Written by Exercise Physiologist, Alex Parsons.
Did you know that diabetes is the fastest growing chronic condition in Australia, with 1 in 4 adults currently living with Diabetes or Pre-Diabetes?
It is all too common that I have conservations with individuals who have been diagnosed with diabetes who are unaware of what this diagnosis means or the extent of the condition, especially many individuals who have been diagnosed with Type II Diabetes.
So, what is diabetes you may ask?
Diabetes is an umbrella term for different conditions in which blood glucose levels (BGLs) are elevated in the blood. Glucose is a form of energy that the body requires for our cells to function and to allow the body to move (kind of like our ‘fuel’). However, when we have too much or too little glucose in our blood stream it can become detrimental to our health, so it is important that the body is able to regulate it.
So where do we get this glucose from? Glucose comes from the carbohydrates that we consume in our foods, like those potatoes, breads, fruit and vegetables, yummy pastries, the list goes on… The body requires carbohydrates as part of a balance diet. However, it is important for this amount of glucose to be regulated by the body to ensure optimal blood glucose levels are maintained, unfortunately for those living with diabetes this processes have been compromised.
To understand how blood glucose levels are affected by Diabetes, I believe it’s easiest to first understand what happens during the digestion of these carbohydrates in someone without diabetes. Let us say an individual who does not have diabetes consumes a banana, they have chewed it all up and it is making its way through the digestive process. First it reaches the stomach where it is broken down, then moves to the intestines where the carbohydrates are absorbed into the blood as glucose. This glucose now can circulate throughout our whole body via the blood stream to the tissues that need it. So, it’s in the blood stream, moving around, but where in the body do we need it? Most of our cells in our body require glucose for fuel including the brain, heart, muscles and other organs. The blood stream essentially acts like a highway transport delivering glucose to these various cells throughout the body. But wait how does it get into these cells? INSULIN! Insulin is the hormone that regulates the ability of glucose to enter the cells, acting like a key to unlock the cell doors, without the insulin the doors remain locked. So where does insulin come from? Insulin is produced in our pancreas. If our blood glucose levels are high, like after we’ve just eaten, this is detected by the pancreas, and as a result the pancreas works harder to produce more insulin, more insulin means more keys to help get glucose from the bloodstream into the cells to provide the cells with fuel and maintain optimal blood glucose levels.
What happens next?
Now that the glucose is in the cells (brain, muscles, heart, etc.) it is either used as energy or stored as energy for later. For example, when we perform an exercise like a bicep curl, glucose enters the muscle where it is used to provide energy to perform the movement. After the exercise, the muscle will then replenish its energy and store glucose. Let us say all our muscles are now replenished, the body has enough energy in the cells, where does extra glucose go? It is stored in the liver, the liver kind of acts like the warehouse for glucose, allowing a backup supply, let us explore this concept a little further. The liver not only acts as a warehouse for storing the extra glucose, the liver can also produce its own glucose. This allows the body to be able to manage blood glucose levels and produces a back up when blood glucose levels might be low, such as in a fasting state. But what if the warehouse gets full? If glucose can no longer be stored in the muscles or liver it tends to be converted to fat and sits around the waistline and I think we can all agree that’s not our preferred warehouse, not only does this affect the number we see on our scales, it can also affect how well insulin works within our body.
So now that we understand how blood glucose is transported and used in the body, let us look at what happens with Type 1 diabetes and how does this affect blood glucose levels. In Type I diabetes the pancreas is unable to produce ANY insulin, which means there is no keys! No keys, means the glucose cannot get in, leaving the blood glucose levels to be elevated and depriving the body of energy. Without this energy the body can not survive, as a result individuals with Type I Diabetes depend on insulin injections daily to be able to manage their blood glucose levels and provide the cells with a fuel source.
Then there is Type II Diabetes, where the pancreas can produce the insulin however it either cannot produce enough insulin, or the insulin that is produced does not work quite as well. As a result, the body is then not able to maintain optimal blood glucose levels with blood glucose levels being elevated. If the insulin is not working well, and blood glucose levels start to remain elevated, the pancreas will start to produce more insulin to compensate, as this process continues to occur, the insulin producing cells of the pancreas become unable to keep up with the demand and become over worked. This decline in the process is usually happening 7-10 years before someone is diagnosed with type II diabetes. Which then leads us to insulin resistance, which you may have heard of before. Insulin resistance occurs when the cells of the body become less responsive to the action of insulin, like trying to open a rusty lock. Having rusty locks then require us to try more keys, meaning greater amount of insulin required, so overtime we require more insulin from the pancreas to open the lock, which continues to wear out the pancreas therefore we have a decline in pancreas function while a worsening of insulin resistance. Unfortunately, therefore Type II Diabetes is recognised as a progressive condition, overtime the body’s ability to continue to regular blood glucose levels continue to decline especially when not proactively managed.
On a positive note it CAN be managed.
One way in which Type II Diabetes can be managed is through EXERCISE! That is right, staying physically active can have a significantly positive effect on your blood glucose levels and overall health. Regular exercise can help decrease blood glucose levels, by increasing insulin sensitivity, increasing glucose uptake into the cells and increasing storage capacity for glucose (bigger muscles equals more storage) ultimately decreasing blood glucose levels. Not only does regular exercise help with decreasing those blood glucose levels it has an on flow effect of decreasing cardiovascular risk, improving body composition, decreasing risk of diabetes complications such as neuropathy (nerves – commonly recognised as feet numbness), retinopathy (eyes) and nephropathy (kidneys), it can also lead to decreased reliance on medication, while improving social and emotional wellbeing. That sounds like a win to me, so what do you think shoulder we can moving?