Type 2 Diabetes

Jarrod Wilson (Exercise Physiologist – Burnie)

What is Type 2 Diabetes?

Type 2 diabetes is an increasingly common metabolic condition that results from improper control of blood sugar levels. The pancreas, an organ found in the abdominal region of the body behind the stomach, is responsible for releasing insulin in response to rising glucose (sugar) levels in the blood. The glucose can then be taken up by cells of the body (i.e. muscles) and be used as energy; to stay alive and to be physically active. When the pancreas malfunctions under the stress of elevated glucose in the blood over a long period of time, insulin begins to work less effectively and the pancreas stops producing as much insulin. Type 2 diabetes is therefore associated with chronic insulin resistance.

Figure 1 Normal function of glucose in the presence of insulin.

The classic prognosis of Type 2 Diabetes infers that the condition should not be taken lightly as it is the associated complications (cardiac and vascular problems, nerve damage, kidney damage, loss of eye-sight, foot damage, etc.) that can be serious and potentially life-threatening. It is said that Type 2 Diabetes results in a 10 year reduction in lifespan.

How does Type 2 Diabetes develop?

Type 2 Diabetes typically develops from undesirable lifestyle factors including poor diet and sedentary behaviours (i.e. not getting enough physical activity). There is also a genetic link and other contributors such as age, gender, poor sleep cycle, stress and other hormones, pregnancy and medications can dictate how well glucose is controlled within the body.

Type 2 Diabetes is often slow to develop with the condition of impaired glucose tolerance presenting first. This is known in the laymen’s world as ‘pre-diabetes’ and precedes Type 2 Diabetes. As pre-diabetes typically goes undetected without any symptoms, it is often difficult to diagnose and it is well known that a large population of Australians are presumed to have pre-diabetes (and even Type 2 Diabetes for that matter) without knowing they do.

Typical Symptoms:

General symptoms associated with Type 2 Diabetes include:

• Increased thirst
• Increased frequency of urination
• Fatigue
• Hunger

Specific symptoms associated with being in a hypoglycaemic state (sugar levels dropping too low) include:

• Blurred vision
• Fatigue/weakness
• Dizziness/light-headedness
• Confusion
• Rapid heartbeat
• Hunger
• Headache
• Sweating
• Tingling skin
• Irritable/agitated

If not treated hypoglycaemia can progress to a worsening physical state where eating or drinking can become difficult and further to that seizures/convulsions and unconsciousness may result. In the worst case scenario death can occur from severe, untreated hypoglycaemia.

Even if you have not been formally diagnosed with Type 2 Diabetes but you are experiencing one or multiple symptoms it is important to get a check-up with your GP who may get you to do a glucose tolerance test to determine how well you respond to a hyperglycaemic state. Typically a diagnosis will be formed by the combination of the symptoms you present with and abnormal results on glucose tests.

How do I lower my risk? prevention and management of Type 2 Diabetes:

• Manage your weight – avoid becoming too overweight as this is a significant risk factor for developing Type 2 Diabetes.
• Get regular exercise – activity on every day of the week. A combination of strength & cardiovascular exercise is best.
• Control food and drink intake. Limit high calorie foods/drinks, processed or refined foods and opt for nutritious foods. Also ensure to drink plenty of water.
• Control stress in your life.
• Aim consistently for 7-8 hours of sleep per night.
• Manage other general health issues (i.e. blood pressure, etc.).

What is the best exercise I can do to help?

• Resistance exercise (strength training) that stimulates an increase in muscle mass leads to a greater abundance of a key protein that helps transfer glucose into the muscle cells for metabolism (Glut-4). Resistance exercise has also been shown to increase the action of insulin in skeletal muscle in healthy people as well as in those with Type 2 Diabetes.
• Aerobic exercise (going for a walk/jog, cycling, swimming, etc.) and improvements in aerobic fitness help to increase mitochondrial function, which also helps to metabolise glucose.
• Therefore an exercise program that incorporates resistance or strength exercises as well as cardiovascular exercise is best for the prevention and management of Type 2 Diabetes.
• For advice on what is suitable for you in terms of the frequency, intensity and type of exercise, it will be in your best interests to have an assessment with one of our Exercise Physiologists at the Burnie clinic.

Whether you want to reduce your risk of Type 2 Diabetes or learn to manage it better, come in and see an Exercise Physiologist at our Burnie clinic. Talk with Simon or Jarrod about what options you have to control your lifestyle.

For personalised advice there is an option to see one of our Exercise Physiologists through an Enhanced Primary Care (EPC) plan under Medicare which requires a referral from your GP. Alternatively there is a group Type 2 Diabetes class that Jarrod runs at our Burnie clinic. A referral from your GP is also required for this 8 week program.

References:

1 Holten MK, Zacho M, Gaster M, Carsten J, Wojtaszewski JFP & Flemming D 2004, ‘Strength training increases insulin-mediated glucose uptake, GLUT4 content, and insulin signaling in skeletal muscle in patients with type 2 diabetes’, Diabetes, vol. 53, no. 2, pp. 294-305.

2 Exercise and type 2 diabetes: american college of sports medicine and the american diabetes association: joint position statement 2010, Medicine & Science in Sports & Exercise, vol. 42, no. 12, pp. 2282-2303.

3 Stanford KI & Goodyear LJ 2014, ‘Exercise and type 2 diabetes: molecular mechanisms regulating glucose uptake in skeletal muscle’, Advances in Physiology Education, vol. 38, no. 4, pp. 308-14.