The term ‘exercise’ can mean something different depending on who you ask. For some it may be a way to connect with others or release restless energy, and for many it is a way to improve health both in mind and body. For someone living with diabetes it could mean all of these things and so much more. Exercise is one of the first line management strategies for those with type 2 diabetes, and is a strong medicine in our arsenal that offers many positive side effects. Consider exercise as a not so bitter ‘pill’ to swallow.
Exercise as medicine for diabetes management
Diabetes is a condition that affects approximately 1 in 20 Australians nationwide, with Type 2 Diabetes (T2D) making up the majority of Diabetes cases (ABS, 2017-18). You may already know that T2D is a condition resulting from a combination of both environmental, genetic, and lifestyle factors that cause a decrease in the body’s sensitivity to insulin, the hormone responsible for controlling our blood sugar levels.
In 2019, over 14 million prescriptions for medicines to treat diabetes were dispensed to the Australian Community, with Metformin, a first line medication for diabetes, being the eighth most dispensed medicine (PBS, 2018-19). However, it is important that we also focus on exercise as key in managing this disease. Today, exercise is recommended as one of the first line management strategies, together with diet and behaviour modification.
Exercise has many positive side effects which allows people who are living with T2D to better manage the fluctuations in their blood sugar levels. This is because exercise can help to shuttle these sugars from our blood into the working muscles to eventually help decrease our blood sugar levels.
Another way exercise helps those living with diabetes is through increasing the body’s sensitivity to insulin for up to two days following exercise. Insulin is the hormone that regulates blood sugar levels by causing sugars to be taken up by the muscles and liver. As the body becomes more sensitive to insulin, the better the body’s insulin is at controlling those blood sugar levels.
The large list of additional, positive side effects of exercise include reduced blood pressure, stress levels, and cholesterol; and improved sleep, weight management, mood, blood sugar levels and heart health. With all these benefits as a bonus to managing diabetes, it only seems FITting that exercise plays a large medicinal role in the lives of those living with diabetes.
Find your right ‘dosage’
Consider exercise as a not so bitter ‘pill’ to swallow. It can be taken in our own individual dose, however and whenever we want it to suit our own abilities and lifestyle. The role of an Exercise Physiologist is to help you understand and optimise this dosage for your lifestyle, health conditions and goals. Physical activity can be a part of our lifestyle and is able to be moulded around our interests, hobbies, commitments and even roadblocks.
The current Australian Guidelines suggest completing just 30 minutes of physical activity each day. For some this may seem like a lot, but out of 24 hours, that’s only 2% of our day. It’s important to remember that these guidelines are just that, only a ‘guide’ for physical activity. For example, this 30 minutes can be split up over the course of your day into 10 or even 5 minute blocks. If you also feel this amount of exercise is outside your ability, why not start small and introduce regular movement into your day with an aim of slowly increasing that number as you feel more comfortable. A start is a step in the right direction.
As you build on your capacity to move, it’s important to understand what type, frequency, intensity and amount of physical activity is best for your conditions. The Australian Guidelines suggest completing two to three resistance exercise sessions each week, in order to strengthen your muscles and even manage type 2 diabetes by helping move sugar from the bloodstream. Resistance exercise can include free weights, machines, resistance bands, any weighted objects at home or even our body weight.
Which ‘brand’ works for you?
For those people living with diabetes, it is important to know that there are people out there that can support you in improving and maintaining your health and exercise activity to fit your lifestyle. Seeing an Exercise Physiologist is a great way to begin this process as they can assist you in finding safe and enjoyable physical activities that work for you.
As you may know, physical activity can look like many different things, it doesn’t have to be a ‘planned’ exercise or sport. It can be incidental to fit our own lifestyles, whether it be gardening, walking to and from work, backyard cricket with friends, playing tag with your kids, walking around the shops or even cleaning the house. These are just a few simple examples of how we can include movement into our everyday life, finding just that 2% of our time. Remember, there is no one ‘right’ way or amount of exercise we need to be doing but rather the way and amount that suits your ability, health, time and lifestyle.
Written by Lucas Paz Marques and Sophie Nash (Exercise Physiology students); approved by Harmonee Dove (Qualified EP)
ABS 2019a. Microdata: National Health Survey, 2017–18. ABS cat. no. 4324.0.55.001. Findings based on detailed microdata file analysis. Canberra: ABS.
AIHW. (2020, July 23). Diabetes. Retrieved from https://www.aihw.gov.au/reports/australias-health/diabetes
PBS. (2018-19). PBS Expenditure and Prescriptions Report. Retrieved from https://www.pbs.gov.au/info/statistics/expenditure-prescriptions/pbs-expenditure-and-prescriptions-report