Diabetes and exercise

Type 1 Diabetes Mellitus – T1DM

In T1DM the cells in the pancreas that produce insulin are destroyed by the body’s immune system. Without insulin the body’s cells cannot take up glucose (sugar) and turn it into energy. Glucose builds up in the blood stream and this can damage organs in the body such as the kidneys, heart and eyes. People with T1DM require daily injections of insulin to control their glucose levels.

They also test their blood glucose levels several times daily. The onset of T1DM typically occurs in people under 30 years, but can occur at any age. About 10-15% of all cases of diabetes are T1DM.

Type 2 Diabetes Mellitus – T2DM

T2DM is the more common form of diabetes, affecting 85-90% of all people with diabetes. While it usually affects older adults, more and more young people, even children, are developing T2DM. In T2DM the pancreas produces insulin but the body’s cells do not respond effectively to the insulin and so do not take up the blood glucose and turn it into energy. This results in a build up of glucose in the blood.

T2DM results from a combination of genetic and environmental factors. Although there is a strong genetic predisposition, the risk is greatly increased when associated with lifestyle factors such as high blood pressure, overweight or obesity, insufficient physical activity, poor diet and the classic ‘apple shape’ body where extra weight is carried around the waist.

The management of T2DM includes healthy eating and regular physical activity. Some people with T2DM may also need medication and insulin injections.

I have T1DM what exercise should I do?

Exercise cannot reverse the damage to the cells in the pancreas that leads to the decreased production of insulin. However, exercise can improve the way the muscles respond to insulin, which, in turn, helps regulate the blood glucose level for some hours after the exercise. Exercise also increases glucose uptake by the muscles in other ways that do not depend on insulin. In addition, exercise can lower the dose of insulin required by improving the body’s response to insulin.

People with T1DM who do not have diabetic complications can be involved in most types of exercise and physical activities. Aerobic exercise, which increases heart and lung fitness, should be performed on most days of the week, at moderate to high intensity, for between 20 and 60 minutes. Alternatively, the total exercise time can be broken into smaller parcels throughout the day. Resistance training should be performed on 2 or 3 days a week. Exercise the major muscle groups with 8–10 different exercises. Repeat each exercise 8–12 times in a set, and perform 2 or 3 sets at moderate to high intensity. It is important to remember, when you start an exercise program, your insulin requirements may change depending on the time of the exercise in relation to your meal and insulin injection, as well as the duration and intensity of the exercise. It is important to discuss this with your GP or an Accredited Exercise Physiologist.

I have T2DM what exercise should I do?

Studies show that exercise can help prevent T2DM, as well as improve control of blood glucose, decrease the proportion of body fat, decrease the risk of heart disease, and increase heart and lung fitness in people with T2DM. Increasing physical activity can reduce the incidence of T2DM by almost 60% in people at risk and those who already have T2DM can increase their fitness levels (and improve their symptoms by about 12%) through exercise training.

How much exercise is enough? Those with T2DM are advised to take on a mix of both aerobic (e.g. walking or running) and resistance training (e.g. lifting weights). Ideally you would carry out 5-6 hours of exercise a week and at least 2 x 30 minute sessions of resistance training.