Type 2 Diabetes - Does Exercise Trump a Poor Diet?

NHS England announced last week that it will be handing out fitness trackers to around 8,000 people at risk of developing type 2 diabetes to motivate them to become more active, stating that this will be a "fabulous next step in diabetes prevention". While a similar scheme was announced in 2017 on the back of ‘The Healthier You: NHS Diabetes Prevention Programme’ (itself launched in 2016) it may be that this kind of digital initiative can have a bigger impact today, particularly with younger people.

So how can exercise help to prevent type 2 diabetes and does diet play an important role too?

The risk factors which lead to developing type 2 diabetes or becoming pre-diabetic are not fully understood but what is known is that it is caused by the body’s resistance to insulin or its inability to respond to insulin.

Insulin is a hormone which is released by the pancreas. When food is digested it is broken down into amino acids, fatty acids and glucose in order to enter the bloodstream. As glucose levels rise in the blood after eating, the pancreas releases insulin which helps glucose enter the body’s cells, lowering the glucose in the blood (blood sugar) and keeping it in a normal range. Insulin helps the glucose present in the blood to enter muscle cells, fat cells and liver cells where it can be used to make energy. If the body has enough energy the insulin signals the liver to store the glucose as body fat.

If the body’s cells become resistant to insulin due to consistently high blood sugar and can no longer take up the glucose to make energy, the pancreas’ beta cells (responsible for producing insulin) produce even more insulin. Over time, possibly years, the beta cells continue in this way producing more and more insulin until they degenerate and can no longer function.

Type 2 diabetes mellitus manifests itself in individuals who lose the ability to produce sufficient amounts of insulin to maintain normoglycaemia in the face of insulin resistance. The ability to secrete adequate amounts of insulin depends on beta-cell function and mass. Chronic hyperglycaemia is detrimental to pancreatic beta-cells, causing impaired insulin secretion and playing an essential role in the regulation of beta-cell turnover.Beta-cells in type 2 diabetes: a loss of function and mass. Maedler K, Donath MY.

Hyperglycemia, or high blood sugar, has been defined by the World Health Organisation as:
  • Blood glucose levels greater than 7.0 mmol/L (126 mg/dl) when fasting
  • Blood glucose levels greater than 11.0 mmol/L (200 mg/dl) 2 hours after meals
Having blood sugar levels consistently greater than 11.0 mmol/L is equivalent to slowly poisoning the body. Raised blood sugar is very toxic to many parts of the body and can damage blood vessels which can lead to:
  • Heart attacks and strokes
  • Vision loss, blindness
  • Neuropathy (nerve damage), tingling or pain in hands, feet and legs
  • Kidney disease
  • Immunity problems leading to high risk of infections
  • Poor circulation
  • Reduced wound healing leading to possible amputation
Keeping blood sugar levels close to normal is advised to prevent type 2 diabetes and the complications that can develop.

The best way to find out if you have raised blood sugar is to go to your GP and have your blood sugar levels tested. You may already have concerns if you are over weight or obese, especially with excess fat around your waist area, as insulin resistance is closely associated with obesity. If your blood sugar is consistently high and you are not converting the sugar into energy the body will store it as fat.

There are two ways to reduce blood sugar levels and help to prevent insulin sensitivity: a low carbohydrate diet and exercise. The first and most important thing to do is to go on a low carb diet which will reduce the amount of sugars that can enter the blood in the first place. Then try to use up any excess sugar in the blood by exercising, like a brisk walk with a fitness tracker.

As for the question of whether exercise can trump a poor diet, the global diabetes community think not, stating: “It is much easier to lose weight on a good diet even if you are struggling to do exercise, than it is through exercise if you’re eating a poor diet.

As we have mentioned in previous blog posts physical activity is important to a long and healthy life and going for a walk with a fitness tracker monitoring your every step might just be the motivation you need to add a little extra activity into your day.

This is a welcome move by the NHS. With 1 in 6 hospital beds taken up by people with diabetes (type 1 and 2) and almost 9% of the annual NHS budget now attributed to the treatment of type 2 diabetes, encouraging those that can take action to prevent/reverse type 2 diabetes can only be applauded.

One of the major reasons cited by people for their own inactivity is a lack of belief in their own ability and there are several initiatives such as This Girl Can to help people overcome barriers to participation.

Within the tahdah community, many of our clients are helping people get started with their activity or targeting specific groups to support their needs. These include: Eat better, do more and, above all, make it fun!

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