Exercise and Diabetes

So today I want to talk about something that should be common sense and everyone knows but few seem to practice.

Back in the 70’s and 80’s movies like Rocky , Commando, Predator, Rambo and the like came to be very popular movies. I watched myself as a kid and was amazed at the awesome physiques of these bigger than life men. Gyms began to be more and more popular, fitness magazines began to really take off and the supplement industry flourished. The fitness industry was in full swing. Passing fad or ingrained culture? I argue a bit of both. Unfortunately I think some of those that advocate exercise sometimes overdo it and those that don’t exercise probably should.

                                                                                                          

It was movies like Predator and Rocky IV that first got me interested into lifting weights and being fit

Diabetes is a growing problem not only in the United States but around the world. According to the US Dept. of Health and Human Services, about 25.8 million people of all ages have diabetes in the US, or about 8.3% of the population. That figure is 18.8 million people with an actual diagnosis and 7 million or so who they consider undiagnosed. The following is also reported at the website:

  • Among U.S. residents ages 65 years and older, 10.9 million, or 26.9 percent, had diabetes in 2010.
  • About 215,000 people younger than 20 years had diabetes—type 1 or type 2—in the United States in 2010.
  • About 1.9 million people ages 20 years or older were newly diagnosed with diabetes in 2010 in the United States.
  • In 2005–2008, based on fasting glucose or hemoglobin A1C (A1C) levels, 35 percent of U.S. adults ages 20 years or older had pre-diabetes—50 percent of adults ages 65 years or older. Applying this percentage to the entire U.S. population in 2010 yields an estimated 79 million American adults ages 20 years or older with pre-diabetes.
  • Diabetes is the leading cause of kidney failure, non-traumatic lower-limb amputations, and new cases of blindness among adults in the United States.
  • Diabetes is a major cause of heart disease and stroke.
  • Diabetes is the seventh leading cause of death in the United States.①

The following chart shows incidence of diabetes mellitus (DM for the rest of this post)

Caucasians have the lowest incidence while American Indians have the highest.

I work with diabetics all the time in the pharmacy. Some seem only to care about getting their insulin or oral medications and care little for the lifestyle that could reduce or even eliminate their need for medication. One patient doesn’t even care about his blood glucose (BG) readings or the impact the disease will have on his life. It will take his life because he doesn’t care.

For many the reality of diabetes doesn’t hit home until a toe is amputated or vision becomes a serious problem. Kidneys can be ravaged by high BG levels and let us not forget the all important arteries. DM is a major risk factor for heart disease.

So why bring up exercise and diabetes? The association is brutally obvious. At least it better freaking be! In one study done in older males aged 60-80 years, hemoglobin A1c (essentially the measure of how much sugar has been hanging around in your blood for the last 3 months) fell significantly in a group of subjects who were using weight training and weight loss vs a group who used only weight loss. The decrease was 1.2±1 vs 0.4±0.8% respectively.③ A drop like that can be seen in drugs like metformin.

Brisk walking can also bring great health benefits. In one analysis, “Minimal adherence to current physical activity guidelines, which yield an energy expenditure of about 1000 kcal·wk-1 (4200 kJ·wk-1), is associated with a significant 20-30% reduction in risk of all-cause mortality.”④

Medical Studies like the UKPDS have shown that over time, conventional therapy vs intensive therapy with insulin and sulfonylureas (a class of drugs that increase insulin secretion in the pancreas) found that no significant difference was found in macrovascular disease (disease of the major blood vessels in the body such aorta, coronary arteries etc). In the study it was found that after 15 years of following over 3000 patients, A1c increased over time.⑤ That seems to imply that even with treatment, BG control dwindles. The tighter control also had more incidence of hypoglycemia, which is a problem in and of itself. Maybe they should have implemented some exercise routines in with that tight BG control and they would have had some better outcomes.

Exercise is nature’s answer to DM, along with good diet. I do not…..I repeat, I DO FREAKING NOT recommend fad diets. Waste of time and money. Eat whole foods and nutrient dense foods such as vegetables, lean meats, and good sources of fat such as butter and coconut oil. If you’re trying to lose weight, try eating less than you burn. Yes there is some merit to the whole “calories in vs calories out”. I will probably address this concept in a later post.

Another note about exercise; it has to be done to keep the benefit. When you stop, the benefit goes away. It annoys me when people tell me what they could do and now can do nothing. I fell into that trap myself with weight lifting and aerobic health. What I could do just 3 short years ago I can’t do now. I’m back on the road to get my fitness back to where it was. (don’t get me wrong, I’m no slouch and have no problem tossing my wife around when we dance and I can still grapple my 16 year old nephew and make him tap out), but I’m not where I should be and I think that is part of the impetus of writing this post.

If somebody is beginning exercise to increase their health, please do so with supervision of a doctor or trainer who can help prevent injuries and create a diet that works for you. One size doesn’t fit all with diet and exercise and what works well for one, doesn’t always work well for another.

CIAO

The Brute

  1. http://diabetes.niddk.nih.gov/DM/PUBS/statistics/#fast   Retrieved  11/6/11
  2. http://www.aacc.org/publications/cln/2007/Oct/Pages/newsbrief_1007.aspx  Retrieved 11/6/11
  3. Dunstan DW, Daly RM, Owen N, Jolley D, de Courten M, Shaw J, Zimett P: High-intensity resistance training improves glycemic control in older persons with type 2 diabetes. Diabetes Care 25:1729–1735, 2002
  4. Lee IM, Skerrett PJ. Physical activity and all-cause mortality; what is the dose-response relation. Medicine and Science in Sports and Exercise, 2001; 33 (6 Suppl): S459-71
  5. UKPDS Group. (1991) UK Prospective Diabetes Study VIII: Study design, progress and performance. Diabetologia 34, 877–890

Disclaimer: All info on this website is for education purposes only. Any dietary or lifestyle changes that readers want to make should be done with the guidance of a competent medical practitioner. The author assumes no responsibility nor liability  for the use or dissemination of this information. Anyone who chooses to apply this information for their own personal use does so at their own risk.

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2 thoughts on “Exercise and Diabetes

    • Sorry about the spelling errors. All I can say is that I was a science major and English classes and literature were not my specialty. I will try better in the future. I have tried to fix some of the more obvious ones.

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