This article will talk about the correlation between physical activity and type 2 diabetes. We will briefly overview the pathology, mentioning the causes, consequences, and possible treatments.
Later, we will go into the details of the dedicated physical therapy, mentioning the types and methods to intervene in the case of type 2 diabetes.
What Is Type 2 Diabetes?
Type 2 diabetes is a metabolic disorder characterized by chronic hyperglycemia (excess glucose in the plasma ) based on two pathological mechanisms:
- Insulin resistance: a lack of insulin effect on peripheral tissues.
- Insulin synthesis deficiency: reduced production of the hormone by the pancreas.
Note: Insulin synthesis deficiency is often a long-term complication of insulin resistance.
It occurs mainly in adults and is the most common form of diabetes (90% of cases). Unlike type 1, it is not insulin-dependent; although the pancreas stops functioning as it should in severe cases, exogenous insulin therapy may still become necessary.
The causes can be of hereditary or environmental nature; among the latter, obesity stands out, followed by a sedentary lifestyle, an unbalanced diet characterized by excess carbohydrates, stress, other diseases, and certain drugs.
Obesity and Diabetes
Benefits Of Physical Activity On The Diabetic
Physical activity is effective in preventing and treating type 2 diabetes. Exercising positively impacts both acute (while working out) and chronic (in the long term) metabolism.
Among the benefits of training on type 2 diabetes we recognize above all an improvement in insulin sensitivity and an increase in the efficacy of cellular glucose transport, with a reduction in blood sugar, insulin, triglycerides and glycated proteins.
The improvement of insulin sensitivity and the emptying of hepatic and muscle glycogen reserves promote better management of carbohydrates, helping optimize weight loss, increasing insulin sensitivity.
Benefits On Insulin Sensitivity
Insulin resistance compromises the absorption of insulin-mediated glucose, therefore on insulin-dependent tissues, by 35/40% compared to healthy people.
The most abundant insulin-dependent tissue in the body is skeletal muscle, which positively correlates with the ability to absorb glucose, while fat mass has an inverse correlation.
In acute cases, physical activity increases insulin sensitivity for 24-72 hours after training, even in people with type 2 diabetes.
After this period of time, it is necessary to apply a new physical stimulus to restore this advantageous situation. This is why those with type 2 diabetes should train more or less every other day.
Benefits On Glucose Transport
The metabolic use of glucose in muscle fiber cells occurs, very briefly, as follows:
Switching from plasma to muscle tissue – Physical exercise improves blood flow, thanks to more significant cardiovascular action and peripheral capillarization. Good distribution is crucial for meeting the need for glucose, oxygen, and muscles and allows the disposal of waste residues.
Physical exercise also promotes the opening of ordinarily unused capillaries; it stimulates further branching in the chronically affected by type 2 diabetes.
Transport of glucose through the cell membrane – The trans-cellular membrane transport of glucose occurs through glucose transporters 4 (GLUT-4), which are typically found in the intracellular cytosol. Physical training stimulates the latter’s emergence, making the cell more able to capture glucose.
Phosphorylation – The energetic use of glucose occurs thanks to an enzyme called hexokinase, which significantly increases concentration if physical activity is performed regularly over the long term.
During and after exercise, a consistent metabolic activation makes the muscle cells partially independent from the insulin action.
Benefits On The Management Of Carbohydrates
Physical activity makes the body able to manage the glycemic load better. This is due to an adequate emptying of the hepatic and muscle glycogen reserves and the metabolic and functional modifications of the exercise phase.
Benefits Of Physical Activity On Other Risk Factors
How To Do Resistance Training With Type 2 Diabetes
The diabetic person cannot easily accomplish a training volume of 20/30 minutes a day.
In fact, despite the indications, obesity, osteoarticular pathologies, and complications of various kinds can compromise this goal.
This is why some alternatives have been proposed. First, resistance training is a valuable and safe tool for some chronic diseases, even in the elderly and obese. It too improves insulin sensitivity, increases calorie expenditure, and optimizes the quality of life; it also increases muscle strength, lean mass, and bone mineral density.
The right training load is at least 2-3 days a week, with 8-10 exercises targeting the largest muscle groups, for 1-3 sets of 10-15 repetitions each. Progressive overload must be pursued, with no less than 50% of 1RM.
Guidelines For An Adapted Physical Activity Protocol
Physical Activity Guidelines In The Presence Of Complications
The physical activity protocol for subjects with complications must be adapted according to those complications, in particular:
- Ischemic heart disease – Physical activities that produce pain or a strong increase in heart rate should be avoided. At the same time, it is recommended to practice physical activities of low-moderate intensity (40% of Vo2max or 50% of HR max).
- Diabetic nephropathy – Only moderate-intensity physical exercises (walking, swimming, biking) are recommended.
- Retinopathy – Physical activities that involve an increase in blood pressure (such as weightlifting at high intensity and with Valsalva) or that involve physical contact (such as combat sports ) should be avoided. In contrast, physical activities of moderate intensity are allowed.
- Sensory-motor neuropathy and autonomic neuropathy – Regular aerobic exercise can slow the progression of peripheral neuropathy. Still, no-load exercises are recommended because of potential traumatic effects on the feet (stationary biking, rowing, swimming).
- Autonomic neuropathy – Light physical exercises aerobic activities in suitable temperature conditions, with adequate hydration are allowed.
My name is Jay Fielding. I gained an interest in fitness since I was a child, and eventually developed my passion into a career path. I am now a Certified Personal Trainer with a natural ability to program customized body recomposition and motivate people in achieving their goals, be it gaining muscle or losing fat.