By Dr. Anthony Policastro

Type 2 diabetes is so common that it does not get the respect it deserves. In the United States it remains in the top ten causes of death. Its a significant cause of heart disease, blindness, kidney disease, nerve disease, and amputation. 

Type 1 diabetes is failure of insulin production by the pancreas. Its treatment is taking insulin. Type 2 diabetes is related to insulin resistance of muscle cells. They fail to take up glucose properly for that reason.

The basic treatment for Type 2 diabetes is diet and exercise. Studies have shown that physical exercise and modest weight loss can lower the risk of developing Type 2 diabetes by 58 percent in high risk populations. We also know that most individuals who are pre-diabetic can prevent outright diabetes by just a 5 percent weight loss. These two things are just as important once the diagnosis of Type 2 diabetes is actually made.

Physical activity directly addresses the issue of insulin resistance in muscle cells. One thing that it does is increase the sensitivity of muscles to insulin. One might think that the issue is less insulin in the circulation. That is not the case. The uptake of insulin into the muscles is more important.

A second thing that happens is related to the fact that a prolonged session of physical activity results in increased blood flow to the muscles. It also increases glucose uptake into those cells. 

A third thing that happens is that physical activity is known to decrease the amount of fat inside the abdomen. That kind of fat is known to be associated with insulin resistance.

Thus there are multiple ways in which exercise is beneficial for individuals with Type 2 diabetes. It has been shown that even one week of aerobic training can improve whole body insulin sensitivity in individuals with Type 2 diabetes.

Resistance training with weights has also been shown to be beneficial for individuals with Type 2 diabetes. In addition, it appears to have an effect on lowering Hemoglobin A-1-C levels.

One study showed that working with a formal exercise trainer had the most benefit to individuals with Type 2 diabetes.

There are specific recommendations for exercise in these patients. There should be a total of 150 minutes a week of aerobic exercise. It should be at least 30 minutes per period. It should not be less than every other day. That is because of the fact that benefits quickly wear off if not continued.

Any method of aerobic exercise is good. That includes brisk walking especially for those with other health issues. The time to start is before the many complications of Type 2 diabetes appear. By then it is too late to give the illness the respect it deserves.