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Diabetes: Explained

Diabetes: Explained

In its simplest form, Diabetes is a disease that occurs when someone’s blood glucose (blood sugar) levels are too high. 

We have a small organ called a pancreas that senses when we have too much glucose (sugar) in our blood. If there is too much, it produces a hormone called insulin, which makes sure the glucose goes to the right places and can be used as energy to fuel our bodies. A common analogy you might hear is that the insulin is like a key, that opens the ‘door’ to let the glucose (sugar) into our cells.

When someone has diabetes, there is either not enough insulin being produced to take the glucose to the cells, OR it is being produced but not effectively ‘opening the door’ for glucose to go into the cell. As a result, the glucose is left to build up in our blood. 

 

The 2 most common types of Diabetes are:

Type 1 Diabetes, which is hereditary and means that the person’s pancreas does not produce insulin. This is less common, and accounts for approximately 5-10% of people with diabetes. 

Type 2 Diabetes, which is usually caused later in life due to lifestyle factors like poor diet & exercise habits. This is most common and accounts for approximately 90% of people with diabetes. 

 

When there is excess glucose in the blood, it leads to a variety of complications. High blood glucose levels reduce the elasticity of blood vessels which means they narrow inside causing a blockage, and blood flow around the body is restricted. Common side effects include:

  • Frequent urination – excess glucose is lost through urination
  • Increase thirst – because of increased urination, we lose more fluid and become dehydrated
  • Tiredness & Fatigue – because glucose is not being converted energy
  • Increased hunger – not getting energy from glucose, leads to an increase in hunger
  • Blurred vision – caused by damage to the blood vessels at the back of the eye
  • Unexplained weight-loss – glucose not being used as energy, so the body uses our fat & muscle instead

Diagnosis

Type 1 Diabetes is usually a quick onset in symptoms followed by a visit to the doctors who will do one of the below tests. However, in Type 2 Diabetes it is more common to not show many symptoms and find out that you are either diabetic or pre-diabetic through routine blood tests. 

  • HBa1C test: For HBa1C test, a doctor will take a blood sample that gives the doctor an indication of a person’s average blood glucose level over the past 2-3 months.
  • Fasting plasma glucose (FPG) test: This measures a person’s blood glucose levels after a period of fasting. Patients must not eat for at least 8 hours before the test, and as a result, many take the test before breakfast.
  • Oral glucose tolerance test (OGTT): This test measures how a person processes glucose. A patient will take a blood glucose test 2 hours before and 2 hours after drinking a sugary drink.
  • Random plasma glucose (RPG) test: A doctor will use an RPG test to measure a person’s blood glucose level at any point in a day. A patient does not have to fast before taking this test.

 

HBa1C (%) FPG
(mg/dl)
OGTT
(mg/dl after 2 hours)
RPG
(mg/dl)
Diabetes 6.5% or above 126 or over 200 or over 200 or over
Prediabetes 5.7–6.4% 100–125 140–199
Normal below 5.7% below 100 below 140 below 200

 

Management

Both type 1 and type 2 diabetes can lead to long-term complications if a person does not adequately manage them. These complications can include:

 

 

How can Exercise help?

Exercise has been shown to effectively treat type 1 and type 2 Diabetes. Exercise lowers blood glucose levels and boosts your body’s sensitivity to insulin – meaning, the insulin that is produced is better at ‘opening the door’ for the glucose to enter the cell. This increase in insulin sensitivity can last up to 72 hours post exercise. 

An increase in insulin sensitivity is the main short-term benefit of exercise for diabetes. The long-term benefits for exercise in people with diabetes means they can live a longer, healthier life whilst reducing the chances of early death. An Exercise Physiologist can help you to come up with a personalised plan of attack to make lasting changes to your daily habits, so that you can make lasting changes to your health. 

It is important that blood glucose levels are monitored before and after exercise to prevent any hypo-glycaemic (blood glucose levels too low) or hyper-glycaemic (blood glucose levels too high) events. 

There are many ways to utilise exercise to help manage Diabetes. The benefits of aerobic exercise are well documented which means you don’t necessarily need access to a gym with weights to get started managing diabetes.

    • Aerobic exercise (walking, cycling, swimming) and resistance training (weights), were equally effective at lowering HbA1c values in people with diabetes (doing both types were better than doing either one alone)
    • People with diabetes who walked at least two hours a week were less likely to die of heart disease than those who didn’t, and those who exercised three to four hours a week cut their risk even more.=
    • Women with diabetes who spent at least four hours a week doing moderate exercise (including walking) or vigorous exercise had a 40% lower risk of developing heart disease than those who did not exercise.

 

If you think you may have diabetes, you should see your local doctor.

If you have diabetes and would like to learn how to best manage it, you can make a booking to see one of our Exercise Physiologists HERE.