What might the differences be and the physical challenges of a Type 2 diabetic exercising vs a non-diabetic exercising? I’m thinking on a cellular and metabolic level.
There really are no challenges. I’m type 2 and can do most anything I care to. Exercise and diet will bring down your glucose and A1C, and many diabetics are able to eventually get off the meds (I’m not one of them).
But you really should ask your doctor.
Exercise will lower your blood sugar, but it doesn’t use insulin to do it. It also doesn’t lower it right away, so glucose levels may fluctuate more than you expect for an hour or two after exercise, and even during it if you exercise long enough. I don’t remember how glucophages work, but if you’re taking something that scavenges glucose from the bloodstream and eliminates it rather than, say, storing it as glucagon, it would be easier to end up with low blood sugar.
IMO a diabetic would struggle with something like a marathon. Assuming he/she cares about managing blood sugar correctly they’d be unable to “carb load” like a normal person. So it’d be easy to “bonk” for lack of energy. Which might be made worse by whatever medication the diabetic might be on. Metformin in particular impedes the liver’s ability to generate glucose to power muscles. Which is one of the ways “carb loading” powers later long-term energy consumption.
Huh.
Obviously regular exercise is of amazing importance in preventing and in reducing the severity of T2DM but my first impulse was to think that the insulin resistance that is the hallmark of T2DM would make muscles possibly more challenged during exercise, but looking it up **Ethilrist ** is indeed exactly correct.
For a less cellular mechanism overview and a more holistic clinical perspective this article may be of interest. Diabetics may have some condition resultant of the the diabetes or comorbid with it that would inform what sort of exercise is advisable and what is not. They can be on medications that may increase certain risks or may have impact on maximal exercise capacity, for example β-blockers which
There is discussion there of what the graded stress test guidelines should or should not be as well.
I am a type 2 diabetic. I’m also an engineer, so my medical knowledge, especially at the cellular level that the OP is asking for, is a bit limited. I can make some more general comments on the topic, though.
The causes of type 2 diabetes vary. Genetics can play a role, as can other things. By far the most common cause though is obesity. Excess fat clogs up the insulin receptors in the body’s cells, causing the entire body to be a bit insulin resistant. This forces the insulin-producing cells in the pancreas to work harder, often over-stressing them to the point where they get damaged and die off. These cells are never replaced, so when they are gone, they are gone for good. At some point, you do enough damage to the pancreas that even at its best it can no longer properly regulate the body’s sugar levels.
Exercise and losing weight will remove a lot of the fat, freeing up the insulin receptors on the cells. I personally started exercising and dropping some weight, and my blood sugars are under control without any medication. I won’t use the word “cured” though, because even though my blood sugar levels are fine, I still have permanent damage to my pancreas.
Exercise and losing weight are the most important things you can do with respect to diabetes. That said, there are some issues.
While causes of type 2 diabetes do vary, a large majority of cases are caused by obesity. Someone who is obese shouldn’t immediately jump in and start trying to run marathons. The obesity itself causes issues with exercise. Carrying extra weight around puts more stress on muscles and ligaments. Someone who is obese needs to start slow and gradually work their way up from there.
Another issue is diabetic nerve damage. High sugar levels damage nerve fibers, and this is often most noticeable in the lower legs and feet. Sometimes this causes nerve pain, and sometimes it causes no symptoms other than numbness. A diabetic person with nerve damage can easily injure their foot and not be aware of it. Someone with diabetic nerve damage who starts walking or running needs to make sure they have good cushioned shoes and they need to take extra precautions to make sure that they don’t injure themselves.
I have been insulin resistant since I was a teen, and have had Type 2 Diabetes for about a year. I’ve always been very active, even though I am very overweight.
I never had much counseling about the insulin resistance, even though it was clear that I had it. It wasn’t until my early 30s that I was put on Metformin. My muscles have always been quite strong (heck, they carry a lot of weight every day!) but my stamina is very low.
And it’s not heart stamina. It’s muscle stamina. I can feel it when I swim that everything is going fine, I am breathing fine, and there just comes a point where my muscles. stop. being. able. to. move. Not a freezing up, just a major lag time between my brain telling them to move and them actually moving.
I get out of the pool and I’m fine. I’m not winded, I’m not sore, I’m not sore the next day. Just, my muscles had run out of energy for the moment.
I noticed it big time this summer when I was setting up for a yearly outdoor party I have. I could do like 15 minutes of work before I couldn’t lift my arms over my head anymore. Last summer (just before my A1C test reached 7.5) I was struggling too.
Exercise totally drops my bloodsugar. Unfortunately so do the meds I’m on. Finding the right balance has been hard.
Just for a positive note, although it involves a T1, not T2 diabetic…
Chris Dudley played 17 years in the NBA as a T1 diabetic.
I’m a Type 2 diabetic and I just came off a fitness walk challenge at work where I came in second place out 500 people by walking almost 30,000 steps a day for three weeks. The first place winner was also a Type 2 diabetic and walked nearly 40,000 steps a day. The problem with your question is that there is a wide range of fitness levels within the “Type 2” definition. I had callouses and blisters during the second week and I just popped them, cleaned them and put a bandage on them and marched on like non-diabetic would. But my blood sugar is under control, still doesn’t mean I’m not a type 2. I went to my yearly physical the day after the competition and informed my doctor and he examined my feet and said as long as I kept checking and didn’t ignore any infections I’d be fine.
So basically, I stayed hydrated and ate fruit while I walked in order to maintain steady blood sugar levels. Pretty much the same thing a non-diabetic person would do. A marathon would be another matter because you don’t stop to have lunch during those type of things.
Although a colleague of mine is a T1 diabetic who raises money every year for diabetes research running the Chicago Marathon in times that I would never hit or come close to no matter how intense and focused my training. His big issue this year was that his insulin pump malfunctioned and swapping it out mid race slowed him down some. This year he was consequently a slow for him 3:44, still in the top third of his age/gender division.
How and when you exercise also matter.
High intensity interval training is better than regular aerobics. Small amounts of exercise after each meal is better than doing all your exercise at once.