Exercise & Type II Diabetes

For information purposes only. Exercise at your own risk

Due to the increasing prevalence of sedentary lifestyles and diets high in sugar, type II Diabetes is rising among the UK population at an alarming rate. Whilst many people rely on drugs for many years, diet and exercise have been proven to be a much more effect intervention than drug therapy.

The main signs of type II Diabetes are fatigue, weight loss, nausea, the frequent need to urinate, constant thirst, blurred vision, frequent infections and wounds that are slow to heal. It’s vital that you consult your doctor immediately if you experience any of these symptoms, as left untreated, diabetes can cause kidney damage and heart disease.

If your body continual receives/consumes high levels of refined carbohydrate, the body’s hormone insulin, becomes more and more insensitive to a rise in blood sugar.

This means that carbohydrate, and other macronutrients, are less readily converted into fuel stored within the body.

With type II diabetes, too much insulin is produced and the body does not make effective use of it. This is known as insulin resistance and prohibits glucose from entering the muscle cells. In turn, glucose rises to abnormal levels in the blood. Thus, type II diabetics are non-insulin dependent.

Type II diabetes, unlike type I, which is genetic, is a degenerative illness that invades unhealthy bodies, usually those overweight. Because most people with type II diabetes don’t begin to think about their health until the disease is diagnosed, the same techniques used for prevention – a healthy diet and regular exercise – are used to control its advance. 



Prevalence of Type 2 Diabetes

Approximately nine out of ten cases of diabetes in the United States are type II and most commonly affect people over the age of 40.Goals of therapy for type II diabetes Type II diabetics must regulate their glucose levels to help reduce the onset of complications from this disease.

If unchecked for extended periods, elevated glucose levels lead to heart disease, kidney failure, blindness and nerve dysfunction.

Therefore, type II diabetics must modify their nutritional habits, as well as physical activity levels.How does exercise help? For type II diabetics, diet and exercise can normalize glucose levels.

It is important for type II diabetics to lose weight to improve glucose control and insulin effectiveness. Also, many health-related outcomes of physical activity (e.g., lowering blood pressure, favorable lipid and lipoprotein changes, body weight maintenance) are part of the exercise therapy.



What exercise is recommended?

Type II diabetics should exercise a minimum of five to six times per week. Exercise should be performed at a low intensity for about 40 to 60 minutes. Walking is highly recommended for type II diabetics. Other non-weight-bearing activities should also be encouraged (e.g., water aerobics and cycling).

In addition to aerobic exercise, type II diabetics should engage in strength training and flexibility exercises as well.

Exercise & Diabetes – What are the precautions?

There are lots, because there are lost of complications with diabetes. But remember, these will only get worse if you do not exercise or diet.

Persons with neuropathy should avoid activities that cause systolic blood pressure to rise to 180-200 mm hg (systolic is the first reading on a monitor). Those with later stages of renal disease should participate in lower intensity exercise with physician approval.

Those with retinopathy should limit systolic blood pressure to 20-30 mmHg above baseline during each training session. Autonomic neuropathy interferes with the heart rate regulation by depressing maximal heart rate and blood pressure, and increasing heart rate. Phsical activity for these persons should focus upon low level daily activities, where mild changes in heart rate and blood pressure can be accommodated. 

Peripheral neuropathy affects the lower legs and feet, and results in loss of sensation. Non weight bearing activities should be performed. Proper foot wear should be worn for daily activities and feet should be examined daily.

Nephropathy. It remains unproven whether exercise induced blood pressure changes exacerbate the progression of nephropathy. If you suffer from this it Is best to consult your GP. (as you should anyway).Type II diabetics should monitor their glucose before and after exercise to understand how they respond to certain types of activities. Also, exercising with a partner and wearing an ID bracelet that indicates one’s diabetic condition are important. type II diabetics should see their physician prior to beginning a physical activity program and should return regularly to assess the status of diabetic complications. If complications of the eye, kidney or heart are present, it is important that a physician give clear boundaries regarding the intensity of any physical activity.

A lovely picture of a neuron

Some Suggestions: If you’re not too keen on going blind or getting a premature heart attack then you need to be exercising. It is recommended that resistance training be performed at least twice a week as part of a well rounded programme.

A minimum of 8 exercises involving major muscle groups should be performed with 12 – 15 repetitions near to fatigue. Caution needs to be adhered to especially with resistance exercise due to the short term increases in blood pressure that can occur. Limiting the amount of isometric exercises and sustained gripping, overhead lifting and using a sensible intensity will help avoid problems.

Risks and complications of Exercise

Moderate intensity exercise increases glucose uptake by 2-3 mg/kg/min above usual requirements. Six to 8% carbohydrate solutions are absorbed better and cause less stomach distress than regular soft drinks and fruit juices, which are 13-14% carbohydrate. Hypoglycaemic reactions in connection with exercise in persons with type 2 diabetes are rare, occurring mainly in persons being treated with sulfonlurea oral medicationsInitially those with type 2 diabetes should engage in physical activity for 10-15 minutes each session. 

Ideally it is recommended that this be increased over a couple of weeks to 30 minutes. Alternatively 30 minutes could be accumulated by undertaking 3 x 10 min bouts of exercise during the day.

When weight loss is the desired goal, individuals should build up to an hour of low to moderate intensity exercise, in order to achieve a significant amount of energy expenditure.Walking is often undertaken as the mode of exercise, as it is low intensity, and safe for most populations.

However those with peripheral neuropathy or arthritis should look to do non weight bearing exercise like cycling, swimming or aquatic activities.At least 3 or optimally 5 days a week should contain physical activity sessions.

The acute effect of exercise on blood glucose lasts 72 hours post session; therefore to maintain these acute benefits, diabetics should exercise on a regular basis. Intensity may be difficult to gage with diabetic individuals, due to autonomic neuropathy.

Therefore it may be beneficial to start to exercise under supervision, until a comfortable but beneficial exercise intensity can be established.Physical activity programmes for diabetics should include appropriate endurance and resistance exercise, this will help ensure calorie expenditure, an increased insulin sensitivity, cardiorespiratorty fitness and muscular function and strength. Light stretching should also be included post exercise 

See our article regarding Exercise & High Blood Pressure

About Drew

MMA, Fitness & Marketing enthusiast from North Wales, UK. A Stoic Hippy with no hair. Not to boast but - 1st Class Degree in Sports Science from Loughborough, MSc in Nutrition from the University of Liverpool. 20 years experience of weight & fitness training.
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