In the year 2013 the American Diabetics Association reported that diabetes affects more that 30 million people, nearly one-tenth of the U.S. population. It is a growing epidemic with more than 5,000 new cases per day and an economic cost of $245 billion per year. These are alarming statistics. Listed below are some health risks associated with diabetes:
- Increase risk for stroke or heart attack
- Two thirds of adults with known diabetes have hypertension
- Diabetes is the leading cause of kidney failure<
- 60% of non-traumatic lower-limb amputations occur in people with diabetes
- Diabetes is associated with mild to severe forms of nerve disease
- People with diabetes may develop or have gum disease, hearing loss and nonalcoholic fatty liver disease
- Diabetes is the leading cause of new cases of blindness in adults>
- 65% of the people with diabetes have elevated LDL, the bad cholesterol
There are three main types: type 1, type 2 and gestational.
Since type 2 diabetes accounts for approximately 90% of diabetes cases, this article will focus on type 2. Type 2 is describes as a condition of insulin resistance, which means the body is misusing the insulin the pancreases produces. As blood glucose levels rise in a type 2 person, the body’s cells become unable to take up the extra glucose. A diagnosis of type 2 diabetes may occur at any age, Insulin resistance and type 2 diabetics are highly associated with overweight and/or obesity. People with type 2 diabetes can manage their condition by exercising, following a meal plan, losing weight and taking oral medication.
Here are some symptoms of Type 2 Diabetes:
- Blurred Vision
- Extreme thrust
- Fatigue for no apparent reason
- Frequent need to urinate
- Nausea and vomiting
- Weight loss even with increased appetite<
The American Diabetes Association (ADA) has established the following risk factors for type 2 diabetes:
- Adults who are overweight (BMI ≥ 25 kg/m2) and have the following risk factors from the list>
- Physical inactivity
- First-degree relative with Diabetes
- High-risk race/ethnicity (African American, Latino, Native American, Asian American, Pacific Islander)
- Hypertension (140/90 mm Hg on therapy for hypertension)
- HDL cholesterol level <35 mg/dl (0.90mmol/L) and or a triglyceride level >250 mg/dL (2.82 mmol/L)
- Women with polycystic ovarian syndrome
- A1C ≥7%, impaired glucose tolerance or impaired fasting glucose on previous testing
- Other clinical conditions associated with insulin resistance (such as severe obesity and acanthosis nigricans-a skin disorder in which there is darker, thick, velvety skin on body folds)
- History of cardiovascular disease
The health consequences associated with diabetes make it imperative for us to understand how to manage or prevent diabetes safely. Research demonstrates that regular exercise may combat some of the harmful effects of diabetes and can sometimes prevent it from striking high-risk individuals. A well designed exercise program should include resistance training and high-intensity and/or aerobic training.
Resistance Training Recommendations for people with type 2 diabetes (Coberg et al. 2010):
Frequency – Two or three times a week, on nonconsecutive days, in addition to daily aerobic activity.
Intensity – For the best strength gain and insulin action, resistance training should be moderate intensity (50% of 1 repetition maximum) or vigorous intensity (75%-80% 1 Rm)
Duration – You should become fatigued after 5 to 10 exercises for the upper and lower body, and core with at least 10-15 repetitions. After some time, the resistance amount should be increased so that you are fatigued after 8-10 reps. Eventually a minimum of 1 set to near fatigue is encouraged but 3-4 sets are recommended for optimal strength gain.
Mode – Resistance machines and / or free weights are appropriate for strength gain and mass. The best ways to regulate your blood glucose are heavier weights or resistance used as your strength increases.
Progression: The rate should be slow to prevent injury. Once you are not fatigued, and then increase the weight and resistance.
High intensity training is appropriate for Type 2 Diabetes. Long term training is more difficult for clients to commit to; the high intensity interval training is more effective and can produce similar insulin sensitivity improvements in untrained adults.
Aerobic Training Recommendations for people with type 2 diabetes (:Coberg et al. 2010):
Frequency – At least 3 days a week, no more than 2 consecutive days, current guidelines recommend 5 sessions of moderate activity a week
Intensity – At least moderate, approximately 40%-60% of maximal aerobic capacity. Brisk walking and other “somewhat hard” exercises qualify as moderately intense for most people with type 2 diabetes. Gradual increase if intensity has better health benefits. Training intensity is a better predictor of training intensity is better for improving blood glucose control than training volume, so clients should increase intensity before increase volume.