Exercise and Diabetes
November is Diabetes Awareness month. I don’t normally write about “awareness months” but diabetes is such an enormously pressing issue it’s important to take a look at it. According to the American Diabetes Association (ADA), 30.3 million Americans (nearly 10% of the population) have diabetes costing $327 billion annually in direct medical costs and lost productivity. The cost to Vermont alone for diabetes was $695 million in 2013. (Center for Disease Control.) Each year 1.5 million Americans are diagnosed with diabetes. One in three adults has “pre-diabetes” or are “borderline” for being officially diagnosed. In 2103, Medscape researchers found that average per-person cost of treating diabetes was over $85,000; $92,000 in today’s dollars. Alarms should be blaring.
We have trillions of cells with specific functions. All need energy, and their energy, or fuel, is glucose. Blood streaming by cells carries glucose, and the glucose needs “receptor” and the hormone insulin to enter the cell. There are two types of diabetes. Type 1, sometimes called “juvenile diabetes” represents about 5% of diabetes cases (ADA) and occurs when the body does not produce the insulin needed to transfer glucose into a cell. Type 2 is more common and means that insulin receptors on the cells are not functioning properly, sometimes called “insulin resistance” and / or that the body is not producing adequate insulin. In this more common type of diabetes, the challenge is to re-sensitize receptors to insulin allowing the body to properly access glucose. According to the Mayo Clinic, the exact cause of diabetes is unknown. Genetics are certainly a factor, and lifestyle plays a very strong role as well. The strong majority of people with Type II diabetes are overweight and inactive.
Lifestyle cannot eliminate risk of diabetes, but clearly exercise helps prevent diabetes, delay the onset of it, and reduce the impact of it. The New York Times recently published findings from a longitudinal study at Harvard following 32,000 men, 2,278 of whom had Type II diabetes, over 18 years. People who did aerobic exercise for 2.5 hours a week had a 52 % lowered
risk of developing diabetes, and those who lifted weights regularly had a
34% reduced risk. Those who did both had the greatest protective benefits. The study found that even just 10 minutes of day of weight training produced benefit. The exact mechanism of exercise benefitting diabetes is unclear but believed to be partially the burning up of excess glucose and partially bolstering insulin reception. Exercise also helps reduce inflammation, which similar to a low-grade infection exhausts immune function over time. Additionally, and more obviously, exercise benefits weight management and fat metabolism. Weight lifting means more lean muscle mass increasing overall metabolism. As excess fat is burned by the body, there’s less fat in the cells and the cells are able to function more effectively. A study by Jacob Haus, a PhD Kinesiologist at the University of Illinois looked at weather exercise could reduce inflammation in the bodies of diabetic people. He found that indeed “exercise is enough to make the cells of people with diabetes resemble those of people without” (Diabetes Forecast, March 2107) and that some people responded better than others.
The evidence is clear; exercise reduces the risk of developing diabetes and reduces the impact of it. With the epidemic rates of diagnosis, the alarming figures of how many of us are pre-diabetic and the $85,000 price tag per person to treat diabetes it seems we could stand to get more serious about supporting individuals who are inactive with the necessary and beneficial business of getting physically active with aerobic and resistance exercise most days of the week. People need education, support and encouragement. Not enough people are exercising adequately and there’s so much we could do to enable safe and effective exercise which could save billions of dollars annually on diabetes alone.... And it would save billions on the prevention of other lifestyle related diseases as well. Exercise benefits physical health and mental health, so whether you’re out biking to reduce complications from diabetes or depression, we are all in this together. Get up. Get going. See you out there.