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Beating Diabetes: Type II Diabetes and Exercise

This month, guest blogger Michelle Matte, CSCS has been discussing diabetes in recognition of American Diabetes Month.  We started with a general overview to increase awareness about diabetes.  We then focused on Managing Type I Diabetes through Exercise.  Today, we extending that discussion to Type II diabetes. 

The Sad Truth

Type II Diabetes Mellitus (DM) is a lifestyle disease. In the not-too-distant past, it was referred to as “Adult Onset Diabetes,” and rarely manifested in children and young adults. But today, Type II DM is escalating at an alarming pace in children, teens and adults of all ages. Research suggests that 35 percent of adults over age 20 are pre-diabetic, and that number rises to 50 percent of adults over age 65. When left untreated, diabetes can lead to blindness, kidney failure, heart disease, and peripheral neuropathy leading to amputation of limbs.

diabetes exercise man

Exercise and Type II DM

Exercise is known to increase insulin sensitivity in pre-diabetics and to reverse the disease in confirmed diabetics. Yet a study published in “Diabetes Care” found that among adults with Type II DM, 31 percent engaged in no regular physical activity, and another 38 percent engaged in less than recommended levels of exercise. The study reported that most of the subjects were overweight, and the majority did not eat a healthy diet that included fresh fruits and vegetables.

Low Activity is Not Enough

Exercise intensity has a great deal to do with the body’s response to exercise. According to the American College of Sports Medicine (ACSM), vigorous physical activity performed three to five times per week on a consistent basis will yield optimal results with regard to improving insulin sensitivity. Sporadic low intensity exercise coupled with a diet high in carbohydrates and processed foods will do little to reverse Type II DM.

diabetes exercise running

ExRx for Type II DM

To prevent or reverse Type II DM, the ACSM recommends resistance training on two to three non-consecutive days per week, performing exercises for all your major muscle groups. Do eight to 12 repetitions of each exercise, at a weight that fatigues your muscles within that range. Perform one to three sets of each exercise. Moderate to vigorous aerobic exercise like running or brisk walking on an incline performed for 30 minutes or longer is also recommended. Do aerobic exercise on at least five days per week. Exercise bouts can be broken up into 10 or 15 minute segments, provided they are done at an intensity that your perceive to be challenging.

 

To gain a deeper understanding about glucose metabolism and diabetes, consider enrolling in W.I.T.S. online courses.  Nutritional Concepts, Certified Personal Trainer Certification, Older Adult Fitness Foundations, and Exercise Program Design for Special Populations all offer insight into how the body uses sugar for energy.

– See more at: http://www.witseducation.com/blog/#sthash.KikkMiAc.dpuf

References

Diabetes Care: Diet and Exercise Among Adults with Type II Diabetes.

http://care.diabetesjournals.org/content/25/10/1722.short

 

American College of Sports Medicine Position Stand: Exercise and type 2 diabetes.

http://europepmc.org/abstract/MED/10912903

 

Dr. Mark Hyman: Five Steps to Reverse Type II Diabetes and Insulin Resistance.

http://drhyman.com/blog/2010/05/20/5-steps-to-reversing-type-2-diabetes-and-insulin-resistance/

 

Journal of Applied Physiology: Effects of Acute Exercise and Exercise Training on Insulin Resistance.

http://www.iub.edu/~k562/articles/diabetes/ex%20insulin%20resistance%20Henriksen%202002.pdf

 

Healthline: Type 2 Diabetes Statistics and Facts.

http://www.healthline.com/health/type-2-diabetes/statistics#1

 

American College of Sports Medicine: Exercise Can Help Tame Type 2 Diabetes, Say New Guidelines.

http://www.acsm.org/about-acsm/media-room/acsm-in-the-news/2011/08/01/exercise-can-help-tame-type-2-diabetes-say-new-guidelines

 

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Beating Diabetes: Managing Type I During Exercise

 Type I Diabetes Mellitus and Exercise

We introduced the topic of diabetes this month to recognize American Diabetes Month.

Type I Diabetes Mellitus (DM), once referred to as juvenile diabetes, is a genetic condition characterized by the inability of the pancreas to produce enough insulin to facilitate the transport of glucose into the body’s cells to be used for energy production. At one time, those born with Type I DM were doomed to a premature death, often preceded by circulatory issues, disability and blindness. Today, thanks to a deeper understanding and advancements in treatment, Type I diabetics often live a full and normal life, so long as they carefully manage their condition. Exercise is an important part of maintaining optimal health, but for Type I diabetics, careful planning is an integral part of physical activity.

diabetes injection

Timing is Everything

Because Type I diabetics must inject insulin on a controlled schedule in order to manage glucose levels, exercise sessions must be coordinated with the timing of insulin injections to prevent a sudden drop in blood sugar. Exercise requires ample amounts of available glucose in the muscle cells and bloodstream to meet energy demands. Longer bouts of vigorous exercise, or high intensity exercise like heavy resistance training, can potentially cause a dangerous drop in blood sugar. Your diabetic client may need to decrease their insulin dose on days when they exercise vigorously. Exercise sessions should take place around the same time every day, to help manage insulin sensitivity.

carbohydrates

Nutrition Matters

Your diabetic client should eat a high-carbohydrate snack about a half-hour before exercise. They may also need to periodically ingest an easily assimilated form of carbohydrate, like fruit juice or a sugary drink, during their exercise session. Your client should monitor their blood sugar levels, checking them before, during and after exercise to ensure levels remain stable. A post-exercise recovery drink like whole milk can help stabilize blood sugar because its balanced content of fat, protein and carbohydrate allows sugar to stabilize gradually. Your client should work closely with their health care provider to manage insulin and exercise.

blood sugar check

Learn More

To gain a deeper understanding about glucose metabolism and diabetes, consider enrolling in W.I.T.S. online courses.  Nutritional Concepts, Certified Personal Trainer Certification, Older Adult Fitness Foundations, and Exercise Program Design for Special Populations all offer insight into how the body uses sugar for energy.

 

References

University of California San Francisco; Diabetes Education Online.

http://dtc.ucsf.edu/living-with-diabetes/activity-and-exercise/exercise-guidelines-faqs/exercise-guidelines-faqs/

 

Juvenile Diabetes Research Foundation: Don’t Sweat It! Exercise and Type I Diabetes.

http://jdrf.org/blog/2013/dont-sweat-it-exercise-and-type-1-diabetes/

 

American Diabetes Association: Exercise and Type I Diabetes.

http://www.diabetes.org/food-and-fitness/fitness/exercise-and-type-1-diabetes.html

 

NHS: Complications Caused by Diabetes.

http://www.nhs.uk/Conditions/Diabetes-type1/Pages/Complications.aspx

 

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Beating Diabetes: The Nature of the Beast

In honor of American Diabetes Month, this month’s blog posts will focus on Diabetes Mellitus.  W.I.T.S. welcomes guest blogger Michelle Matte. 

From Awareness to Understanding

Most of us are aware of diabetes as a common disease found in adults and children, and many of us know of a friend, co-worker or family member who has been diagnosed with the condition. Yet the cause of diabetes is rarely understood by the average individual. In November’s series of blogposts, we will attempt to break it down for you in terms you can grasp, in hopes of empowering you to help yourself and others combat this growing metabolic disorder.

Diabetes graphic text

Diabetes Discovered

Diabetes Mellitus, the proper name for what we commonly refer to as diabetes, is defined by an unhealthy amount of circulating blood sugar that can lead to a plethora of undesirable degenerative symptoms, culminating in kidney failure. Symptoms of DM were first described  3000 years ago by the ancient Egyptians, and the word “diabetes” was first used to describe the condition by Araetus of Cappodocia, who lived from 81-133 AD. It was not until 1675 that British physician Thomas Willis added the word mellitus, meaning “honey sweet”, when he discovered that the blood and urine of patients exhibiting the condition had a sweet flavor. (Kudos to Willis for doing the taste test!) Willis also noted a high incidence of depression in diabetes patients. One hundred years later, in 1776, Matthew Dobson, another British physician, confirmed that the blood and urine of diabetes sufferers did in fact contain elevated levels of sugar, explaining their sweetness.

Diabetes Basics

Diabetes Mellitus manifests itself under two distinct sets of circumstances, leading to the categorical distinction between Type I DM and Type II DM.

Type I diabetes is a congenital condition under which the pancreas either underproduces or fails to produce insulin sufficient to aid in the transport of glucose to the body’s cells, where it can be used for energy. Put simply, glucose is the end product of carbohydrate foods. You can think of insulin as the key that unlocks the door to the cells, allowing glucose to enter. Type I diabetics do not produce sufficient insulin to facilitate the process of glucose metabolism. Type I diabetics must inject insulin on a regular basis to help in that process.

Diabetes finger stick

Type II diabetes is a chronic condition that escalates over time. At one time referred to as “Adult Onset Diabetes”, Type II rarely manifested in children and younger adults, and was considered to be an age-related disorder. Today, Type II diabetes is seen with alarming frequency in children and young adults. Simply explained, Type II diabetes manifests when carbohydrates are consumed in amounts that exceed the cell’s requirements. When large doses of sugar are consumed, the brain sends a message to the pancreas to produce more insulin to transport glucose to the cells. However, the capacity of the cells to store glucose is limited. If the cells are already full to capacity, insulin cannot do its job. Over time, the cells become insulin resistant, and sugar remains in the circulatory system until it can be eliminated via the kidneys.

 

Insulin resistance is directly linked to physical inactivity and excess carbohydrate consumption. Continually over-consuming sugary processed foods and drinks is the catalyst for insulin resistance. Physical activity depletes cellular glucose stores, making room in the cells to store more, thus reducing insulin resistance.

Diabetes Digits

In 1997, an estimated 4.5 percent of the population in the United States had diabetes. By 2012, that number had escalated to 9.3 percent, affecting over 29 million Americans. It should not surprise you that these figures correlate with a rise in obesity over the same time period. That is because diabetes and obesity share common roots in their onset. Both are linked to sedentary lifestyle and imbalanced nutrition.

More to Come

We will delve deeper into understanding diabetes throughout the month of November. Topics will include Managing Type I Diabetes During Exercise, Reversing Insulin Resistance, Diabetes Programming Tips for Fitness Professionals, and more. We hope you will join us in fighting diabetes through education and behavioral wellness.

References

 

Stang J, Story M (eds) Guidelines for Adolescent Nutrition Services (2005).

http://www.epi.umn.edu/let/pubs/adol_book.shtm

 

American Diabetes Association: Statistics About Diabetes.

http://www.diabetes.org/diabetes-basics/statistics/

 

Centers for Disease Control and Prevention: Maps in Trends in Diagnosed Diabetes and Obesity.

http://www.cdc.gov/diabetes/statistics/slides/maps_diabetesobesity_trends.pdf

 

Saudi Medical Journal, April 2002: History of Diabetes Mellitus.

http://www.ncbi.nlm.nih.gov/pubmed/11953758

 

American Diabetes Association: Diabetes Basics.

http://www.diabetes.org/diabetes-basics/

 

Cleveland Clinic: Diabetes Basics.

http://my.clevelandclinic.org/health/diseases_conditions/hic_Diabetes_Basics

 

 

 

 

 

 

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Personal Training and Clients with Diabetes

We are in the middle of Diabetes Month and I thought I’d continue with the theme and reach out to you for input.  Many of you responded to the last post about Diabetes and suggested that you work with clients who struggle with this disease.  I hope you’ll share your expertise with us so we can better support our students and new professionals. 

The following case study is based on a real client and comes from our Exercise Program Design for Special Populations online course.  How would you respond to this scenario?

Jane is 50 years old and was diagnosed with Type 2 diabetes 5 years ago. Jane is 5’2” and weighs 180 lbs. She is currently taking an oral medication (troglitazone) for her diabetes and an antihypertensive medication (beta blocker) for her stage 1 high blood pressure, and does not monitor her blood glucose. Jane reports that her health is OK. She does not suffer from complications, but gets easily fatigued doing housework and cleaning. Furthermore, she reports that taking a stroll with her husband at the local mall makes her knees and hips uncomfortable after about 15 to 25 minutes. She has not seen her doctor in over a year; however, her diabetes educator has encouraged her to participate in regular physical activity. She has asked you to assist in the development of an activity regime. Her goals are to improve her endurance and lose about 45 lbs.

We will gather your responses to share with our students.  Help us help our students!  I look forward to hearing from you! 

 

If you want to learn more about exercise program design for individuals with diabetes, please check out our online course, Exercise Program Design for Special Populations.   We have a section completely dedicated to Diabetes.  Also, our Personal Trainer Certification and Older Adult Exercise Specialist Certification touch on the importance of safe and effective exercise to prevent and slow down this disease. 

For more information about Diabetes and American Diabetes Month, please visit http://www.diabetes.org/diabetes-basics/?loc=GlobalNavDB

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November is American Diabetes Month!

Yesterday was Halloween, and although I don’t want to be a “party pooper” and understand how much fun the holiday can be— I have to say, seeing so many children walking around with bags of candy—who also appear to be moderately or morbidly obese was disheartening.   Ironically, today, the day after Halloween, starts the beginning of American Diabetes Month. So, I’d like to focus today’s blog on diabetes, and more importantly, how we can prevent or slow down the disease with physical activity.

Diabetes complications can be prevented or delayed by properly managing blood glucose, blood pressure and cholesterol levels.  Eating healthy, being physically active and quitting smoking also can help lower the risk of diabetes complications.

Prevalence

  • Nearly 26 million children and adults in the United States have diabetes.
  • Another 79 million Americans have prediabetes and are at risk for developing type 2 diabetes.
  • Recent estimates project that as many as one in three American adults will have diabetes in 2050 unless we take steps to Stop Diabetes.

The Toll on Health

  • Two out of three people with diabetes die from heart disease or stroke.
  • Diabetes is the leading cause of kidney failure and of new cases of blindness among adults.
  • The rate of amputation for people with diabetes is 10 times higher than for people without diabetes.
  • About 60-70 percent of people with diabetes have mild to severe forms of nerve damage that could result in pain in the feet or hands, slowed digestion, sexual dysfunction and other nerve problems.  

How Can Physical Activity Help?

  • Keep blood glucose, blood pressure, HDL cholesterol and triglycerides on target
  • Lowers risk for pre-diabetes, type 2 diabetes, heart disease and stroke
  • Relieves stress, strengthens your heart, muscles and bones
  • Improves your blood circulation and tones your muscles
  • Keeps your body and your joints flexible

 I’m curious to know how many of our Personal Trainers are working with clients who have diabetes or prediabetes?  Please share your experiences and success stories so we can all learn from you.   I think we all have a responsibility to do what we can to reduce the prevalence of this serious disease. Please share! 

If you want to learn more about exercise program design for individuals with diabetes, please check out our online course, Exercise Program Design for Special Populations.   We have a section completely dedicated to Diabetes.  Also, our Personal Trainer Certification and Older Adult Exercise Specialist Certification touch on the importance of safe and effective exercise to prevent and slow down this disease. 

For more information about Diabetes and American Diabetes Month, please visit http://www.diabetes.org/diabetes-basics/?loc=GlobalNavDB