Introduction
We are all aware of at least one person either in our own household or from our acquaintances who is diabetic. The term ” diabetes” has become so common that it's almost taken for granted that we will end up diabetic, if not already or in our fading years. The fact is, more and more people in the younger population are becoming diabetic. Apart from the reality that India is home to the world's second-highest number of diabetic patients, the prevalence of diabetes among the population can be estimated just by counting the number of people suffering from this disorder among our own circles.
Prevalence as per stats:
According to the IDF (International Diabetes Federation), one out of every seven diabetic adults worldwide resides in India, and one in every third household has diabetic patients. According to the National NCD Monitoring Survey (NNMS), the diabetes prevalence in India stood at 9.3% in 2018. The IDF has provided comparable figures, stating that the prevalence of diabetes was 9.6% in 2021 and is expected to rise to 10.4% by 2030.
What is Diabetes? Let's get into the details.
Let us first try to understand how our body processes food, which will eventually lead us to a better understanding of the condition called ‘Diabetes’.
The food that we eat, which is all mushed up by our teeth and saliva, is further converted to glucose inside the stomach with the help of digestive enzymes. Glucose, which is a type of sugar, is then absorbed by the inner walls of the stomach and small intestine and released into the bloodstream. This increase in blood glucose level acts as a trigger for the pancreas to release insulin into the bloodstream. Glucose and insulin in the bloodstream reach each cell in our body, and insulin acts like a key that enables the cell to absorb glucose. Insulin facilitates the entry of glucose into cells for energy utilisation.
Consider a scenario where you consumed a chocolate donut. ,this sugary delight elevated your glucose levels in the blood. The pancreas, now sensing the spike in glucose, releases insulin into the bloodstream to facilitate glucose absorption by various cells of our body. But if this onslaught of glucose continues because of your insatiable cravings for dessert and carbonated drinks like Coke, the pancreas cannot help but release more insulin to aid glucose absorption, but cells at some point become resistant to insulin; the cells do not accept glucose. Even if there is an increase in insulin inflow into the bloodstream, resulting in high glucose levels in the bloodstream, this is called insulin resistance.
But if we are able to make the cells within our body more sensitive to insulin by some means,such that they allow the absorption of glucose, then the glucose levels in the bloodstream would drop, the insulin level would also drop, and once the glucose enter the cells, the cells would have the energy to do their job, and we would be on safer ground. One way of making the cells more insulin-sensitive is by controlling the inflow of glucose; in other words, by keeping a watch over what we eat and our physical activity. We will cover more of this as we proceed with the article.
There are two main types of diabetes: Type 1 and Type 2.
In Type 1 diabetes, our body’s immune system has destroyed the insulin-producing beta cells in the pancreas because of an autoimmune response. As a result, our body is unable to produce any insulin on its own. Patients have to rely on external sources of insulin in this condition. This type of diabetes accounts for about 10 percent of all cases, usually affecting those under 40 years of age, and it's by far the most common type of diabetes found in children.
A higher percentage of instances of diabetes are type 2, which is also more complex. It is estimated that around 90% of instances of diabetes are of this kind. The over-40 age group in the global population is where it is most prevalent. and in the South-East Asian community's over-25 age range. This condition is caused by either insufficient insulin production by the body or improper insulin function. This syndrome is typically caused by insulin resistance.
Glucose Storage Mechanism:
It's important to understand how and where the glucose is stored in our body . Let me explain the process, when you consume food ,that food breaks down into glucose, the glucose enters the bloodstream and insulin facilitates the storage of that glucose into one of three places inside your body , here is the order, based on metabolic preference.
❖ Liver: The liver, which is responsible for an array of functions in our body, stores glucose in the form of glycogen. When there is a need for glucose, glucose is released from glycogen( through a process called glycogenolysis), making it available to be used in the cells of our body for performing various functions. However, the liver has a limited storage capacity; if the liver is already filled with glucose, glucose passes through the liver and heads for the next storage medium.
❖ Muscle tissues: Glucose is stored in muscle tissue in the same form as in the liver, which is glycogen, but muscles also have a limited storage capacity. But unlike your liver, the size of your muscles can change. You can increase their volume through exercise; the more exercise you indulge in, the larger your muscles grow, and consequently, more glucose can be stored inside those muscles. But if your muscles have reached their maximum glucose storage capacity, there is no more room for glucose, then excess glucose heads toward the next storage medium.
❖ Fat (adipose): The third storage medium inside your body is your fat issue. Now your fat adipose tissue is like a long-term storage lot; no matter what, you're always going to find a space to park glucose inside your fat cells. Unfortunately, that's how we gain weight.
Understanding the Link Between Exercise ,Insulin sensitivity and Diabetes.
Thus far, we have understood that it's vital that glucose regulation happens as it should for maintaining optimum overall health. If this does not happen, the free glucose in the bloodstream will begin to have a negative effect on almost all organs of our body, like the liver, kidneys, eyes, etc. The preceding section on glucose storage would have given us a fair idea of how exercise helps with glucose regulation. Let's dive deep into this topic in this section.
When we exercise, we empty our muscle and liver glucose reserves. Glucose is used to provide energy to perform that activity, and eventually that stored glucose runs out.
If we continue to exercise, the glucose stored in the muscles is utilised and eventually both storage mediums—the muscles and the liver have no glucose in them. Now we have created a situation where there is space for glucose storage in the liver and the muscles.
For people with type 2 diabetes or prediabetes, exercise can have an enormously positive impact on increasing insulin sensitivity and lowering blood glucose levels. Essentially, what exercise does is free up the traffic jam of glucose circulating around your bloodstream and creates the space; it opens the parking lots of your muscles and your liver for glucose to go, and it stops the fat tissues from continuing to expand (by storing up glucose).
For those with type 1 diabetes, you get a great workout and you empty the muscle and liver glucose reserves. The next time you eat food, you'll need less insulin than if you hadn't worked out. Since muscles and liver are empty and have zero glucose, less insulin is required to facilitate the storage of glucose in these storage mediums.
Summary of benefits of exercise
● Lowers blood sugar levels or your blood glucose
● Lowers your blood pressure and cholesterol
● Helps manage weight
● Improves insulin sensitivity
● Builds endurance and bone strength
● Reduces the risk of Heart attacks and Stroke.
Exercise Plan for Optimal Diabetes Control:
Before you start the exercise regime, one must consult the physician for guidance.
Let us discuss the type and frequency of exercise, the precautions you should take before starting an exercise, and the other aspects of exercise.
There are two types of exercises: aerobic exercise and resistance exercises.
● Aerobic exercises include walking, jogging, swimming, or cycling.
● Resistance training or Strength training, includes lifting weights.
It is generally recommended to start with 15 minutes of exercise daily, then progress to 30 minutes of exercise 5 to 6 days a week. Before starting exercise, there are some precautions that you should take.
1. Start with light-intensity exercises: If you're not accustomed to exercise, start slowly and then gradually increase the intensity until you are able to achieve a higher intensity exercise.
2.Choose the right Gear: The footwear you wear should be comfortable, and it should not cause any injuries when you walk.
3.Check Glucose levels: Check whether your blood glucose levels are under control. It is not advisable to do intensive exercise when your sugar levels are very high or very low.
4. Check for other complications: If you have complications like eye disease or untreated heart disease, then you should consult an eye doctor or a heart doctor before starting your exercise program. And one note about hypoglycemia: when you don't plan your exercise properly, your sugars may go down very low and cause problems like loss of consciousness resulting in a fall or seizures. It is always advisable to check the blood glucose levels with a glucometer.
5. Nutrition and Sleep: You should have adequate protein in your diet and also have at least 7 to 8 hours of sleep at night.
6. Consistency: Remember, this is a long-term commitment. If you do these exercises for a very long time, you can have greater benefits with respect to diabetes,control of hypertension, cholesterol, and also heart disease.
As a fitness enthusiast myself, I can personally vouch for the benefits that exercise has, not only on your body but also on your mental health. Your overall health only improves for good once you make exercise part of your daily routine.
Balancing Diet for Sustainable Results
Here are a few tips on how you can balance your diet to control blood sugar spikes.
● Limit Sugars and Processed Carbs: Avoid Refined sugar, reduce sugary foods, sugary drinks, and highly processed carbs, like bakery snacks and biscuits with added sugars, as they can cause glucose spikes in the blood.
● Choose Complex Carbs: Opt for whole, unprocessed foods like leafy vegetables, whole, unpolished grains (like rice, millet, etc.), and legumes that contain complex carbs and fibre.
● Prioritise Healthy Fats: Consume avocados, nuts, flax seeds, and fish (salmon).
● Intermittent fasting: This is where you cycle between periods of eating and fasting.
● Consume fibre rich foods:Consume more Broccoli, Spinach, Drumstick leaves, Bitter Gourd, Curry leaves, Other leafy vegetables, Jamun Fruit, Amla, Sprouts. Including fermented foods such as buttermilk, fermented porridge etc, has a positive impact on gut bacteria biome which in turn improves overall health.
Conclusion:
In conclusion, regular exercise can play a crucial role in improving diabetes control by regulating blood sugar levels, boosting insulin sensitivity, managing weight, and enhancing mental health. Recognise that there is no one-size-fits-all solution. Try out various methods to discover the most effective options for your body and daily routine. Make sure that your approach is evidence-based and emphasises sustainable lifestyle changes for long-term health benefits.By incorporating physical activity and healthy eating habits into your daily routine, you can experience significant benefits in managing your diabetes and overall well-being.
FAQs:
1.What are symptoms of diabetes:
Diabetes often presents with minimal symptoms, such as the urge to urinate a lot, often at night, having thirst, thrush, or genital itching,slow healing of wounds, blurred vision, tiredness, and weight loss, or without severe consequences early on. Taking all precautionary measures to ensure diabetes is prevented is the best way forward.
2.How can one prevent getting diabetes?
Have a balanced diet that is rich in fibre and less in carbohydrates; consume more leafy vegetables; avoid sugary foods and drinks; exercise regularly,Prioritise Sleep & Manage Stress .Get a periodic blood checkup done to ascertain sugar levels and consult a doctor or nutritionist for further advice.
3. Can I immediately start exercising to control diabetes.?
Before you start the exercise regime, you must consult a physician or a Fitness expert for guidance.
4. How often should I exercise to improve my diabetes control?
It is generally recommended to start with 15 minutes of exercise daily , then progress to 30 minutes of exercise 5 to 6 days in a week. you must consult a physician or a Fitness expert for guidance
5. I'm over 65 years old and have diabetes. Can I start exercising now?
Certainly you can; people who are older than 65 years exercise regularly., but first consult your doctor.
6. What are some suitable exercises for individuals with diabetes?
You can start with Aerobic and resistance training, first with light intensity and you can progress slowly.
7. Can exercise alone replace medication for diabetes management?
Exercise, along with the right diet, surely helps control blood sugar levels. Consult your physician for medication dosage related queries.
8. How does strength training help in controlling blood glucose?
Muscle mass is increased when we do strength training; the more muscle mass there is, the more room for glucose storage, hence glucose levels in the bloodstream drop.