Type 2 Diabetes

In the year 2000, it was reported that diabetes mellitus (DM) affects 171 million adults worldwide (O’Hagan, De Vito, & Boreham, 2013). By 2030, this statistic was estimated to increase an upward of 4.4 % to 366 million (O’Hagan, De Vito, & Boreham, 2013). Of those who suffer from DM, 90-95% have what is called type 2 diabetes (T2DM), a chronic disease characterized by some insulin resistance and deficiency (O’Hagan, De Vito, & Boreham, 2013). This means the body begins to produce excess glucose as it believes there is a lack of it available, due to the body not utilizing or metabolizing it adequately (Franz et al., 2017; O’Hagan, De Vito, & Boreham, 2013). Typical treatment for T2DM is through management of the disease, by preventing or slowing its progression. If the disease remains uncontrolled or unmanaged, further complications such as cardiovascular disease (CVD), kidney disease, neuropathy (nerve damage in the limbs), and retinopathy (damage to the eye’s blood vessels) can occur as a result (Franz et al., 2017; Keshel, 2015; O’Hagan, De Vito, & Boreham, 2013). Treatment plans are typically approached with a combination of lifestyle changes, medication, dietary habits, and increased physical activity (Colberg et al., 2016; Franz et al., 2017; Keshel, 2015; O’Hagan, De Vito, & Boreham, 2013). These changes can help reduce glucose concentrations in the blood, control blood pressure, and provide desirable weight loss; if recommended (Colberg et al., 2016; Franz et al., 2017; Keshel, 2015; O’Hagan, De Vito, & Boreham, 2013).

Taking a collaborative approach with the individual affected by T2DM is crucial in empowering the person’s self-efficacy, self-management, and compliance of the recommended diet and lifestyle interventions (Colberg et al., 2016; Franz et al., 2017). Overall changes to lifestyle and dietary habits are vital and can have very beneficial effects. Such as reducing the risk of other complications by reducing blood pressure, increasing physical activity, improving blood sugar levels, weight management, and preventing tissue damage acquired through the progression of the disease (Franz et al., 2017; O’Hagan, De Vito, & Boreham, 2013). Controlling blood pressure can reduce the risks of CVD and for every 10-mm Hg reduction in systolic blood pressure, a 12% reduction for the risk of diabetes related complications have been reported (O’Hagan, De Vito, & Boreham, 2013). Controlling blood sugar issues benefits individuals affected by TD2M, as for every 1% reduction in A1c there is a 40% reduction in the risk of developing microvascular (eye, kidney, and nerve disease) diabetic complications (O’Hagan, De Vito, & Boreham, 2013). As for dietary modifications, the perspective of carbohydrates should be looked at in terms of overall energy balance. Although, low glycemic foods (such as complex carbohydrates) improve glycemic control, the total amount of carbohydrates consumed is more vital and imperative in achieving successful control of blood sugar levels (Colberg et al., 2016; Franz et al., 2017). Research on resistance training and its impact on T2DM has found that it increases glucose uptake in the skeletal muscles and improves overall glucose uptake (Colberg et al., 2016; Keshel, 2015). Additionally, resistance training has found improvements in how the body utilizes and produces excess glucose (Keshel, 2015). Although many studies have been inconclusive on a specific type of exercise and deem that further research is required to give a more conclusive and detailed recommendation. The ADA, however, recommends at least 150 mins of moderate intensity, of physical activity to prevent or delay the onset of T2DM (Colberg et al., 2016; O’Hagan, De Vito, & Boreham, 2013).

As previously mentioned above, a unique and tailored approach to the individual affected by T2DM is essential and provides the best outcomes. A collaborative approach with the RD and the individual affected by T2DM is crucial in developing adequate lifestyle changes, exercise regimens, and dietary modifications. This collective approach can help identify liked food that fit into the recommended guidelines and working together to find unique opportunities to fit liked physical activities in to the treatment plan.

References

Colberg, S. R., Sigal, R. J., Yardley, J. E., Riddell, M. C., Dunstan, D. W., Dempsey, P. C., . . . Tate, D. F. (2016, November 01). Physical Activity/Exercise and Diabetes: A Position Statement of the American Diabetes Association. Retrieved July 15, 2020, from https://care.diabetesjournals.org/content/39/11/2065#:~:text=type 2 diabetes.-,Daily exercise, or at least not allowing more than 2,week of moderate-intensity exercise.

Franz, M. J., Macleod, J., Evert, A., Brown, C., Gradwell, E., Handu, D., . . . Robinson, M. (2017). Academy of Nutrition and Dietetics Nutrition Practice Guideline for Type 1 and Type 2 Diabetes in Adults: Systematic Review of Evidence for Medical Nutrition Therapy Effectiveness and Recommendations for Integration into the Nutrition Care Process. Journal of the Academy of Nutrition and Dietetics, 117(10), 1659-1679. doi:10.1016/j.jand.2017.03.022

Keshel, T. E. (2015). Exercise Training and Insulin Resistance: A Current Review. Journal of Obesity & Weight Loss Therapy, S5. doi:10.4172/2165-7904.s5-003

O’Hagan, Ciara, De Vito, Giuseppe, & Boreham, Colin A. G. (2013). Exercise Prescription in the Treatment of Type 2 Diabetes Mellitus. Sports Medicine, 43(1), 39-49.