How Does Exercise Help Diabetes

Diabetes Mellitus is a metabolic disease that affects 9% of the population of industrialized countries over 18 years of age, according to the WHO. More than 1.5 million people died In 2012, with direct reasons of diabetes and it is measured that in 2030 it will be the seventh leading cause of mortality.

These figures will be huge in the coming years due to their connection with the disease of obesity. The positive part of this issue is the great implication of physical exercise for the improvement of diabetes mellitus and all its comorbidities. The Higher Technician in Physical Conditioning is aware of the importance of physical activity in populations with diabetes, and therefore will be able to design workouts that are adapted to their needs to move towards a more exhaustive control of this disease.

What is diabetes?

In the first place, we will begin by defining Diabetes as a pathology that results in uncontrolled blood sugar levels. This is due to the improper functioning of the pancreas when it comes to secreting insulin or the inability of this hormone to perform its function correctly.

Insulin helps in the absorption of glucose from the food you eat. This means that by not creating or generating insulin in a reduced way, glucose remains in the blood and does not reach the cells.

For its part, the increase in blood glucose can be very dangerous for the body, but mainly affects the kidney, the heart, and the different arteries, therefore, normally people who have diabetes tend to develop kidney problems, loss of vision, loss of lower limbs and heart attacks among others.

Types of diabetes

Several types of diabetes can be differentiated: Type I, Type II, and Gestational; there are even authors who name the fourth type. We are going to focus on the first two:

Type I Diabetes

Type I Diabetes has as its etymology an autoimmune process in which the beta cells located in the pancreas destroy each other resulting in the inability to secrete insulin, therefore the subjects who suffer from it are dependent on insulin exogenously.

Today, this type of diabetes has no cure and the only thing we can do is try to control it so that collateral damage does not occur in our body due to high concentrations of both insulin and sugars.

Type II diabetes

In Type II Diabetes, the problem causing the disease is not the inability of the pancreas to secrete insulin (at least initially), but rather the inability of insulin to carry out its function, which is to transport glucose from the bloodstream to muscle tissue or liver. This concept is called 'insulin resistance.

This type of pathology develops over time and two key aspects affect it as a priority: physical inactivity and poor eating habits, being scientifically proven that an improvement in diet (reducing the levels of sugars in meals) together With well-planned physical exercise, they can control glucose levels or give reversibility to the disease in the best of cases.

To understand the relationship between Type II Diabetes and obesity (more than 50% of Type II diabetics are obese) it is necessary to understand that the Adipocyte is not a passive structure whose only function is to store triglycerides, but currently,

It is considered a true endocrine organ capable of releasing cytokines (pro-inflammatory cells) such as TNF-alpha, capable of inhibiting signaling pathways and therefore blocking the activation of glucose transporters, thus generating the inability of insulin to introduce glucose both within muscle tissue and liver tissue.

Diabetes and physical exercise

Physical exercise can be one of the basic strategies to combat diabetes mellitus since muscle contraction allows the consumption of sugars that exist in the muscle (muscle glycogen), and improves insulin sensitivity (the ability of this hormone to activate glucose transporters and glucose receptors within the muscle cell).

According to the Position Stand of the American College of Sports Medicine (ACSM, 2010), the combination of resistance training along with strength training (nowadays called “concurrent training”) is the best option to combat diabetes mellitus.

Other studies, such as the review by Pedersen and Saltin (2006), also refer to the combination of both modalities as the best treatment option through physical exercise. Resistance training along with training force have beneficial effects on fat and insulin sensitivity in patients with Type II Diabetes.

How should training be in patients with diabetes mellitus?

It is important to note that the resistance training practiced by a patient with diabetes mellitus must be of low impact, and running and even long walks should be excluded if we are in the initial stages of the exercise program. A good option could be working in water, but always with correct intensity control.

Recent works such as those published by Yin et all (Springerplus, 2015) see positive responses in the use of body electrostimulation for the improvement of insulin sensitivity due to the reduction of muscle damage thanks to the effect of electrostimulation in the training of force.

How many exercises Should You Get When You Have Diabetes Mellitus?

In this sense, the general prescriptions of physical exercise for diabetes mellitus (American Diabetes Association; American College of Sports Medicine) establish that aerobic resistance work will be carried out at least 3 days a week with a total duration of at least 90 minutes at an intensity below 70% of Vo2 max.

For strength training, a minimum of 2 days will be required, and the loads to be worked are those that do not produce "muscle damage" since this would trigger high concentrations of TNF-alpha in the blood and with it an increase in insulin resistance. to say, the opposite of what we are looking for.

For this type of patient, the time of day in which physical exercise is carried out should always be the same and, if possible, do not practice sports in afternoon-night sessions (American Diabetes Association, 2004) since glucose consumption by Muscle continues to be produced hours after sports practice, and can generate severe nocturnal hypoglycemia, generating a highly dangerous situation for health.

In summary, the practice of physical exercise is a vital strategy for the control of blood glucose and the improvement of insulin sensitivity, and the combination of low-impact resistance training along with strength training that does not cause muscle damage is the best choice for glucose control and insulin sensitivity improvement.

Never forget that the best way to deal with these issues is to get in touch with your family doctor, although a remote Physical Conditioning professional can offer diabetics a series of pieces of training adapted to their condition and needs, favoring the maintenance of life more active and with controlled glucose levels.