Wednesday, 13 July 2016 03:56

The importance of remaining active for optimal diabetes management

Given this week is National Diabetes Week, it is a timely occasion to remind all diabetics about the importance of movement (structured and/or incidental) to ensure optimal glycaemic control.

Two powerful graphs were presented at our recent Research to Practice conference in Melbourne and they immediately resonated with not only us – the AEP Exercise Physiologists, but everyone in the auditorium. They are based on research conducted by Dempsey et al (2016) whereby 3 groups participated in a study that examined the body’s response to prolonged sitting for type 2 diabetics.Glucose_Response.jpg

The “sitting group” were required to complete a 7 hour period of uninterrupted sitting (except for toilet breaks). What does this sound like? A sedentary occupation perhaps?

The “light walking group” were required to remain sitting for the same 7 hour period, however every 30 minutes, their sitting was interrupted with light walking for a 3 minute period.

The “simple resistance group” were once again required to remain sitting for the 7 hour period. They performed simple resistance training exercises such as chair squats, calf raises and knee lifts every 30 minutes for a 3 minute period.

As you can see, the graph shows a much larger initial “spike” in blood glucose levels (BGLs) for the “sitting group” than the other 2. This greater level was then maintained throughout the whole 7 hour study.

 

But why is this important?

If you have been diagnosed as a diabetic, your GP would be measuring your HbA1c. As this is a measure of your average BGL for a 2-3 month period, a reduction in BGL through moving often will ensure your risk of diabetic complications is lower.HbA1c_Explanation.jpg

 

But my HbA1c is good already, why should I need to change anything?

Apart from exercise and physical activity being a great way to keep your glycaemic control optimal, it also helps to regulate the hormone called insulin. But I am diabetic you may ask, my body isn’t producing enough insulin… This is certainly correct for most type 1 diabetics who have an autoimmune condition whereby their pancreas secretes little to no insulin, however in those with type 2 and gestational diabetes, high BGLs are commonly due to insulin resistance.

 

What is insulin resistance?

Insulin resistance is a condition whereby it is much more difficult to move glucose from the bloodstream into an “insulin resistant” cell than a “normal” cell. This can often lead to fatigue because the cells that require glucose are not able to metabolise it when required. This often leads to even greater levels of insulin being secreted because the body recognises the BGLs are not decreasing. If this continues for a lengthy period of time, the body avoids placing emphasis on secreting insulin and slowly reduces the insulin secretion – leading to greater levels of blood glucose and the reliance on medications such as oral hypoglycaemics or synthetic insulin.

 

The impact of movement on insulin secretion.Insulin_Response.jpg

As you can see in this graph, insulin has a similar response to exercise as the blood glucose. It is much lower and stays much lower right throughout the 7 hour study. Once again, this highlights the importance that movement has on regulation of BOTH glucose and insulin.

Hopefully this provides you with a little motivation next time you decide to remain seated for a lengthy period of time, because after all, YOUR health is YOUR greatest asset! Make sure YOU take good care of it…

 

By Caelum Schild

Accredited Exercise Physiologist