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Diabetes and Exercise – Why the Connection is Vitally Important
Nearly 21 million people in the U.S. are living with diabetes, and an estimated 6.2 million of those people do not know they have diabetes because they are not diagnosed. According to the American Diabetes Association, people with diabetes have, on average, 2.3 times more medical expenses than non-diabetics. Another study in Population Health Management estimates that diabetes costs our country $218 billion in health care each year. However, most cases of diabetes can be prevented or reversed through exercise, weight loss and a healthy lifestyle.
I found myself wondering. What if the 6.2 million undiagnosed people knew they had diabetes? Or have the estimated 57 million Americans with prediabetes been educated on how they can take care of their health and avoid becoming type 2 diabetics?
Being diagnosed as prediabetic does not mean that type 2 diabetes is inevitable. If you lose weight and increase your physical activity, you can prevent or delay diabetes and even bring your blood glucose back to normal (ACSM 2006). (see sidebar for defined terms related to diabetes)
This is a very important point that many people don’t understand – if you exercise and lose weight, you can prevent or delay diabetes.
Do you know the symptoms of diabetes? Look around you. Are you seeing any signs of diabetes in your friends and family right now? (See sidebar for common diabetes symptoms) It’s very possible that there are people around you every day who are diabetic (or will become diabetic). The Centers for Disease Control and Prevention estimates that one in three Americans may develop diabetes during their lifetime. These statistics are staggering and for the most part preventable.
What about type 2 diabetics who have been diagnosed? What if we taught them that diet and exercise can reduce or eliminate medication? What would that do to our health crisis? I know that we would first have to break down many myths, magical solutions and limiting beliefs. Even the drug companies won’t be happy about me revealing this secret. But damn, our healthcare is in crisis! Our nation is sick! I said it. So let’s get down to taking some personal responsibility for our health.
Many of you who are trying to understand diabetes and take responsibility for your health have several questions:
o Should you cut out sugar?
o Does your weight put you at risk?
o If you’re skinny, you don’t have to worry, right?
o Can exercise and diet really help you?
o How can I control my blood sugar?
And then there are the issues you may not even know to ask:
o If you have had diabetes for more than five years, you may increase your chances of developing cardiovascular disease
o Regular exercise can make you more sensitive to insulin, which can reduce medication doses
First, let’s talk about insulin, the main drug that keeps diabetics functional, and then you can clearly see the answers to your questions.
How does insulin work? Insulin is the main hormone that controls the entry of blood sugar from the bloodstream into the cells of the body to be used as energy. How does exercise affect the hormone insulin? Exercise has an insulin-like effect on the body. When you exercise, your muscles require a steady supply of sugar to keep contracting and keep you moving. Exercise increases the rate at which your muscles take up sugar from the bloodstream; so exercise works the same way insulin does by flushing excess sugar from the bloodstream into the muscles. This action therefore lowers the blood sugar level. One twenty-minute walk a day can lower your glucose level by twenty points.
Here is a great example to explain the function of insulin in your body. Think of insulin as a bus for a moment. The passenger is glucose (sugar). There are two types of diabetics. Type 1 diabetics do not produce any insulin (or have no insulin), which accounts for 5 to 10% of all diagnosed cases, according to the Centers for Disease Control. The other type (Type 2) has insulin resistance, which means the bus is there but not picking up passengers and there are fewer buses on the route. According to the Centers for Disease Control, type 2 diabetes accounts for 90% to 95% of all diagnosed cases.
When you exercise, your muscles work harder than usual and require more fuel than usual; so your muscles send out their own buses to pick up sugar in the bloodstream and bring it back to the muscles. Working muscles take up insulin and (in type 2 diabetics) can even tell the buses (insulin) how to work again (pick up passengers).
Exercise has many benefits for a diabetic. It increases glucose uptake by cells, improves insulin sensitivity by improving glucose metabolism and reduces the risk of cardiovascular disease. Lowering blood glucose improves insulin sensitivity by making it more effective. Exercise can reduce dosage requirements or medication needs and improve the ability to lose and/or maintain body weight when combined with intuitive dieting. (See the sidebar for a safe exercise checklist)
There are many popular myths about diabetes. Here are a few that I hear a lot.
Myth #1 – Diabetics can’t eat sugar or sweets and the only reason they have diabetes is because they ate too much sugar. Yes, simple carbohydrates or sweets raise blood glucose levels, but if you eat them in moderation and include them in your diet, you can still have a sweet once in a while.
Myth #2 – When I’m skinny, I’m fine. Diabetes is only a disease that obese people suffer from.
It’s not entirely true, 20% of people with type 2 diabetes are thin. Yes, obesity puts you at risk for type 2 diabetes, high blood pressure, and high cholesterol. The key thing to remember is that there is no atypical “diabetes” body type, genetic trait, race, age or gender. Type 2 diabetes is caused by lifestyle choices and diabetes is a disease that needs to be taken seriously.
Myth #3 – There is no natural cure for diabetes. If I take insulin or insulin sensitivity medication, I can continue the same lifestyle and be fine. There is a natural cure, it’s called exercise and a balanced diet. You can control diabetes by monitoring your glucose levels, combining exercise with a balanced diet, or taking medication.
Myth #4 – I’m just borderline and 170 mg/dL blood sugar is normal for me. As a diabetic, you may feel normal, but high glucose levels are not safe. There is no such thing as a border. You are either diabetic or you are not. This is a serious illness that requires you to take personal responsibility for your body. There are serious health complications associated with diabetes, especially when you burden your body with high blood sugar. You need to start changing your lifestyle in order to live a quality life in the long run.
Myth #5 – Exercise! What can it do for me? Blah! Blah! Healthy Lifestyle Blah! Yeah, yeah, I know. The American Diabetes Association recommends 150 minutes of exercise per week. It is an exercise of 20-60 minutes, in continuous sessions, 3-5 times a week. The Diabetes Prevention Study revealed that exercising for a total of two hours a week can reduce your risk of diabetes by 50%, which can be as little as 20 minutes, 6 days a week. Take a short, ten-minute walk before and after work and you can prevent diabetes or lower your glucose levels.
The fact is that over 90% of diabetes cases are preventable and can be managed with some natural means such as exercise, a healthy diet and/or combination with low-dose medications without disrupting our $218 billion health care system. Start gradually and practice a little each day until you reach the recommended guidelines. Eat a balanced and healthy diet and lose your all or nothing attitude. Get educated about your disease, find out what your diabetes beliefs are and make lifestyle changes starting today. (See sidebar Want to learn more)
Diabetes is serious, but you can do something about it!
Definition of terms for diabetes
o Type 1 = an autoimmune disease that destroys the insulin-producing cells in the pancreas. The body cannot make its own insulin because the beta cells of the pancreas, which are responsible for producing insulin, are destroyed. About 5-10% of all diagnosed cases (CDC 2005)
o Type 2 = the body loses sensitivity to insulin, so the body’s cells are unable to use insulin properly (also known as insulin resistance or adult-onset diabetes). About 90% – 95% of all diagnosed cases (CDC 2005)
o Prediabetes = If you have a fasting plasma glucose (FPG) test and your levels are 100 mg/dL to 125 mg/dL, they are diagnosed as diabetes symptoms unless you make some lifestyle changes
o Gestational diabetes = When pregnancy hormones interfere with the mother’s insulin, causing glucose levels to rise. This is a form of insulin resistance, which in most cases ends with the birth of a child.
o Metabolic syndrome = A combination of health disorders that increase the risk factors for the development of cardiovascular disease, obesity, hypertension, low high-density lipoprotein (HDL), high cholesterol levels, and elevated plasma triglyceride levels.
o Hypoglycaemic = abnormally low blood sugar, which can be caused by too much insulin or your diet. Symptoms would be: trembling or shaking, nervousness, fast heartbeat, increased sweating, headache, difficulty concentrating or attention, unconsciousness and coma
o Hyperglycemic = abnormally high blood sugar. Symptoms would be: frequent urination, great thirst, nausea, abdominal pain, dry skin, disorientation, labored breathing and drowsiness.
Do you know the symptoms of diabetes? Some very telling signs include:
o frequent thirst, hunger and urination
about losing weight
o frequent infections
about blurred vision
o cuts/bruises that heal slowly
about tingling and numbness in hands and feet
o recurrent skin, gum and bladder infections
Safe Exercise Checklist
o Get your doctor’s clearance before starting any exercise program
o Test your blood glucose before exercise, immediately after exercise, and again two hours after exercise
o Follow general guidelines for safe exercise; warm up, cool down, stretch, maintain Type 1 (3 to 5 RPE) and Type 2 (3 to 6/7 RPE) intensity, drink plenty of water
o Wear well-fitting, well-cushioned and supportive shoes
o Wear polyester or cotton polyester socks to keep your feet dry and minimize foot injuries
o Avoid strenuous, high impact or static activities unless specifically approved by your doctor
o Carry a carbohydrate snack with 10-15 grams of carbohydrates
o In case of a hypoglycemic reaction, wear an ID number to tell others you have diabetes http://www.n-styleid.com
o Know and monitor the symptoms of exercise-induced hypoglycemia
o Do not exercise if your blood glucose is 250 mg/dL or if you have ketones in your urine
o If you have autonomic neuropathy, peripheral neuropathy, neuropathy, retinopathy, or other conditions related to diabetes, you must get your doctor’s approval before starting an exercise program. These conditions require specific and strict instructions.
o Practice with a partner until you know your reaction to exercise
o Always check your feet for lesions before and after exercise
o Drink plenty of water. A good rule of thumb is to have a bite or two at least every fifteen minutes
Want to learn more? Additional resources:
o Live for free! CD and Workbook System http://www.livingfreediabetes.com
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