Definition

Type 2 Diabetes is a progressive disease whereby too much glucose (sugar) is in your blood. Glucose comes from food you eat such as carbohydrates (starchy food), sweet food and drinks. Diabetes risk factors are age, heredity and obesity. High blood sugar levels result from defects in insulin secretion and action. Blood glucose levels are controlled by insulin, a hormone produced by the pancreas. Insulin lowers the blood glucose level. When the blood glucose elevates (after eating food), insulin is released form the pancreas to create and normalize glucose levels.
Type 2 Diabetes results from not producing enough insulin to keep blood glucose levels in the normal range, the body can’t make enough insulin, or it has become insensitive to insulin and the pancreas can’t make more to compensate. The body is insulin resistant and doesn’t respond to insulin properly. A healthy blood glucose range is 4-8mmol/L. Insufficient or absence of insulin causes Hyperglycaemia is a term used describing high blood glucose and is a risk factor for Type 2 Diabetes. Measures are persistently above 15 mmol/L.
Type 2 Diabetes is a chronic condition that although it can be controlled, it lasts a lifetime. Insulin has two jobs in the body; to move glucose from the blood into fat and muscle cells and to stop the liver making glucose when the level of glucose in the blood is high enough.
Control Type 2 Diabetes – Eat fat free, low fat, lean! Cut out sweets and fizzy drinks! Exercise! Eat more vegetables! Drink water! Stop smoking! Cut out refined foods!

• Type 2 Diabetes develops slowly, can take years before noticeable.
• Symptoms can develop over a short period of time.
• People can be very sick by the time they are diagnosed.
• Some people have high blood sugar and no problems.

Dynamics of insulin

Insulin allows cells to use and absorb glucose. Once secreted, insulin molecules circulate freely in the blood stream until they attach to insulin receptors on the outer membrane of the cells. Insulin attracts glucose and directs it through the protective membrane to the cells interior.
Some of this glucose is used immediately, some converted into glycogen and stored in the liver and muscles until needed.
Associated consequences of Type 2 Diabetes is hyperglycaemia – high blood sugar levels, hypoglycaemia – low blood sugar levels, ketoacidosis – blood glucose too high and not enough insulin to convert it to energy, the body relies on fat for fuel, producing ketones (toxic in high concentrations). A person can become poisoned and may ultimately lapse into a coma.

Symptoms

• Frequent urination.
• Excessive thirst.
• Fatigue.
• Blurry vision.
• Hunger.
• Weightloss.
• Abdominal pain.
• Sweating.
• Pain in legs and wounds that don’t heal.
• Tingling and numbness in hands.

Long-term complications

Cardiovascular disease, heart attacks and strokes Peripheral Neuropathy – Nerve damage, loss of sensation in feet, which can lead to infections that go unnoticed leading to ulcers and amputation if left untreated. Bladder and bowel incontinence. Eye problems, causing blindness. Retinopathy – caused by damage to the small blood vessels in the retina (light sensitive layer at the back of the eye). Male sexual dysfunction. Depression, anxiety and other mental illnesses. Kidney damage – kidney disease or failure. Hearing loss and gum disease. Gastroparesis – Muscles of the stomach stop working.

Types of exercise to do for Type 2 Diabetes condition

Low impact cardiovascular exercise. Yoga and Tai chi. Low impact resistance training and flexibility training. Water base exercises.
Aerobic exercises: Requires the use of large muscles making the heart work faster, making you breathe harder. Strength training: Using hand weights, elastic bands, weight machines, will build muscle. More muscle means less fat and more calories being burnt and used by the body.
Low impact exercise is best alongside stretching.
Stretching: Increases flexibility, lowers stress, prevents muscle soreness.

Healthy eating. Control and minimizing complications

• • Avoid being over weight and lose excess weight. Cut sugar out!
  • Follow a healthy eating guideline – Eat more vegetables and fat free foods.
  • Do regular exercise, consisting of flexibility, cardiovascular training and strength training.
  • Avoid smoking. Drink water.
  • Have regular check ups with a medical practitioner/doctor.
  • Avoid fatty foods and sweet drinks.
  • Get more sleep and reduce stress.
  • Treat hypertension and high blood fats.
  • Reduce high cholesterol.
  • Monitor your blood glucose levels.
  • Don’t drink alcohol.

The importance of exercise

Exercise maintains weight and stops obesity: Weight loss improves blood glucose control by lowering the liver’s glucose production and increasing insulin sensitivity. Boost pancreatic insulin secretions and decrease fat and adipose tissue.
Exercise improves quality of life: Lowers your risk of falling, gives you more energy, keeps your joints flexible, keeps bones strong, supports psychological well-being – depression, anxiety and mental illness is decreased. Look and feel better, sleep well, prevent premature disability such as amputation.
Perform exercise within suggested guidelines, to have a positive effect on the body.

Exercise for people with Type 2 Diabetes

Regular exercise helps with:

• Weight loss. Prevent complications. Good blood flow, heart strength Reduce the amount of insulin needed to control sugar levels by improving the body’s insulin efficiency.
  Helps balance weight and keep an ideal weight.
  Raise the use of glucose by muscles, therefore lowering blood glucose levels

Intensity: Increase levels of exercise gently, building up to a maximum level that remains comfortable. You should be able to talk or sing. Vigorous or intense exercise you should not be able to say more than a few words without pausing to breathe.
Frequency: It is recommended to do 2 – 3 days per week. This should consist of a combination of aerobic, resistance training and flexibility training.
Time: 10 – 30 minutes, increasing with client’s progress. Increase up to 60 minutes.
Suggested intensity: Moderate 40- 59% VO2 R or HRR. Moderate to vigorous – Resistance training 2 – 4 sets with 8 – 10 repetitions, 1 – 2 min rest intervals. No more than 2 consecutive days without exercise. Vigorous – aerobic workouts i.e. swimming at 70 – 89% HR max.
Exercise in comfortable socks and well-fitting shoes, to prevent infections, ulcers or sores.
With diabetes complications, certain kinds of exercise can make your problems worse, i.e. heavy weight lifting can increase eye pressure and the blood vessels of your eyes, nerve damage can make your feet numb, sores or blisters could get worse and you won’t feel them.