A LOOK INTO TYPE 2 DIABETES

UNDERSTANDING BLOOD SUGAR Blood sugar, or blood glucose, refers to the concentration of glucose in your blood. Our bodies constantly regulate blood glucose levels to keep them within a healthy range. When blood glucose is too high, it’s referred to as hyperglycaemia, and when it’s too low, it’s hypoglycaemia. The pancreas is essential for maintaining homeostasis, particularly in regulating blood glucose levels. When blood glucose levels fall below the normal range, the pancreas secretes a hormone known as glucagon. This hormone prompts the liver and muscles to release stored glucose, thereby elevating blood sugar levels. Conversely, when blood glucose levels rise excessively, the pancreas responds by releasing insulin, which facilitates the reduction of glucose levels back to their physiological norm. WHY IS INSULIN IMPORTANT?

Think of insulin as a key that unlocks a door. When insulin binds to receptors on your skeletal muscles, it opens the door, allowing glucose to enter and be stored. This process helps lower blood sugar to a healthy level. However, in Type 2 Diabetes, the receptors become resistant to insulin, often due to prolonged high blood sugar. As a result, the glucose can’t enter the cells and stays in the bloodstream. CONSEQUENCES OF CHRONICALLY ELEVATED  BLOOD SUGAR?

When the body struggles to bring glucose levels back down to a healthy range, chronically elevated blood sugar (hyperglycaemia) begins to take a serious toll. While short-term highs can cause immediate symptoms like increased thirst and urination, prolonged exposure to high glucose is toxic to many tissues and organs. Think of excess glucose as microscopic shards in your bloodstream. Over time, this damages the delicate lining of your blood vessels and nerves throughout the body. THE LONG-TERM COMPLICATIONS FOR CHRONICALLY ELEVATED BLOOD SUGAR INCLUDE:

• Cardiovascular Disease: Damage to large blood vessels significantly increases the risk of heart attack and stroke.

• Nephropathy (Kidney Disease): Damage to the tiny filtering units in the kidneys (nephrons) can lead to impaired function and, eventually, kidney failure.

• Retinopathy (Eye Disease): High blood sugar can damage the blood vessels supplying the retina, which can lead to vision loss and blindness.

• Neuropathy (Nerve Damage): Damage to peripheral nerves often results in tingling, pain, or numbness, particularly in the feet and hands. This loss of sensation dramatically increases the risk of foot ulcers and amputations because injuries go unnoticed and unhealed.
  

These complications underscore the critical importance of effective blood glucose management, a process where exercise plays a powerful and central role. This leads to elevated blood sugar. HOW DOES EXERCISE HELP WITH BLOOD GLUCOSE MANAGEMENT?

Our skeletal muscles are the body’s largest insulin-sensitive organ. Resistance training and physical activity improve the way our body responds to insulin, especially in muscle and fat cells. This means insulin can more effectively “unlock” cells, allowing glucose to enter. When you exercise, your muscles need energy, primarily from glucose already circulating in your bloodstream or from stored glycogen. Exercise & physical activity boost the glucose transporters (especially GLUT4) on muscle cells' surfaces, allowing more glucose to enter.

This enhanced glucose uptake can last for up to 48 hours following a single session, underscoring why consistent, regular resistance training and physical activity are one of the most potent forms of holistic medicine for managing blood glucose and reversing insulin resistance. DIAGNOSING TYPE 2 DIABETES

Type 2 diabetes is diagnosed through a series of blood tests, as outlined by the Australian Diabetes Society (ADS). A confirmed diagnosis often requires a second test. The key diagnostic tests include:

• Fasting Plasma Glucose (FPG): A blood test after fasting for at least 8 hours.

  • Normal: <5.5 mmol/L

  • Pre-diabetes: 5.5–6.9 mmol/L

  • Diabetes: ≥7.0 mmol/L
    

• Oral Glucose Tolerance Test (OGTT): After fasting, you drink a sugary solution, and blood samples are taken at 1-hour and 2-hour intervals.

  • Normal: 2-hour plasma glucose <7.8 mmol/L

  • Pre-diabetes: 2-hour plasma glucose between 7.8 and 11.0 mmol/L

  • Diabetes: 2-hour plasma glucose ≥11.1 mmol/L
    

• HbA1c (Glycated Hemoglobin Test): Measures average blood glucose over the past 2–3 months.

  • Normal: <5.7% (39 mmol/L)

  • Pre-diabetes: 5.7–6.4% (39–46 mmol/L)

  • Diabetes: ≥6.5% (48 mmol/L)
    

COMMON SYMPTOMS OF TYPE 2 DIABETES Along with the diagnostic tests, type 2 diabetes is often suspected if you experience symptoms such as extreme thirst, frequent urination, blurred vision, and fatigue. If you’re noticing any of these signs, it’s important to visit your medical doctor for further evaluation. EXERCISE PRESCRIPTION AND TYPE 2 DIABETES Exercise Sport Science Australia (ESSA) recommends undertaking resistance training using progressive multi-joint exercises, focusing on large muscle groups at a moderate to vigorous intensity. The sessions should consist of 8-10 exercises, performed in 2-4 sets of 8-10 repetitions, with 1-2 minutes of rest between sets, 2 or more times per week.  This can be combined with moderate or vigorous aerobic exercises, including walking, running, cycling, or swimming, on most days with no more than two consecutive days without exercising. The reason for suggesting regular physical activity is due to the increased insulin sensitivity response, which has been documented to decline after 48 hours post-exercise or activity. The cornerstone of building an effective holistic intervention to help manage Type 2 Diabetes is a combination of structured resistance and aerobic training, increased daily physical activity, improved nutritional habits, better sleep, effective stress management, and consistent hydration.

While all of these essential habits may seem like a daunting overhaul at once, you don't have to tackle the whole battle uphill in one go. The most successful and permanent health shifts come from establishing small, attainable goals over time. Instead of striving for immediate perfection, focus on building one single, sustainable habit until it becomes second nature, a default setting in your life and then continue to build upon that foundation.

For example:

1. Start Small with Movement: Don't commit to 10,000 steps off the bat; commit to 500 more steps than you already do daily. Once that feels easy, add another 500 steps each week until you're between 8000 - 10,000.
   

2. Focus on less calorie-dense options: Instead of cutting out all sugary drinks, opt for a no-sugar option. 
   

This approach of continually building on successful habits creates momentum and ensures your healthy changes are lasting, not fleeting.

CONSISTENCY IS KEY

The science is clear: physical activity & resistance training are NON-NEGOTIABLE for Type 2 Diabetes management. The boost in insulin sensitivity you gain from a workout is a temporary, yet profound effect that makes consistency key. By staying active most days of the week and ensuring you have that combination of resistance and aerobic training, you maintain a continuous, powerful defence against insulin resistance.

Exercise physiologists are trained to prescribe exercise as medicine to assist with managing diabetes. If you would like to get in touch to discuss how we can help you, please set up an initial consultation with one of our exercise physiologists.