Diabetes is an umbrella term for several different conditions that all relate to the way our body manages the regulation of the fuel, glucose, to our body’s cells. Whilst the nature of these different conditions may vary relating to the way the glucose distribution has become impaired, the underlying problems are quite similar. Despite this, there are many misconceptions about Diabetes - that it only occurs in the very young or in the overweight, that you have to have symptoms to worry about it , or that it’s harmless. The truth is that Diabetes occurs in many ways you wouldn’t expect.
Glucose is essential to our body’s function - it’s the main source of fuel for the cells in our brain - and can be produced by the body from other energy sources and is most easily derived from carbohydrate that we consume from foods like breads and cereal or fruit. This essential fuel, though, requires processes to occur that allow for its storage, release, or entry into cells. The hormones insulin and glucagon are both produced by the pancreas to help glucose respectively either enter into cells to provide fuel, or be stored in the liver for later use. When our storage abilities are exceeded we see issues with conditions like type II diabetes, where by insulin loses some of it’s ability to perform its role. This can happen, though, in people with relatively normal body weight and even with diets not considered extremely unhealthy.
Diabetes can also occur when there are changes to the cells that produce insulin or glucagon. This may often occur as part of an autoimmune process, whereby the body’s own immune resources act destructively upon these cells. This can happen in childhood or later adulthood. Further, harm to the pancreas through episodes of pancreatitis, for example, can also lead to a form of Diabetes.
One of the biggest problems with Diabetes is that, in part because of the different ways in which it can develop, the processes of Diabetes can occur without noticeable symptoms. This often leads to people being diagnosed with Diabetes through routine blood testing who sometimes don’t actually believe that they have a condition that they ought to be concerned about. Rather than the diagnosis becoming an event that leads to change, behaviours that harm the management of the condition can persist leading to some awful harms. AT the other end of the spectrum, some individuals diagnosed with Diabetes consider that their only treatment options are pharmaceutical in nature.
Believe it or not, exercise can have a tremendous effect on diabetes by helping to regulate blood glucose and normalise the function of insulin in powerful ways. Specialised exercise medicine approaches can help to improve the way insulin assists glucose into cells. This improved insulin sensitivity can last for up to 24-28hours following activity, meaning that doing some form of activity on most days of the week will have a significant impact in managing blood glucose. It may also provide alternate pathways for glucose into working muscle cells providing a therapeutic benefit that pharmaceuticals cannot.
Because of this potency, people taking medications such as insulin or the class of drug known as ‘sulphonylureas’ (e.g. Diamicron) should check their BGLs before exercise to ensure they are in a safe range - above >5.5mmol/L - and consider the type of exercise you are going to do. Checking BGLs after exercise is also important, as it helps with understanding how your BGLs have responded to an activity and whether additional carbohydrates are required. If you are on these medications and are unfamiliar with exercise it is imperative you get advice from an exercise medicine specialist like your friendly local Exercise Physiologist to make sure that your dose of exercise is right for your circumstances.