TOPIC: What Should A Type 2 Diabetic Do To Live Healthy?
The Question:
More and more people are at risk for type 2 diabetes. It's a serious health concern amongst a number of Americans.
What should a type 2 diabetic do to live healthy?
What is a good nutrition program for a type 2 diabetic?
How could a diabetic benefit from an exercise routine?
Bonus Question: How does one know if they are at risk for diabetes?
Show off your knowledge to the world!
The Winners:
- 1. ho_124
- 2. Opiewags99
View Profile (Mighty Kev)
- 3. blackirish
- 3. jdiritto
Prizes:
- 1st place - 75 in store credit.
- 2nd place - 50 in store credit.
- 3rd place - 25 in store credit.
1st Place - ho_124
View This Author's BodySpace Here.
Type 2 diabetes is a serious disease that is classified by the center for disease control as a growing epidemic. It used to be the case that mostly older adults would contract the disease; however it is now increasingly seen in adolescents and younger children. It is unfortunate that diabetics have to live with the negative aspects of the disease; however by taking careful steps they can still enjoy a good quality of life.
Before delving further I would like to quickly give an outline of what type 2 diabetes is. Type 2 diabetes is classified by the inability of the pancreas to produce enough insulin or the fact that the body does not properly use insulin generated by the body. This leads to hyperglycemia or a build up of sugar in the blood and has negative effects on the body.
Living Healthy With Diabetes
What Should A Type 2 Diabetic Do To Live Healthy?
There are many steps one with type 2 diabetes can do to live a healthy life. Here is a list:
1. Maintain An Acceptable Blood Glucose Level:
It is essential that you maintain proper blood glucose levels. If your blood glucose levels are frequently at a high level then a number of negative effects can occur such as:
- Blindness
- Heart disease
- Reduced blood supply to the limbs, leading to amputation
- Nerve damage
- Erectile dysfunction
- Stroke
There is a number of things you can do to control blood glucose levels however. The main thing is the second point, a good diet:
2. A Good Diet:
A good diet will either make you or break you. It is through diet that you can control your blood glucose levels. Basically when you eat foods with carbohydrates, your body digests the carbohydrates into glucose to use as energy. Different foods have carbohydrates that break down into glucose at different rates.
As a diabetic you want to eat foods with carbohydrates that break down into glucose slower so it does NOT cause a rapid increase in blood glucose.
Foods that break down into glucose fast or are simple sugars are foods that you should AVOID as this will cause a rapid increase in blood glucose and negative effects. Your best friend is a G.I. or glycemic index which ranks foods according to how fast they breakdown into glucose. I will cover a good diet further in the article.
This brings me to the third point. Not only is it important to eat foods with slow digesting carbohydrates, but also eating a healthy diet meaning limiting or even abstaining from eating things like fried, fatty, and sugary foods.
3. Weight Control:
Weight control is a major factor in controlling diabetes. Weight gain leads to increased insulin resistance and thus placing more stress on the pancreas to produce more insulin. Also an alarming statistic for you, about 55% of people with type 2 diabetes are obese. Therefore weight control is a significant factor in dealing with diabetes. This means eating a clean and healthy diet as I stated before and one other thing exercise.
4. Staying Active:
Staying active is another highly recommended activity for anyone with type 2 diabetes. Exercise has been shown to reduce blood glucose levels and therefore help diabetics live a healthier life. Also by staying active you will be able to keep fat levels under control which is another factor contributing to decreased quality of life for type 2 diabetics.
You do not have to take on the most rigorous training program to get benefits. Just so long as your doing consistent exercise at an acceptable duration you should be fine.
5. Maintain Good Blood Cholesterol Levels:
Maintaining good blood cholesterol levels has been shown to help manage diabetes. Scientists have speculated that when toxic lipids build up in beta cells (which release insulin), they become impaired and thus leading to abnormal blood glucose levels.
There are many things you can do to lower cholesterol such as exercising, eating a healthy diet low in saturated fats, quitting smoking, and losing weight if you need to. You can also talk to your doctor about more options.
6. Take Medication:
For some people medication is needed to maintain a good quality of life. There are numerous medications that are used in many different situations and people. Some work by increasing insulin sensitivity or by stimulating the pancreas to release insulin.
This is not something that you can just read off the internet and get a clear idea what you need. This is something you MUST talk to your doctor about so he/she can prescribe something that works best for you.
7. Take Care Of Your Eyes:
Diabetes can sometimes cause eye problems and blindness. Therefore to reduce the risk visit your eye doctor regularly so that any serious issues can be sorted out.
8. Be Aware Of Hypoglycemia:
From time to time diabetics will suffer from hypoglycemia which is not enough sugar in the blood. Some symptoms include:
- Dizziness
- Sweating
- Shaking
- Hunger
- Headache
- Pale skin
- Behavior changes
- Confusion
- Irritability
- Weakness
- Cold skin
The best say to treat this is by using a blood sugar monitor that you can carry around and by ingesting food that contains sugar to get your blood glucose levels back up. Talk to your doctor for more information and your options.
 |
What Is Hypoglycemia? Hypoglycemia or hypoglycaemia is the medical term for a pathologic state produced by a lower than normal level of glucose (sugar) in the blood. The term hypoglycemia literally means "under-sweet blood". |
|
|
||
9. Take Care Of Your Feet:
Diabetes can cause the nerve damage which reduces sensation in the feet. Foot problems can arise if you do not take care of your feet. In some cases some diabetics have had their feet amputated because of infections which can be protected by wearing proper footwear and proper foot care.
Nutrition
What Is A Good Nutrition Program For A Type 2 Diabetic?
There are a number of points you should be aware so that you can follow a good nutrition program to control your type 2 diabetes.
1. Eat Foods With A Medium And Low Glycemic Index:
This is probably the most important point on diet. As I stated before foods with carbs that break down into glucose slowly are ideal. Your diet should consist mostly of foods with a low glycemic index and a few foods with a medium glycemic index.
You really should stay away from foods with high glycemic index. Here is something to consider. If your not sure on something, just look it up and there are a plethora of sites that will tell you the glycemic index of a food.
Low and medium glycemic index foods:
- Brown rice
- Basmati rice
- Whole wheat pasta
- White pasta
- Couscous
- Quinoa
- Whole-wheat bread and other whole wheat products
- Oatmeal
- Fruits excluding some such as watermelon
- Vegetables
- Sweet potatoes
- Nuts and seeds
2. Eat Foods Low In Saturated Fat:
Eating a diet low in saturated fat will control your cholesterol which is something that will help you stay healthy and control your diabetes. Also a diet high in saturated fat is usually one that is high in calories resulting in fat gain. Fat gain is another thing you must avoid to control your diabetes.
3. Eat Your Healthy Fats:
Eating healthy fat not only is good for your health, but it is good in one other way. It slows down the absorption of glucose from digested sources thus helping maintain good blood glucose levels. This means eating your essential fatty acids which are omega 3, 6, and 9 and also some poly and mono unsaturated fats. Sources of these include:
- Fish
- Nuts
- Seeds
- Avocados
- Oils
- Some vegetables
4. Don't Eat Excessive Protein:
It is a good idea to eat a good portion of protein, however do not eat excessive protein. The reason is that the protein can be converted into glucose by the liver thus raising blood glucose levels which is something you do not want. Still don't be afraid to up protein consumption after a workout etc.
5. The Main Rule Is Eat Healthy:
The general rule is eat a healthy and balanced diet to maintain overall health. This will help maintain your weight, cholesterol, and also your blood pressure and thus give you a higher quality of life.
Exercise Routine
How Could A Diabetic Benefit From An Exercise Routine?
A diabetic can benefit from an exercise routine in a bunch of different ways.
1. Reducing Blood Sugar Levels:
Exercise can help your bodies cells to respond better to insulin and thus take up glucose better from the blood. This will in turn help regulate blood sugar levels to acceptable levels.
2. Reducing Fat:
Reducing fat not only is good for overall health but as stated before having a lower body fat percentage is one such way of increasing insulin sensitivity. If your overweight then chances are it will make your diabetes worse.
3. Maintaining Good Cholesterol Levels:
Exercise has been proven to reduce blood cholesterol which is important in keeping your diabetes in check.
Some tips:
- Exercise should be consistent, at least 3-4 times per week.
- Exercise should also last at least 15-20 minutes in duration. Going longer is optimal but remember not to burn out.
- Remember to do something fun and switch things up, for example just running on a treadmill staring at a wall all the time is something that you probably wont be able to keep up that long.
Bonus Question
How Does One Know If They Are At Risk For Diabetes?
There are a number of risk factors such as:
1. Family History:
Research has shown that having a family history of diabetes increasing your own risk of developing the disease. 25-33% of diabetics have family members with the same condition.
2. Ethnicity:
Not to be racist or anything here but studies have shown certain ethnicities have a higher risk of developing diabetes. African Americans, Native Americans, Asians, and also Hispanics have a higher incidence of diabetes.
3. Obesity:
Obesity is a major risk factor in developing type 2 diabetes.
4. Apple-Shaped Figure:
People who carry most of their weight above the hips tend to have a higher incidence of diabetes than people who have more weight at the thighs and hips.
5. Age:
People over the age of 65 have a much higher risk of type 2 diabetes than people ages 34-64.
6. Inactive Lifestyle:
Being overweight which is something that contributes to diabetes can be controlled by exercise.
7. High Blood Pressure:
About 60% of people with undiagnosed diabetes have high blood pressure.
8. High Cholesterol:
More than 40% of type 2 diabetics have high cholesterol levels.
References:
- http://www.diabetes.ca
- http://www.medicalnewstoday.com
- http://www.diabetes.org
- http://www.acefitness.org
- http://bodyandhealth.canada.com
- http://www.phac-aspc.gc.ca
2nd Place - Opiewags99
View This Author's BodySpace Here.
More and more people are at risk for type 2 diabetes. It's a serious health concern amongst a number of Americans.
Living Healthy With Diabetes
What Should A Type 2 Diabetic Do To Live Healthy?
Diabetes is an extremely hard condition to live with. More than likely, you've lived your life and been able to have a nice little sweet cheat meal whenever you wanted without even needing to think twice. Now that you've got type 2 diabetes, it seems that things have changed for you.
Your doctor says that you need to change your lifestyle in addition to testing your blood sugar often. Perhaps that statement from your doctor has led you here, in which case, you're in the right place. Although living with type 2 diabetes will be different, sometimes drastically different than the lifestyle you knew before, it can be done.
In order to live a healthy life, there are a few things a diabetic person must look at.
1. The First Of These Is Leading An Active Lifestyle:
I'm sure you've heard time and time again that exercise is an essential part of the recipe to living a long life, but have ignored it until now. Now the fact is staring you in the face, your health is compromised and will only get worse if not taken care of. So go for a walk, or a bike ride.
Start off slow and get yourself out there and be active. I also advise that you look into finding a way to incorporate some resistance training into your day, whether it be simply through doing household chores, or even going to the next level to actually lifting weights, it can help you build lean muscle which will speed your metabolism, which can help get rid of some of that extra weight that the majority of us carry around and would like to get rid of.
2. The Second Of These Pieces Of The Puzzle To Leading A Healthy Life Would Be The Proper Diet:
Diet has a lot to do with not only causing diabetes, but it can also lead to its worsening. It's pretty well known that being overweight is one of the biggest risk factors for developing diabetes type-2, and it's also very well known that years of eating fatty and sugary foods can lead to this overweight risk factor, sometimes to the extreme of obesity.
The good news is that by carefully watching your diet and minimizing your intake of these types of foods will be the key to lowering your bodyweight to a healthy level which can in turn help you further control your diabetes.
3. The Third And Last Thing That Is Essential To The Diabetic Looking To Lead A Healthy Life Is That They Need To Find A Motivation To Succeed And Live Through This Condition:
Without a specific goal in mind, it's hard to stick to any plan, so whether it's to get in shape enough to run a 5k with your wife or on the other end of the spectrum and it's to see your grandchildren get married, you have a reason to resist both the temptations of that last piece of Swiss chocolate cake or to go for a walk rather than watching the game from the couch.
The real goal is to get into the mindset that this is the means to a better life, and not a means to an end. Simply put, you're not getting yourself in better shape for the sake of being in better shape; it's to accomplish some more important goal to you.
So find what motivates you, get checked by your doctor, and do what you need to do to live healthier; not only for you, but for your loved ones also.
Nutrition Program
What Is A Good Nutrition Program For A Type 2 Diabetic?
A good nutrition plan for a person controlling their type two diabetes is not that much different than a traditional weight loss diet, by virtue of the fact that the majority of people afflicted with diabetes are trying to lose a little bit of weight.
Now, the goal to a healthier life is to eat healthier foods, such as fruits, veggie, lean protein sources, and whole grain foods. But quantity is also an issue in addition to quality.
Even healthy foods when eaten in large quantities can cause weight gain. So keep in mind that you want to consume the same amount of calories as you burn if you want to maintain your weight, or since a pound of fat is 3500 calories, reduce your caloric intake by 500 cals per day to lose a pound a week, assuming you want to lose weight. But regardless of if your goal is to lose weight or not, eating healthier foods will make you a healthier person.
Perhaps one of the best ways to structure your diet is to take the number of calories that you eat throughout the day, and split it into 6 different and equal sized meals throughout the day. This will help keep you constantly alert and fully awake during the day.
If you think about it in a logical manner, it only makes sense that if you have a steady flow of food coming into your body, your energy levels will be much more consistent throughout the day.
This only holds true if you are eating the right kinds of foods also. As very sugary foods can cause drastic spikes in blood sugar, which due to your condition will not be able to go down as quickly as typically desired by the body, it can be harmful to you. This is why foods containing fiber are important.
A carbohydrate rich food full of complex carbohydrates takes longer for the body to digest and process, thus not causing the spiking effect. A much slower rise in blood sugar allows the body to function more normally due to the lack of need for the insulin hormone.
In Summation:
Keep a healthy weight
- This can be done by eating 6 small meals throughout the day.
- Eat 500 fewer calories less per day than you expend, for a pound of weight loss a week.
- These meals should be composed of lean protein sources, complex carbohydrates, and fruits and veggies.
Visit your doctor regularly to keep your condition constantly closely monitored.
Exercise Routine
How Could A Diabetic Benefit From An Exercise Routine?
One of the common accompanying afflictions that are associated with type 2 diabetes is obesity. Extra weight is not only a risk factor for developing diabetes; it also can increase the severity of your situation, so it is absolutely essential to take the best care of your body as possible.
One of the best ways to maintain a healthy weight is not only to watch your diet, as was discussed above, but also to begin an exercise routine. Daily exercise not only helps raise the amount of calories burned in a day by the body, it also raises the metabolism for further caloric burn for hours and sometimes days after performing the exercise.
Getting the proper amount of exercise each day helps promote lean muscle growth as well as fat loss. Essentially it all boils down to being an active person and doing your best to take good care of your body.
Bonus Question
How Does One Know If They Are At Risk For Diabetes?
There are a few risk factors that you can look at to see if you are at a high risk for developing diabetes. These include:
- Obesity
- Sedentary Lifestyle
- High Blood Pressure
- Family History of High Blood Pressure
- High Cholesterol
- Impaired Tolerance of Glucose
- Ethnic Ancestry
- History of Diabetes in pregnancy (gestational)
- Increasing Age
Of course there are risk factors for diabetes, but you can never truly know unless you visit the doctor to know for sure. Medical attention absolutely essential in the management of this condition, so don't think you can just tough it out.
Many people do that and harm their health further, sometimes to a point of no return. If you suspect that there is a possibility that you are developing diabetes, seek medical attention as soon as possible.
Left untreated, diabetes can cause blindness, liver damage, in addition to necessary amputation of limbs due to the lack of blood flow and nerve damage.
Thanks fore reading!
Opiewags99
References:
3rd Place - blackirish
View This Author's BodySpace Here.
Type II diabetes, alternatively known as non-insulin dependant diabetes, is a serious health problem in the western world. Preceded by insulin resistance, this disorder results in high levels of both glucose and insulin in the bloodstream, resulting in a plethora of health issues. Blurred vision is one of the more benign symptoms.
On the other end of the spectrum are the cardiovascular effects that diabetes can exert. Insulin has been found to be damaging to arteries, causing scar tissue to form on inner surfaces.
As any modern bodybuilder knows, insulin is anabolic. This anabolic action extends to fat stores, skeletal muscle, and unfortunately, the smooth muscle tissue that comprises the heart and circulatory system. The result of too much insulin is thickened, hardened arteries.
The circulatory issues also include decreased circulation. It is well known that diabetics must pay close attention to their feet. Loss of blood flow to the extremities, especially the feet, can lead to a loss of sensation in the affected area. Any wound or infection can grow out of control, unnoticed, if not treated immediately. Gangrenous lesions leading to amputations are not uncommon among severe diabetics.
It should be clear that diabetes is not a condition to be taken lightly, and all effort should be taken to tightly control it.
Living Healthy With Diabetes
What Should A Type 2 Diabetic Do To Live Healthy?
There are many things a type 2 diabetic can do to keep their condition in check, and in some cases even reverse it. We will see that these actions all relate in some way to a single, central issue: insulin sensitivity.
Of primary importance, and this cannot be overstated, is weight loss. More specifically, one MUST reduce central adiposity. This is the fat tissue that accumulates around the core of the body, abdominal fat for men and ab/hip region fat for women.
Studies have shown a clear and powerful correlation between diabetes and this type of fat. Interestingly, obese individuals with an equal distribution of fat across their entire frame have a far lower risk of diabetes and heart problems than those who gain fat primarily around their core. This is because disproportionate fat mass in the core strongly indicates a lack of insulin sensitivity.
When the body tissues are resistant to the actions of insulin, they will not effectively store energy. The fat cells in the abdomen and hips are generally the most receptive cells in the body to insulin. Therefore, if fat cells in other areas of the body will not respond to insulin, the core fat stores will be only too happy to pick up the slack.
Central adiposity is also associated with impaired growth hormone secretion and action, as well as with cardiovascular issues. Growth hormone is also an important player, as it, and the activities that stimulate its release, increases insulin sensitivity. I'll address this in both of the following questions.
Adequate sleep is another important issue for diabetics. Sleep deprivation has many negative effects on human performance. For our purposes, there are two issues that stand out.
First, sufficient sleep is critical for the release of growth hormone. Sleep causes pulses of GH output, the most pronounced being in the early stages. As I mentioned earlier, growth hormone acts to improve insulin sensitivity.
Second, lack of sleep increases cortisol output. Cortisol is well known to be an aggravating factor in insulin resistance, which is why you see "anti-cortisol" supplements advertised as "belly fat burners." In fact, for those who have a cortisol overload, these supplements may simply make other energy storage cells more amenable to accepting glucose, diverting it from the central fat stores.
Taken together, these two hormonal repercussions of inadequate sleep can have disastrous consequences for diabetics or those with other risk factors for developing diabetes.
A third area of concern for diabetics and those at risk for diabetes is stress management. Primarily this is due to the effects of stress upon body levels of cortisol, the nasty little hormone we discussed above. In addition to its effects on insulin sensitivity, cortisol also makes us want to eat, especially high carbohydrate foods. This is exactly what needs to be avoided.
Diabetics must learn to control and cope with stress. Whether one chooses to use yoga, or to simply take long, relaxing baths, there is ample benefit to justify time taken to reduce your stress level on a regular basis.
Nutrition Program
What Is A Good Nutrition Program For A Type 2 Diabetic?
Ideally, I would suggest a very low carbohydrate diet (VLCD) or even a zero carb diet. The central issue is insulin, and despite a modest blood glucose elevating effect of protein, a VLCD will not stimulate any appreciable insulin spikes. This is especially true if one eats enough fat at every meal.
This type of diet was the standard, and very effective, treatment for diabetes prior to the advent of insulin injections. If an individual can deal with eating meats, eggs, and cheese while excluding carbs (>10g per day) then this is the way to go.
For many, however, this diet will be nearly impossible to stick to. One step down the ladder is the cyclic VLCD, in which several days of low carb intake is broken up by a "carb-up" day.
The low-carb portion of this diet can be followed for as little as three days before indulging in a moderate amount of carbohydrates for one day. These carbs should be low glycemic, if at all possible.
If one must have a sweet, high-glycemic treat, then apple cider vinegar may be taken beforehand. Whether in liquid or capsule form, vinegar has proven almost as effective as a major diabetes drug in slowing the entry of glucose into the bloodstream. Essentially, this equates to lowering the glycemic impact, and therefore moderating the release of insulin.
If you happen to be a vegetarian or vegan diabetic, then you need to focus on low glycemic vegetables, legumes, beans, and grains. You can also use the apple cider vinegar trick to keep your blood sugar and insulin on an even keel.
Exercise Routine
How Could A Diabetic Benefit From An Exercise Routine?
Exercise is the perhaps the best way, outside of diet, to help control diabetes. Even low to moderate intensity exercise increases muscle cell insulin sensitivity. This effect not only helps your body re-learn how to deal with high blood sugar levels through the insulin pathway, it also helps focus the anabolic actions on skeletal muscle. More muscle equals a faster metabolism, and also promotes greater insulin sensitivity.
Resistance training especially is great for this purpose. It is the opposite of the vicious cycle of eating, wherein eating makes you gain weight, which makes you feel depressed (cortisol), which makes you want to eat, which makes you gain more weight.
Weight training, with or without extra cardiovascular work, will address every one of the issues I have mentioned in this discussion. It will help you lose weight, gain muscle, reduce stress, achieve more restful sleep, and increase, through all of these pathways, your insulin sensitivity.
My recommendation for those beginning an exercise program, after they have cleared it with their doctor, is to perform resistance exercise only. The reason for this is that one should keep exercise to a minimum for as long as that minimum is producing results.
It is always better to start slowly, and add volume or intensity gradually as needed to avoid plateaus. Starting with a minimalist program also aids you in avoiding overtraining.
My recommendation is a three day per week resistance program to start. Work every muscle group with one set of your choice of exercises. Focus on learning the correct form for a few weeks until your body adjusts to the load, then begin to challenge yourself with gradually increasing loads.
Eventually, you can move to a split routine focusing on different muscle groups every workout, and slowly add in cardio after your workouts if you find you need to lose more weight. There are many excellent routines to be found both in the forums and in the article archives of many fitness websites.
Bonus Question
How Does One Know If They Are At Risk For Diabetes?
An easy way to access your risk is to find your waist to hip ratio. Measure your waist at the naval, then measure your hips at the largest point. If the ratio is greater than 1:1.1, or .9, you are at greater risk. If your waist is larger than your hips, you are in serious jeopardy of developing metabolic syndrome x and associated disorders, including type 2 diabetes.
There is also evidence that, at a certain point, your BMI number becomes indicative of risk. We all know that BMI is largely useless for bodybuilders, but if you are overly soft, it is still a number to keep in mind. While not as strongly indicative of risk as the above mentioned w/h ratio, a BMI above thirty is not to be taken lightly.
A third measure is simple waist size. Again, this is not as strongly correlated to risk as w/h ratio. Generally speaking, a waist size of >40 inches for males, >35 inches for women, indicates that you are at higher risk for diabetes.
Taken together, these three measures will give you a good idea of your risk level for developing diabetes and other metabolic disorders.
You may also need to take into account ancestry, recent family history, and for women, past problems with gestational diabetes.
Individuals with African, Asian, and Native American ancestries are thought to be more likely to develop type 2 diabetes. Latin Americans are often included in these lists, for clarity, but it is likely the Native American, rather than the European, genes in that population that account for their increased risk. Europeans, for some reason, seem to be somewhat more resistant to developing diabetes.
A history of type 2 diabetes in one's parents, grandparents, and onward for a few generations, is a strong indicator of susceptibility.
All that being said, considering the modern American diet, it is best to consider yourself at risk regardless of other risk factors.
3rd Place - jdiritto
View This Author's BodySpace Here.
As our society becomes more sedentary, more and more people are at risk for type 2 diabetes. It's a serious health concern amongst a number of Americans. One of the top causes for individuals developing type 2 diabetes is a lack of physical activity coupled with poor dietary habits.
Nearly a million are diagnosed each year with diabetes, with current levels estimated to be approximately 17 million, and it is widely believed that there will be a diabetes epidemic in the next decade or so.
Diabetes mellitus is a metabolic disorder characterized by excessively high and/or uncontrolled blood glucose (sugar) levels. This affects all anabolic processes of the body, including fat and proteins; sugar is simply measured for diagnostic purposes. The main symptoms and indicators of diabetes are:
- Increased frequency of urination and excessive thirst (resulting from fluid loss through the kidneys)
- Increased appetite (the body literally thinks it is starving)
- General (overall) weakness and fatigue
- An unexplained weight loss with no change of behavior
* Pregnant mothers that develop Gestational Diabetes (resistance to insulin resulting in elevated glucose levels during pregnancy) are at a high risk for developing type 2 Diabetes in the future after giving birth (approximately a 40-50% increased risk).
The clinical diagnosis of diabetes mellitus is based upon one of the following:
- Two separate measurements of fasting blood glucose levels = 126 mg/dL
- Two separate measurements of blood glucose levels =200 mg/dL two hours after a glucose load of 75g
- Two separate casual measurements of blood glucose >200 mg/dL
Diabetes is the single leading cause of cardiovascular disease (greater risk factor over even obesity!), as well as blindness, renal failure, and lower extremity amputations. Other serious risks resulting from chronic uncontrolled diabetes is permanent damage to the eyes, kidneys, nerves, heart, and blood vessels.
Individuals with diabetes are also at an increased risk for autonomic neuropathy (effects the body's ability to breakdown food and provide blood sugar), silent ischemia's, peripheral neuropathy (high impact/weight bearing exercise being problematic), and developing blunted responses to hypoglycemia.
Type 2 Diabetes is commonly known as non-insulin dependent diabetes mellitus (NIDDM), or a relative deficiency. Approximately 90% of those individuals with diabetes have type 2, and generally it is developed before the age of 25.
In more modern times type 2 Diabetes is being found earlier and earlier, as a result of the average individual being obese, overweight, and just plain ignoring their diet and level of physical activity. Additionally, those with a family history of diabetes are at an increased risk for developing type 2 diabetes.
As you have hopefully picked up by now, diet and exercise provide numerous beneficial adaptations that help the body prevent diabetes or function better with it.
Of main importance is the increased insulin sensitivity in muscle, combined with a better utilization (absorption) of glucose by muscles after exercise causes muscle glycogen depletion. These primary actions work to lower blood glucose levels (which is essential for a diabetic) and reduces the risk for other conditions, such as hypertension and hyperlipidemia, from arising.
The main precaution for a diabetic to consider prior to exercising is to avoid hypoglycemia, which occurs when blood glucose levels drop to 65mg/dL or lower. As their blood glucose level lowers, the individual will generally loss concentration/focus, shake or shiver, sweat excessively, or even completely lose consciousness (faint). If any of these situations begin to take place, the diabetic should end exercise immediately and consult a physician if they persist!!
Other complications which may arise during exercise are:
- Retinopathy
- Hypertension
- Autonomic and peripheral neuropathy
- Nephropathy
It is extremely important for a diabetic to exercise with caution, generally avoiding maximal efforts, and to rehydrate often while avoiding exercise is extreme conditions (heat or cold).
Additionally, a diabetic individual may need to eat carbohydrates and/or take insulin 30-60 minutes prior to a workout. Anytime a diabetic is engaged in exercise, they should closely monitor their blood sugar levels before, during, and after the workout!
Finally, if the individual is working out close to their bedtime, they should be aware that their blood sugar level could drop significantly while they are asleep.
Exercise
It is very important for a diabetic to achieve an adequate level of physical activity; this is generally achieved through formal exercise programs.
An aerobic exercise program will help lower blood sugar, deplete glycogen (which keeps blood sugar from re-elevating after dietary intake), and control body weight as well as blood lipid profiles. It is recommended that individuals with diabetes perform aerobic/cardiovascular exercise 3-5 days a week, for 20-60 minutes at an intensity of 50-85% their VO2 max.
Obviously, a deconditioned individual should begin at a lower intensity level for a longer duration (if possible), or as long as they are able to achieve. It is essential to perform a low intensity 5-10 minute warm up prior to beginning exercise, as well as cool down after completing the exercise session.
Though resistance training exercise generally offers the same benefits as aerobic exercise, it will deplete blood sugar fairly rapid, and the individual will need to have good ability to prevent hypoglycemia. That being said, the intensity of resistance exercise should progressively be increased with diabetic individuals whom are inexperienced in such.
Typically 2-3 sessions a week provide the desired physiological adaptations for a diabetic. Exercises that stress the major muscle groups of the body should be performed, with repetitions ranging from 8-12. As is the case with all individuals, those with less experience or more serious diseased states should begin with lower intensities/weights.
Again, it is CRUCIAL to stress that exercise will increase insulin sensitivity and peripheral glucose uptake, while decreasing the counter regulatory hormones and hepatic (liver) glucose output. When this is all combined, it will lead to much better control over blood glucose levels!
Nutrition
In terms of a nutrition program for diabetes, I feel less inclined to comment on such (with good logic). As I am by no means a licensed dietician, it would be out of my league to provide any direct dietary/nutrition counsel for this very serious metabolic syndrome.
Therefore, it is with great hopes that a diabetic individual will seek nutritional advice from a professional, licensed dietician rather than an article on such. The dietician, in communication with that individual's physician, will be able to provide a more holistic approach to treating their diseased state through proper nutrition!
Carbohydrates:
What follows is a brief overview of how the body handles carbohydrate.
As it is, the body typically has 6L of blood, and an average blood sugar level of 80-100 mg/Dl (or 6g total, about one teaspoon of sugar). Therefore, dietary intake almost always elevates blood sugar, causing insulin to be released from pancreas for sugar to enter tissues (muscle) as a fuel or to replenish glycogen (muscle energy).
Then whatever blood glucose is left travels to the liver where it is used as a fuel, as the liver is very metabolically active, stored as liver glycogen, or converted to fat. Doing this returns blood sugar levels to normal.
As the body has a need to replenish blood sugar, the pancreas releases glucagon, which in turn causes the liver to breakdown the store glycogen (glycolysis). If the livers store of glycogen is depleted, the body is able to make it from various regulatory hormones or at the cost of amino acids/proteins.
References:
- ACSM's resources for the personal trainer. (2007). Indianapolis, IN: American College of Sports Medicine.
- Brooks, G. A., Fahey, T. D., & Baldwin, K. M. (2005). Exercise physiology human bioenergetics and its applications. Boston: McGraw-Hill. *** this one is great; it's the text I had for my grad ex phys!
- Caspersen, C.I., and G.W. Heath. 1993. The risk factor concept of coronary heart disease. In: ACSM's
- Resource Manual for Guidelines for Exercise Testing and Prescription, 2nd ed. Philadelphia: Lea & Febinger, pp. 151-167
- Earle, R. W., & Baechle, T. R. (2004). NSCA's essentials of personal training. Champaign, IL: Human Kinetics.
- Ehrman, J. K. (2003). Clinical exercise physiology. Champaign, IL: Human Kinetics.