Part of this interview was explaining bits and pieces of this disease, and I found myself questioning the content of their conversation when the interviewee told the audience that the difference between Type 1 and Type 2 Diabetes is that Type 1 is not responsive to exercise and activity levels have no bearing on the severity or treatment of Type 1 Diabetes. In my opinion, because of the strong trend for Americans to get little to no physical activity, people should not be told that there is no benefit of exercise regardless of what disease is being discussed.
Type 1 Diabetes affects only 5-10% of diabetic patients, and is usually diagnosed in childhood or before young adulthood. Many factors are involved in the risk of having Type 1 Diabetes: Gut infections, mother's Vitamin D deficiency, poor protein digestion, genetic predisposition, auto immune destruction of pancreatic cells, viral or environmental triggers. To diagnosis of Type 1 Diabetes is usually due to high C-Peptide levels, autoantibody presence, glucose and ketones in urine, and random blood glucose above 200 mg/dL. Signs and symptoms of the disease include: increased hunger and thirst, excess fatigue, increased urination, weight loss, blurred vision, numbness in hands or feet, rapid breathing, dry skin and mouth, sweet odor of breath, and vomiting.
Because the pathogenesis of Type 1 Diabetes is destruction of the insulin-releasing cells of the pancreas, medical treatment consists of insulin injections and daily monitoring of blood glucose levels. Severe cases are treated with pancreas transplants.
My diet and other recommendations:
- Eat several meals at the same time each day, using portion size control.
- Choose low glycemic foods, non-starch vegetables, reduce sugary snacks and desserts.
- Increase fruits and vegetables.
- Use lean meats, dried beans, fish, non-fat dairy, whole grains and water.
- No-flush Niacinamide to reduce immune-mediated cell destruction. Dosage should be given by a healthcare professional.
- Epicatechin to save beta-cells.
- Vitamin D
- Exercise and physical activity
The benefits of exercise are numerous:
Reduce blood pressure and blood sugar levels
Raise good cholesterol levels, lower the bad ones
Improve how your body uses insulin
Reduce the odds of having a stroke or developing heart disease
Promote a strong heart and strong bones
Reduce your odds of falling
Help you shed pounds
Provide more energy
Reduce stress levels
Make sure to balance stretching, aerobic and strengthening exercises. Be careful to avoid exercising in a dangerous way, particularly to diabetics, heavy weight training and high impact aerobics should be avoided due to the side effects of diabetes. Always tell your doctor your activity levels and know your ketone levels, the signs for too low blood sugar, and do not exercise alone if you have numbness in your feet or other conditions that would make exercise dangerous to you.
References:
Riddell M and BA Perkins. Exercise and Glucose Metabolism in Persons with Diabetes Mellitus: Perspectives on the Role for Continuous Glucose Monitoring. J Diabetes Sci Technol. 2009;3(4):914-23.
Man CD, Breton MD and C Cobelli. Physical activity into the meal glucose-insulin model of type 1 diabetes: in silico studies. J Diabetes Sci Technol. 2009;3(1):56-7.
Rachimiel M, Buccino J and D Daneman. Exercise and type 1 diabetes mellitus in youth; review and recommendations. Pediatr Endocrinol Rev. 2007;5(2):656-65.
Enjoy,
Dr. Behnke
Alison, great blog post and good use of references. My 8 year old nephew was recently diagnosed with Type I diabetes and they walked at this event. I agree with your comments regarding exercise and Type I diabetes. It is true that exercise alone won't control diabetes but that doesn't mean it doesn't have a very important role. My nephew's insulin dosages are much lower when he exercises. Also, since we know that those with diabetes are at so much greater risk of heart disease it would be unethical not to promote exericise in this population.
ReplyDeleteIn fact, research indicates that excercise induces the translocation of the GLUT-4 glucose transporter to the plasma membrane to increase utilization of glucose. No insulin required! Here is the reference:
ReplyDeleteKristiansen S, Hargreaves M, Richter EA. Exercise-induced increase in glucose transport, GLUT-4, and VAMP-2 in plasma membrane from human muscle. Am J Physiol Endocrinol Metab 270: E197-E201, 1996; 0193-1849/96.
Alyson, I agree with you whole heartedly. The interviewee obviously didn’t take into consideration that exercise increases skeletal muscle glucose uptake, and, after exercise, there are increases in the rates of both glucose uptake and glycogen synthesis. With this in mind it is important to advise type 1 diabetics on the importance of close blood sugar monitoring. My brother is a type 1 diabetic; I will send him a link to your blog. I’m sure he can benefit from your information. Great job!
ReplyDeleteThank you so much for the info doc! The media just really misses the boat on most topics. I will not beat a dead horse on this one. We know how important physical activity is for all people.
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