“… no essential part of the drink is absorbed by the body while great masses of the flesh are liquefied into urine.”
- Aretaeus of Cappadocia
Should we run away from sweetness or does everyone need a little extra of it, especially, in today’s time, and yet somehow we humans are not able to enjoy these little pleasures, even more so now.
Is there something we can add to our lives that will actually decrease blood sugar and amplify the joy of living?
The answer is YES, of course!
The burden of diabetes is increasing globally, and in developing economies like India, mainly fueled by the increasing prevalence of overweight/obesity and unhealthy lifestyles. The estimates in 2019 showed that 77 million individuals had diabetes in India, which is expected to rise to over 134 million by 2045. Approximately 57% of these individuals remain undiagnosed.
To find a solution to a problem, it is essential to understand what the problem is. This blog aims to explain the signs of diabetes and how simply moving can help keep it under control.
Diabetes is simply explained as an increase in blood sugar level over a prolonged period of time.
Simply put, Insulin is a hormone released from your pancreas to move glucose from your bloodstream into your liver, muscle, and fat cells to store it as glycogen, hence, reducing blood glucose, and works like a key for the glucose, unlocking the cells, allowing the glucose to enter. Without insulin, our cells can’t function well because glucose remains locked out, which acts like a source of energy for the cells, and hence the glucose from food gets accumulated in the bloodstream.
In a less common type of diabetes, type 1, there is no key(insulin) i.e. it is an autoimmune disorder where the body destroys the cell responsible for producing insulin.
Whereas, In type 2 diabetes, the key (insulin) to unlock the cells is rusty and therefore can’t open the lock as well.
Type 2 diabetes, accounts for the majority of the cases and is associated with the body not responding correctly to insulin. Over months/years cells of the pancreas that are working too hard to keep up with the increased demand, get worn out and can no longer keep pace with the demand for insulin than is normally needed leading to insulin resistance. Insulin resistance is when you need more insulin than that is normally needed. The end result is higher levels of circulating insulin.
For the most part, high levels of insulin do not cause any symptoms and are usually elevated for years, silently before, your blood glucose may begin to rise.
Insulin resistance is present for 10 to 15 years before the appearance of type 2 diabetes. For these 10 to 15 years, a person’s glucose will be entirely normal.
There will be NO signs of any issue on traditional blood glucose or HBA1c blood tests. Insulin levels can be measured with a simple blood test that is usually overlooked by healthcare professionals.
How to know if you have diabetes?
Diabetes mellitus is diagnosed with a test for the glucose content in the blood, and is diagnosed by demonstrating any one of the following:
Some easily overlooked signs of diabetes:
An increase in waist circumference (central obesity).
An excessive thirst that’s stronger than that feeling you get on a hot day.
unceasing hunger that is more bottomless than the hangry feeling you get after skipping meals.
The urge to urinate more often than usual.
Weight loss can affect some people with type 2 diabetes.
Blurred vision can come on quite suddenly and may also come and go because it results from high blood sugar levels that cause the lens of your eye to swell.
Extremity paresthesia, or tingling feet and hands, may feel similar to the sensation you get when your foot “falls asleep”.
Fatigue, If you feel like you are never rested, your body feels heavy, and small tasks seem overwhelming, you may be experiencing fatigue.
How does increased glucose in the blood affect our body?
Not to scare you all, but long-standing diabetes can lead to an array of disabling complications, including visual impairment, peripheral and autonomic neuropathy, silent schema, cardiac arrhythmias, and an increased risk of sudden death.
Insulin resistance itself has been shown to significantly increase the incidence and prevalence of cardiovascular disease in individuals with T2DM
The primary role of skeletal muscle is to allow the body to move via the generation of force. This importance is highlighted in conditions where muscle mass is lost, such as in sarcopenia (the age-related loss of muscle mass and function). This loss of skeletal muscle is also accelerated in several disease states, including type 2 diabetes.
Inversely, evidence indicates that low muscle mass and function are associated with an increased risk of type 2 diabetes. Hence, the loss of muscle mass isn’t only the cause but also the consequence of type 2 DM leading to a high risk of falls and fractures and a decrease in independence in elderly diabetics.
How do exercise and building muscle help with diabetes?
Focusing on type 2 diabetes, the skeletal muscle is the primary site for glucose disposal, it acts as a sponge to absorb glucose from the blood as fuel for physical activity, with ~80% of glucose being taken up into muscle in the postprandial state. Additionally, exercise training improves glucose clearance rate and reduces visceral adipose tissues, which seems to be related to insulin sensitivity. Nevertheless, exercise training is beneficial to improve insulin sensitivity, independently of weight reduction and current physical activity guidelines for people with type 2 diabetes mellitus promote at least 150 min activity per week.
The Look AHEAD trial was the largest randomized trial evaluating an intensive lifestyle intervention (ILI) in older adults with type 2 diabetes compared with a diabetes support and education (DSE) control group.
The trial was conducted on 5145 persons in 16 centers in the USA. The ILI intervention focused on behavioral, nutrition, and activity themes, while the DSE was invited to 3 group sessions in the first year which reviewed general information on diabetes management.
The authors concluded that “There were many other health benefits of ILI, including improved biomarkers of glucose and lipid control, less sleep apnea, lower liver fat, less depression, improved insulin sensitivity, less urinary incontinence, less kidney disease, reduced need of diabetes medications, maintenance of physical mobility, improved quality of life and lower costs.
“There was some regression of diabetes in the ILI group. This did not occur in the DSE group. This occurred more in patients with a short duration of diabetes diagnosis and who had lost more weight and improved fitness better. This is good news since DM2 leads to a host of complications that are costly in terms of quality of life and dollars spent. It suggests that if one intervenes forcefully early on as soon as diabetes is diagnosed, a chance for remission is there”
And no, resistance training doesn’t mean lifting 50kgs in your first attempt, it should be tailored according to you depending on your individual characteristics and health status! It
can be as simple as doing some bodyweight exercises (where body weight acts as resistance) like squats, lunges, push-ups, or using some resistance or dumbbells, with a goal of slowly progressing the overall intensity of the program which could mean increasing one or few of the variables of the program like the repetition, time, frequency and not just the weight being lifted.
Does all of this seem too overwhelming to start? We got you!
Something as simple as walking can help. This study found that walking at least 2h/week was associated with a 34% to 39% reduction in T2DM and CVD mortality rates. That is just walking for about 15-20mins a day! Additionally, significant amounts of walking (i.e. about 3-4h/week) were associated with about 54% reduction in diabetes. They also found that if you level up your walking a little and walking at moderate intensity levels was better for a reduction in diabetes. Overall the study concluded that brisk walking on a regular basis is a key health behavior for persons with T2DM.
In fact, walking at least 10 minutes after your meals can not only impact the spike in glucose that occurs after eating (helping avoid the need for an increased total insulin dose or additional mealtime insulin injections that might otherwise have been prescribed to lower glucose levels after eating), it can also lead to a collectively higher amount of walking when multiple bouts of walking are accounted for.
Too confused about what to do exactly?
Walk more. Wherever you can, preferably for at least 10-15 minutes after a meal.
Just move, whenever you can. Adding a little bit of cardio and strength training into your routine. It doesn’t have to be too extensive, just a combination of both that works for you.
Invest in your health. Sleep more, eat well, and get moving!
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