Exercise for Treatment and Prevention of T2DM
Exercise for Treatment and Prevention of T2DM
Effect of Exercise on Type Two Diabetes (T2DM)
· American Diabetes Association: Physical Activity (PA) and Exercise SHOULD BE PRESCRIBED TO ALL INDIVIDUALS LIVING WITH T2DM as part of managing glycaemic control and for overall health.
· T2DM is PREVENTABLE. It is known as a Lifestyle Disease (non-communicable, caused by lack of physical activity, unhealthy eating, alcohol or substance use)
· Lifestyle intervention
o Targeted weight loss of 7% body mass through diet and exercise resulted in: improved cardiovascular fitness, blood glucose control, & blood pressure, and overall quality of life and reductions in medication needed, sleep apnea, kidney disease, retinopathy, depression, sexual dysfunction, urinary incontinence, joint pain, and health care costs.
Danger of Diabetes
· Diabetes is a group of chronic metabolic disorders characterized by hyperglycaemia (high blood sugar) resulting from either reduced insulin secretion, reduced insulin action, or both. This causes glycation of tissues leading to acute disturbances in metabolism and long-term end organ damage and severe health complications.
o Neuropathy (death of nerves, may lead to amputation of limbs)
o Retinopathy (damage to eyes, may lead to blindness)
o Increased risk of stroke and heart attack
o Pharmacological interactions
Rates and Stats
· In 1999, about 4% of the world population had diabetes. Scientists warned that by the year 2025 that number could increase to 5.4%. By 2016 we had already reached 8.3%. Scientists projected that number to increase by 55% by 2035. As of 2021 we have reached 10.5% of the world population.
Where to start?
· Problem: Recommendations and precautions vary depending on individual characteristics and health status. Specific recommendations are too broad to be prescribed on mass
o Type of diabetes, age, modality of exercise, diabetic health complications present
o Recommendations should be tailored to specific needs of each individual
· Supervised exercise improves glycaemic control regardless of dietary cointervention, however unsupervised exercise fails to make improvement without diet changes
· General recommendations
o Aerobic activity: 150 minutes of moderate to vigorous intensity every week spread over at least 3 days
o Resistance Training (RT): at least 2 sessions per week on non-consecutive days. 1-4 sets of 5-10 multi-joint exercises per session
o Training for flexibility, balance, mind-body may be necessary to maintain functional movement needed for aerobic and RT training. In some cases, corrective exercises may be required to restore functional movement
· Exercise science to improve results and efficiency
o Sessions that combine RT and aerobic activity are recommended by most guidelines (more beneficial effect on glycaemic control)
o Those able to exercise at more vigorous intensity can achieve benefits with only 90 minutes per week of aerobic PA
o Aerobic PA can be accumulated in 10-minute bouts. Short bouts throughout the day also helps to reduce sedentary time.
§ Excessive Post-Exercise Oxygen Consumption (EPOC). Following exercise your metabolism is still elevated. Taking several shorter bouts of exercise throughout the day can allow for more time spent in EPOC.
· What if these recommendations are too challenging for me?
o Do as much as you CAN not as much as you CAN’T. WGA Kinesiology is here to help you whether you can afford services or not.
o Previously sedentary adults can improve insulin action with as little as 400kcal per week of energy expenditure with dose-response up to 2500kcal per week.
§ Eg a 100kg female walking at 3pmh for ~12minutes burns about 75kcal
· Doing this 5 to 6 times a week would get you to 400kcal
How does exercise improve / prevent T2DM?
· Type 1 Diabetes refers to an inability to produce insulin
· T2DM refers to reduced sensitivity to insulin. Insulin is a hormone that aids in the absorption of blood sugar into tissues and cells. When sensitivity to insulin is reduced, blood sugar remains in the blood and the body must find less optimal solutions for storage. Exercise creates additional pathways for the body to get glucoses out of the blood and into tissues that need glucose- for example, muscle tissue can store glucose as glycogen.
Conclusion
· T2DM rates continue to increase around the world
· Lifestyle interventions including exercise can prevent and treat T2DM
· Needs differ between individuals combined with an overabundance of generalized recommendations can complicate and confuse people seeking to begin exercising.
· Supervised tailored exercise intervention is the most efficient way to increase your PA
· Benefits of exercise extend beyond T2DM (mental health, cardiovascular, musculoskeletal)
· WGA has a variety of resource (including free ones) to help you take back control of your health
