Preventing, Controlling, and Treating Diabetes with Exercise
Diabetes is one of the most common chronic diseases, and one of the leading causes of death, nationwide. According to the Centers for Disease Control and Prevention, over 29 million (10%) Americans have diabetes, with another 89 million having prediabetes. The also estimate that over 25% of these individuals do not realize they have these conditions.
Diabetes, specifically Type 2 Diabetes, is a condition in which the body does not respond effectively to the hormone insulin, typically as a result of chronically eleveated blood sugar. Blood sugar and insulin on their own are not bad for you. Blood sugar, or "glucose," is actually the primary energy source for most of the things our bodies do throughout the day, and insulin helps shuttle the fuel into our muscles to power our exercise and general activity.
Unfortunately, poor diet, lack of exercise, smoking, and excess body fat can all lead to elevated glucose levels and diabetes risk. If your fasting blood glucose level is above 100 mg/dL you may be at risk for prediabetes and diabetes. Chronically elevated insulin and glucose can lead to insulin resistance in our cells, and damage to nerve cells, blood vessels, kidneys, and more.
Fortunately, this result is not inevitable. Regular exercise has been proven to prevent, manage, and reverse the onset and development of diabetes.
Exercise as Prevention
Regular exercise is one of, if not the, best way to protect yourself from developing diabetes. In fact, the American College of Sports Medicine reports that regular physical activity can reduce your risk by over 58%! Regular exercise helps prevent diabetes by controlling your blood sugar levels, improving your insulin sensitivity, reducing the buildup of fatty acids in your liver, and improving your body composition.
More specifically, regular exercise changes the primary energy source in our body. At rest, we tend to metabolize fat for energy. However, once we start exercising we generally use glucose and glycogen (long chains of glucose) for energy. As a result, blood sugar levels tend to decrease throughout exercise as our muscles burn the glucose for energy. For individuals with high blood sugar levels, this can help them control and lower those levels naturally, reducing their risk of insulin resistance.
Regular exercise, particularly strength training, can also help prevent diabetes by increasing your muscle mass and reducing your body fat. Increased muscle mass means there are more muscle cells in your body in need of blood sugar for fuel. As a result, there will be lower levels of blood sugar, as more cells will be absorbing and metabolizing it throughout the day.
Exercise as Treatment
It is never too late to start exercising, even if you have already been diagnosed with diabetes or prediabetes. Not only does exercise help prevent the onset of diabetes, but it can actually help manage, treat, and in some cases reverse the condition one diagnosed as well!
In particular, exercise can stimulate insulin-independent glucose absorption. Typically, we absorb blood sugar into our cells when insulin levels increase after eating. With diabetes, our cells develop insulin resistance, meaning even when insulin levels are high the cells may not respond properly by absorbing insulin. Fortunately, exercise has a solution! Using what is called the GLUT-4 Pathway, our muscle cells can actually absorb blood sugar completely independent of insulin! This means that for people with diabetes, even a little bit of exercise can help lower your blood sugar levels by stimulating this GLUT-4 mechanism that works as essentially a "back door" to our cells, allowing glucose to rush in and fuel our activity.
Along with improved glucose absorption during activity, exercise can improve our insulin sensitivity for up to 24 hours after we stop exercising! This means that even if you suffer from insulin resistance chronically, for a time period after exercise your resistance will decrease and your cells will become more responsive to insulin, helping you control your blood sugar levels and mitigate the negative effects of diabetes.
Exercise truely is medicine, and should be front and center in everyone's medicine cabinet.
What to do?
The American College of Sports Medicine and the Centers for Disease Control and Prevention recommend 150 minutes (2 1/2 hours) of moderate-intensity activity each week to reduce your risk of diabetes, including at least two, 30-minute strength-training sessions per week. Something as simple as going for a walk counts as "moderate intensity exercise" and the bouts can be broken up into as little as 10 minutes. Try to fit 10 minutes in before work, over lunch, and in the evening and before you know it you'll hit your 150 for the week! Greater than 150 minutes per week will create even greater benefit, as will vigorous intensity activity. In fact, just 75 minutes of vigorous intensity activity (i.e. jogging) will drastically decrease your risk too.
If you can burn a little more calories than you take in per day, there will be instant results. Instead of taking the bus or your car somewhere, go on a relaxing bike ride or walk. If there is an elevator you take to the third floor daily, substitute it by taking the stairs. You could even try an activity you have been longing to do like hiking, yoga, or joining a community sports team. Slightly different paths throughout your day and life will add up, and can improve your overall health and wellness.
Now get out there and get moving!