HOW EXERCISE HELPS TO FIGHT DIABETES

HOW EXERCISE HELPS TO FIGHT DIABETES - BioCoach

Along with diet, exercise is one of the most well-understood forms of self-care that can promote health and well-being. But for people with diabetes, physical activity goes beyond the general lifestyle enhancement and can actually help to control the onset and progression of this incredibly common metabolic condition.

The health benefits of exercise for those with diabetes include weight loss, improved insulin sensitivity, improved blood lipids, and reduced risk of common diabetes complications.

In this article, we'll explore how physical activity can help to improve diabetes risk factors and, in some cases, turn the condition around entirely.

How Exercise Helps To Fight Diabetes

Exercise is a broad term that encompasses a range of physical activities, including resistance training (strength training, resistance bands, lifting) and aerobic activity (such as HIIT workouts and moderate-intensity workouts like jogging or brisk walking).

While some people could run for days, others are much happier lifting weights at the gym. But here's the good news — research shows that no matter what you choose, any physical activity can help fight diabetes.

So let's dive into the specifics.

Enhances Capacity For Skeletal Muscle Oxidation (Glucose Use)

Diabetes is marked by high blood glucose levels that cannot enter your cells due to issues with the hormone insulin. Specifically, your cells become "insulin resistant" and lose their sensitivity to insulin signals. Under normal conditions, your body releases insulin when blood sugar rises, and insulin instructs your cells to open their "doors" and let the glucose in. 

When your cells can't hear the message from insulin (i.e., they are insulin resistant), blood sugar builds up, and you enter a state of hyperglycemia. 

While insulin is the primary conduit that ushers glucose into your cells, exercise actually offers another entryway – glucose transporters that act independently of insulin. Exercise is an energy-intensive activity, which means that your muscle groups require more fuel to keep up with the work. Without any help of insulin, muscles that are active increase the number of glucose transporters on their cell membranes to allow more glucose in from your blood.

And as you build more muscle mass through exercise, transporters increase exponentially.

Since this process happens independently of insulin, even those that are insulin resistant can benefit from the upsurge of glucose transporters.[1] In other words, exercise makes your muscle cells hungrier for glucose without needing a signal from insulin. 

Research shows that with exercise, this increase in glucose uptake remains high for about two hours after your workout.[2]

While any type of workout can enhance glucose uptake, studies indicate that high-intensity interval training (HIIT) is among the most effective.[3] 

Improves Overall Insulin Sensitivity

Studies show that in addition to enhancing glucose uptake by muscle cells, exercise can also increase your cells' sensitivity to insulin. As just described, active muscles become hungrier for glucose, allowing for increased transporter expression on the cell membranes. Once this acute effect of exercise wears off, however, studies show that it's replaced by increased insulin sensitivity within your cells.[1] 

In one study, investigators found that exercise increased insulin sensitivity for at least 16 hours post-workout in both diabetic and non-diabetic individuals.[4]

This means that when you work out, you get a one-two punch of glucose-lowering activity. First, your cells become sponges for glucose (independent of insulin), increasing their insulin sensitivity.

Weight Loss

While it's fair to say that weight loss is a complex process, it's pretty well understood that a combination of diet and exercise plays a significant role in allowing your body to burn up excess fuel, releasing fat stores. Specifically, research shows that physical activity can help you maintain the weight that's lost through diet instead of rebounding and gaining it all back.[5]

Being overweight greatly increases your risk for diabetes and sets the stage for various other metabolic issues. And, of course, once metabolic conditions take hold, it can make it even harder to lose weight. This vicious cycle is one reason so many people struggle to control conditions like diabetes, obesity, and heart disease. 

Once you begin to turn the table on weight gain, however, your body responds by shedding pounds and learning how to use fuel more efficiently. In fact, research shows even modest weight loss can lower type 2 diabetes risk by up to 58% in high-risk populations.[6]

Furthermore, studies indicate that weight loss can significantly increase your body's sensitivity to insulin, but if the weight is regained, it will once again drive a loss of insulin sensitivity.[7] 

Exercise Targets Abdominal Obesity

While being overweight can contribute to diabetes and insulin resistance, abdominal obesity is specifically detrimental for those with metabolic issues. While research has yet to uncover the exact reason why abdominal obesity is so dangerous, there are several theories, including:[8]

  • Increased inflammatory compounds released from abdominal fat  
  • Dysregulation of hormones that originate in these types of fat cells
  • Increased release of free fatty acids

Either way, what is clear is that accumulated abdominal fat leads to an increased risk for diabetes and other metabolic conditions. 

Luckily, one of the best ways to reduce abdominal fat is to move your body. In fact, research suggests that there is a compound called interleukin-6 that may be behind the magical ability of exercise to burn off belly fat.[9,10]

Lowers Triglycerides

Another factor that plays into glycemic control and diabetes is blood lipid regulation. In fact, elevated blood triglycerides (TG) are well-understood to increase the risk of diabetes and are associated with blood sugar irregularities.[11]

Research shows that when you exercise, in the hours that follow, your TG levels are slowly (but steadily) reduced.[12]

Once again, while all forms of exercise may help to reduce your TG level, HIIT workouts seem to do so most efficiently. This is likely due to the increased energy utilization that follows a high-intensity workout as compared to lower-intensity exercise.[13]

Other Tips For Diabetes Care

In addition to following a regular exercise program, there are a handful of other tips and tools that can help you reduce your risk for diabetes or improve your diabetes management.

Consume a Low-Carbohydrate Diet

While there are many opinions on what type of diet works best for people with diabetes, the research strongly supports eating low-carb to implore insulin sensitivity. On the surface, it may sound like a no-brainer – of course, if you cut carbs, your body won't require as much insulin, problem solved. 

However, the impact of low-carb dieting goes beyond the reduced need for insulin and, in fact, allows your cells to become more sensitive to insulin signaling. One study saw a 30% improvement in insulin sensitivity after just three meals on a low-carb diet.[14]

Glucose Monitoring

A crucial aspect of managing diabetes is tracking and identifying your blood sugar levels. If you want to attain blood glucose control, you first have to know where you stand. And of course, the best way to accomplish this is with a blood glucose monitor. 

At first, you may need to use your monitor pretty often to get a sense of how your body responds to different foods and forms of movement. However, over time this tool will be able to provide you with enough data that you should be able to predict with fairly good accuracy how your body is doing. 

With that being said, it's never a bad idea to keep the glucose monitoring habit going. 

Monitor Your Risk Factors

There are several risk factors associated with diabetes that can impact the progression of this condition. 

We've already covered the importance of maintaining a healthy body weight and balanced blood triglycerides, but some other factors to keep in mind include:

  • Hypertension (high blood pressure)
  • Cardiovascular disease or dysfunction
  • Cholesterol
  • Stress 

It's also important for everyone, even non-diabetics, to stay aware of their blood glucose levels. Even slight shifts can be an early sign of prediabetes, which can be stopped in its tracks if identified in time. 

Takeaway

The American Diabetes Association (ADA) recommends at least 150 minutes of moderate-intensity workout each week, which averages out to about 30 minutes of activity five days a week.[15] 

If you're someone who puts off exercise because you feel like you are not fit enough, you're too old, or you simply don't enjoy it, it's important to keep in mind that there are many different types of exercise out there, and you might be surprised at how good you feel once you start a new program.

For example, many older adults enjoy interventions like tai chi or brisk walking. Even gentle aerobic exercise can get your heart rate up. If aerobics is absolutely not for you, resistance exercise can boost your metabolism and enhance your muscle mass, which means more glucose transporters to pick up the excess sugar in your blood.

Either way, any type of physical movement beats a sedentary lifestyle, especially when you're managing metabolic issues like diabetes.

Connect with us at BioCoach to learn more about the various types of exercise programs that exist and to find the right choice for you.

Citations

  1. Holloszy, John O. "Exercise-induced increase in muscle insulin sensitivity." Journal of applied physiology 99.1 (2005): 338-343.
  2. Venkatasamy, Vighnesh Vetrivel, et al. "Effect of physical activity on insulin resistance, inflammation and oxidative stress in diabetes mellitus." Journal of clinical and diagnostic research: JCDR 7.8 (2013): 1764.
  3. Matos, Mariana Aguiar de, et al. "High-intensity interval training improves markers of oxidative metabolism in skeletal muscle of individuals with obesity and insulin resistance." Frontiers in Physiology 9 (2018): 1451.
  4. Borghouts, L. B., and H. A. Keizer. "Exercise and insulin sensitivity: a review." International journal of sports medicine 21.01 (2000): 1-12.
  5. van Baak, Marleen A., et al. "Physical Activity, Weight Loss, and Weight Maintenance in the DiOGenes Multicenter Trial." Frontiers in nutrition 8 (2021): 389.
  6. Colberg, Sheri R., et al. "Exercise and type 2 diabetes: the American College of Sports Medicine and the American Diabetes Association: joint position statement." Diabetes care 33.12 (2010): e147-e167.
  7. Clamp, L. D., et al. "Enhanced insulin sensitivity in successful, long-term weight loss maintainers compared with matched controls with no weight loss history." Nutrition & diabetes 7.6 (2017): e282-e282.
  8. Westphal, Sydney A. "Obesity, abdominal obesity, and insulin resistance." Clinical cornerstone 9.1 (2008): 23-31.
  9. Wedell-Neergaard, Anne-Sophie, et al. "Exercise-induced changes in visceral adipose tissue mass are regulated by IL-6 signaling: a randomized controlled trial." Cell metabolism 29.4 (2019): 844-855.
  10. Venkatasamy, Vighnesh Vetrivel, et al. "Effect of physical activity on insulin resistance, inflammation and oxidative stress in diabetes mellitus." Journal of clinical and diagnostic research: JCDR 7.8 (2013): 1764.
  11. Zheng, Deqiang, et al. "Association between triglyceride level and glycemic control among insulin-treated patients with type 2 diabetes." The Journal of Clinical Endocrinology & Metabolism 104.4 (2019): 1211-1220.
  12. Cullinane, Eileen, et al. "Acute decrease in serum triglycerides with exercise: is there a threshold for an exercise effect?." Metabolism 31.8 (1982): 844-847.
  13. Yang, Tsung-Jen, Ching-Lin Wu, and Chih-Hui Chiu. "High-intensity intermittent exercise increases fat oxidation rate and reduces postprandial triglyceride concentrations." Nutrients 10.4 (2018): 492.
  14. Lin, Po-Ju, and Katarina T. Borer. "Third exposure to a reduced carbohydrate meal lowers evening postprandial insulin and GIP responses and HOMA-IR estimate of insulin resistance." PLoS One 11.10 (2016): e0165378.
  15. https://diabetes.org/healthy-living/fitness/weekly-exercise-targets 

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