end, the goal is to find an activity and regimen that is enjoyable, safe, and sustainable!
- Improves Blood Flow
One of the consequences of poorly managed diabetes is known as Peripheral Arterial Disease (PAD). Essentially, blood flow gets restricted to the extremities and eyes, which can result in blindness and/or amputation if severe enough. While the literature has shown that those with diabetes have a less-pronounced response to exercise compared healthier individuals, that does not mean exercise is not beneficial. More importantly, those who continuously exercise, and those who combine resistance and cardiovascular training, tend to show increased blood flow (and other benefits like lower HbA1C) in limbs compared to those with diabetes who are sedentary.
- Reduces Anxiety
An all too often unnoticed side-effect of living with a chronic disease is the mental taxation it can cause. It can be challenging to manage the systemic complications associated with any chronic disease, but especially diabetes because there can be comorbidities and downstream negative physiological effects. Consequently, this poor quality of life can result in anxiety and emotional instability. Furthermore, there is evidence of association between depressive symptoms and complications of diabetes.
Exercise can be one of the ways to cope while on your journey towards a healthier you. Not only does exercise provide the physiological benefits above, but there are also psychological benefits. While results are somewhat equivocal, due to heterogeneity of exercise type, duration, population size, supervision, etc., there is a general positive association between physical activity improving negative affect emotions. While the exact mechanisms of these beneficial effects are unknown, it is suggested that there is a combination of psychological and neurobiological pathways that synergistically work together. Examples of these domains include social support, improvement in self-esteem, a sense of mastery, increased serotonin and dopamine, and adrenaline release.
While having diabetes can be debilitating, there are steps you can take to improve the quality of life and mitigate the associated consequences. By utilizing exercise as a tool, you can experience the beneficial effects from head-to-toe!
Disclaimer: This information is educational only and not providing healthcare recommendations. Please see a healthcare provider.