Type 2 Diabetes

Definition:

Type 2 diabetes is not a discrete disease like type 1 diabetes or rheumatoid disease. People are informed that they “have type 2 diabetes” when their blood sugar level is above a certain internationally standardised threshold. Being at this level and above puts them at increased risk of a number of serious diseases and complications which means that they need to take action to reduce their risk.

Cause and scope for prevention:

The cause is years or decades of consuming more carbohydrate than they need for the energy required for their daily life. Most are obese and it is sometimes regarded as a result of exhaustion of the cells of the pancreas from overuse. This is completely different from type 1 diabetes which also results from death of the cells in the pancreas, but this is from an unknown cause unrelated to the overconsumption of carbohydrates.   

Diagnosis:

Typically two separate fasting blood tests where the results show sugar levels of 7 mmol/L (126 mg/dL) or higher. 

Standard medical therapy:

There are different ways of treating Type 2 diabetes. Some people can manage it by healthier eating, being more active and losing weight. It can also be prevented and sometimes even reversed with early diagnosis if significant lifestyle changes occur. However  most people will need medication to bring their blood glucose down to a safe level.

Whatever the treatment, everyone with Type 2 diabetes needs to learn how to live with and manage it in order to reduce further complications. 

Type and benefit of exercise therapy:     

Type 2 diabetes is potentially curable by a combination of diet, exercise, and weight loss. In conjunction with medication exercise will also positively affect blood sugar levels.

Exercise will also have a positive impact on their mental health which can lead to them taking more control of their diabetes.

Faculty of Sport and Exercise Medicine Guidelines on the balance of risks and benefits of activity for   people with Dysglycaemia:

The benefits of physical activity   outweigh the risks in both Type 1 and Type 2 diabetes. There is a risk of   short-term dysglycaemia with physical activity.

Hypoglycaemia is the most common adverse   event associated with physical activity in Type 1 & 2 diabetes, and other   forms of diabetes treated with insulin or insulin secretagogues. This can be   recurrent if not managed appropriately. Guidelines are available to help reduce the risk of hypoglycaemia, and evidence suggests that the overall risk of severe hypoglycaemia is not increased in those who are more physically active. People with diabetes should be made aware

that high intensity physical activity can cause a rise in blood glucose and offered strategies to combat this.

Key references:

Effect of exercise on the quality of life in type 2 diabetes mellitus: a systematic review.

Resistance exercise versus aerobic exercise for type 2 diabetes: a systematic review and meta-analysis.

Exercise training modalities in patients with type 2 diabetes mellitus: a systematic review and network meta-analysis. 

Key organisations:

Diabetes UK