Diabetes is a serious and complex condition that affects your whole body. If left unmanaged, diabetes can lead to significant deterioration in both health and quality of life. It is important to manage diabetes via the support of your doctor and allied health team, with the eventual goal of improving self-management strategies to optimise health outcomes.
Here, we’ll explore what diabetes is and how guidance provided by an Exercise Physiologist can help to not only better manage diabetes, but can promote healthy lifestyle behaviours and weight loss that may lead to remission from type 2 diabetes.
What is diabetes?
Diabetes develops when your body either doesn’t produce enough (or any) insulin, or becomes de-sensitised to insulin.
The hormone insulin, made in your pancreas, helps your body move sugar (glucose) out of your bloodstream and into your cells where it can be converted into energy.
It’s important to remember that sugar isn’t only found in sugary foods like cakes and sweets. Many healthy foods contain natural sugars, including fruit, milk, yogurts, bread, pasta and oats. Whenever we eat these (and many other) foods, we rely on insulin and our body’s cells to turn them into energy.
If you are no longer producing insulin, or not making enough for your body’s increased needs, then you will have higher than normal levels of glucose in your blood. This is known as hyperglycaemia – over many years it can increase your risk of serious health issues such as vision loss, kidney problems, heart disease, and amputation.
Symptoms of diabetes include:
- Excessive thirst and hunger
- Frequent urination
- Slow wound healing
- Itchy skin and more frequent skin infections
- Blurred vision
- Weight gain (type 2 diabetes) or weight loss (type 1 diabetes)
- Mood swings
- Feeling dizzy
- Leg cramps
A brief history of diabetes
Over 3,000 years ago, the ancient Egyptians mentioned a condition that caused excessive thirst, frequent urination and weight loss. It was probably type 1 diabetes, an autoimmune condition where the body attacks and destroys its own insulin-producing cells in the pancreas leading to higher levels of glucose (sugar) in the blood.
In ancient India, they talked of a condition called ‘honey urine’ and used ants to test a person’s urine for diabetes (the ants were attracted by high sugar levels).
By 1776, a British doctor, Matthew Dobson, confirmed that the urine and blood of people with diabetes tasted sweet (don’t ask how he found out!) and published his findings in an early medical journal. He also noted that diabetes was fatal for some people but that others were able to live a long time with the condition (an early hint about the different nature of type 1 and type 2 diabetes).
The real breakthrough in diabetes management came in 1921 with the discovery of insulin. Insulin is a hormone that moves glucose out of the bloodstream and into the body’s cells where it can be converted into energy. This was a game changer for people with type 1 diabetes – their condition was no longer a death sentence.
Since then, there’s been a huge amount of diabetes-related research, which has won at least 10 Nobel Prizes.
That research and the lived experience of countless people with diabetes has changed the management of the condition. People with diabetes are thankfully no longer told to eat rancid animal food, eat no carbs or take narcotics like opium!
Managing diabetes today
Today, diabetes management involves a range of measures to help keep blood glucose within a healthy range. The type of management used depends on which type of diabetes you are treating. Typically, treatment can include:
- Testing your blood sugar regularly using a glucose sensor or a finger-prick test to improve self-awareness of how food and activity influence your blood glucose levels;
- Having regular appointments with your diabetes team, which may include a GP, Endocrinologist, Dietitian, credentialed Diabetes Educator and/or Exercise Physiologist;
- Exercising to improve the way your body uses insulin (and to help boost your mood, improve your cardiovascular fitness and manage your weight);
- Eating a healthy diet (much the same as the healthy eating guidelines recommended for non-Diabetics);
- Taking medication or insulin based on your doctor’s advice.
The three main types of diabetes
There are multiple types of diabetes with different causes. The three key types are:
- Type 1 diabetes: An autoimmune condition where the body attacks its own insulin-producing cells.
- Type 1 diabetes develops rapidly and is therefore usually diagnosed quickly.
- People with type 1 diabetes must take lifelong insulin injections or use an insulin pump as their body no longer makes any insulin of its own.
- This type of diabetes is not caused by lifestyle but (we think) by a complex interplay between genetics and a triggering virus.
- Type 2 diabetes: Your body is still able to produce insulin but can no longer use it well. This is known as insulin resistance.
- Over time, your pancreas may also gradually lose the capacity to make enough insulin.
- Genetic factors (including ethnicity) play a role in type 2 diabetes, but it is often caused or worsened by lifestyle factors, such as inactivity and carrying excess weight, especially through the mid-section.
- Type 2 diabetes used to be a condition that developed in middle age but we’re now seeing more cases in younger people, including children.
- Symptoms develop gradually, meaning you may have had the condition for several years before it is diagnosed.
- Gestational diabetes: This type develops in pregnancy in women who have not previously had diabetes.
- Pregnant women are routinely screened for gestational diabetes and, if you have the condition, your pregnancy will be managed more closely.
- Gestational diabetes usually resolves once you give birth but can increase likelihood of developing type 2 diabetes later in life.
We now also recognise some people as having pre-diabetes. This means your blood sugar levels are higher than normal but not yet high enough for a diagnosis of type 2 diabetes.
If blood tests show you have pre-diabetes, you have the perfect window of opportunity to make lifestyle changes to potentially prevent type 2 diabetes from developing. Through tailored exercise plans that help to generate weight loss and improve overall health, an Exercise Physiologist can help you do that.
Type 2 diabetes may be managed by improved lifestyle, for example via increased physical activity and weight loss. This can help to decrease the symptoms of type 2 diabetes and reduce risks of complications and further health deterioration. Type 1 diabetes has no cure, but it can be managed via lifestyle optimisation and medication.
The importance of exercise in diabetes management
A common theme throughout the prevention, management and in some cases, reversal of diabetes is exercise and activity. Diabetes Australia recommends discussing your health with a doctor or accredited Exercise Physiologist before increasing the intensity of your exercise, especially if you have had any previous or recent diabetes complications.
Exercising regularly will help you to:
- Improve your diabetes management by enabling your insulin to work more effectively
- Achieve and maintain a healthy body weight
- Lower your blood pressure
- Reduce your risk of heart disease
- Know that you are doing something positive for your health, and alleviate depressive symptoms.
How can Restart Exercise Physiology help you?
Restart’s accredited Exercise Physiologists love working with people with diabetes to help manage their symptoms and get the most out of life.
Whatever type of diabetes you have, our Exercise Physiologists will:
- Work with you to devise a realistic, achievable and tailored exercise plan aimed at achieving the best health outcomes for your individual needs and goals;
- Prescribe specific exercises intended to reduce the risk of diabetes complications such as aerobic exercises to improve blood glucose control, and heart and lung function;
- Develop strategies to help fit regular exercise into your daily routine;
- Encourage and support you along the way.
An accredited Exercise Physiologist is specifically trained to provide the tools and knowledge to empower you towards lifestyle change, factoring in your medical history, health goals, exercise history and stage of life.
Speak with your GP to see if you’re eligible for a Chronic Disease Management Plan. You may be eligible for up to five appointments per calendar year with an accredited Exercise Physiologist. Exercise Physiology and Medicare Chronic Disease Management Plan.
All information is general and is not intended to be a substitute for professional medical advice. Restart Exercise Physiology can consult with you to confirm if a particular treatment or procedure is right for you.