Importance of regular exercise study

[HpprKM]

Hoping this is ok to add to forum, apologies in advance to administrators if not!

This is to be found on - and struck as interesting information (that we may know but do not necessary always follow (me included) http://care.diabetesjournals.org/content/current and is attributed to: Sheri R. Colberg, Ronald J. Sigal, Bo Fernhall, Judith G. Regensteiner, Bryan J. Blissmer, Richard R. Rubin, Lisa Chasan-Taber, Ann L. Albright, and Barry Braun
Exercise and Type 2 Diabetes: The American College of Sports Medicine and the American Diabetes Association: joint position statement
Diabetes Care December 2010 33:e147-e167; doi:10.2337/dc10-9990

Exercise and Type 2 Diabetes
The American College of Sports Medicine and the American Diabetes Association: joint position statement
Abstract
Although physical activity (PA) is a key element in the prevention and management of type 2 diabetes, many with this chronic disease do not become or remain regularly active. High-quality studies establishing the importance of exercise and fitness in diabetes were lacking until recently, but it is now well established that participation in regular PA improves blood glucose control and can prevent or delay type 2 diabetes, along with positively affecting lipids, blood pressure, cardiovascular events, mortality, and quality of life. Structured interventions combining PA and modest weight loss have been shown to lower type 2 diabetes risk by up to 58% in high-risk populations. Most benefits of PA on diabetes management are realized through acute and chronic improvements in insulin action, accomplished with both aerobic and resistance training. The benefits of physical training are discussed, along with recommendations for varying activities, PA-associated blood glucose management, diabetes prevention, gestational diabetes mellitus, and safe and effective practices for PA with diabetes-related complications.

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See creativecommons.org/licenses/by-nc-nd/3.0/ for details.

 

[Patch]

No denying - "PA" as they put it is a great tool for BG control.

But why? What happens when we exercise that makes BG control easier?

Insulin resistance is reduced - but, how and why?

Sugar is fuel, and when we exercise, we use it. I'd like to know more about how this happens. Off to Google - I'll be back...

 

[HpprKM]

Patch, good question, interested to see your results

 

[Cowboyjim]

Maybe not to question the how but be glad that it works... 8)

Possibly temperature related?

 

[phraedus]

My google search came up with glut4: seems glut4 is forced to the cell membrane upon exercise and picks up glucose on the muscle contraction. The effect persists for a short time ~24 hours and then diminishes.

Contracting skeletal muscles acutely increases glucose transport in both healthy individuals and in people with Type 2 diabetes, and regular physical exercise is a cornerstone in the treatment of the disease. Glucose transport in skeletal muscle is dependent on the translocation of GLUT4 glucose transporters to the cell surface. It has long been believed that there are two major signaling mechanisms leading to GLUT4 translocation. One mechanism is insulin-activated signaling through insulin receptor substrate-1 and phosphatidylinositol 3-kinase. The other is an insulin-independent signaling mechanism that is activated by contractions, but the mediators of this signal are still unknown.

jap.physiology.org/content/99/1/330.abstract

 

[phraedus]

We conclude that in contrast to the previously reported defect in insulin-stimulated GLUT4 translocation in skeletal muscle of individuals with type 2 diabetes, a single bout of exercise results in the translocation of GLUT4 to the plasma membrane in skeletal muscle of individuals with type 2 diabetes. These data provide the first direct evidence that GLUT4 translocation is an important cellular mechanism through which exercise enhances skeletal muscle glucose uptake in individuals with type 2 diabetes.

diabetes.diabetesjournals.org/content/48/5/1192.short

 

[cugila]

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[Cowboyjim]

Alright... so for us that may be a bit slow after the weekend's wine - wassit all mean?
You can overcome insulin resistance by exercise but only temporarily? It is no cure but surely even temporary relief is worthwhile?
Is it proportional to the amount or intensity of the exercise? How soon after eating for example? No doubt its effects vary individual to individual.
Someone please answer as this has been bugging me for a while.
In the meanwhile I will order a takeaway then clear the drive after scoffing it down...8)

 

[HpprKM]

CowboyJim, I guess it does mean there is temporary relief, like you I think that this is better than nothing! If anyone has any real answers - we are interested to hear from you!

 

[phoenix]

This video might give you some answers, also google Sheri Colberg, on her own site and more academically on pubmed there are links to lots of articles and papers about D and exercise.
http://www.youtube.com/watch?v=bcCVcSxJa7g

 

[HpprKM]

From the bit of research I have carried out it seems that resistance training (weight bearing), walking and aerobics exercises are best, it is a shame that no one runs a specific diabetes training course in any of the local gyms, I am sure there would be lots of members to join

 

[phraedus]

Copwboyjim asks?

Is it proportional to the amount or intensity of the exercise? How soon after eating for example? No doubt its effects vary individual to individual.
Someone please answer as this has been bugging me for a while.

If I am over 7.8mmol/l I exercise I have a weight room in the basement.

My suggestion is exercise all the major muscle groups with situps; pushups; bends; lunges; crunches ;etc. using your own body weight.

I exercise for ~5min, ~ 45 min to 1hour after eating I find the drop in BG to be ~ 1 mmol/l after moderate exercise.

 

[phraedus]

The graph is a screen shot from Dr. Christiansen's presentation at the European Diabetes symposium.
It show cgms of healthy individuals after a high carbohydrate breakfast.

The right hand margin has been cut off for some reason so I will explain briefly.

1 green line is c peptide
2 yellow line is insulin
3 bottom brown line is lower range limit of the group
4 blue line is the mean average BG of the group
5 pink is venous BG
6 top brown line is upper range limit of the group

This is what I use to maintain what was presented as the normal range of BG in healthy individuals.
Y axis is in mg/dl to convert to mmol/l divide by 18.

 

[Cowboyjim]

Very interesting and many thanks for taking the time.

Once again the means exist to ameliorate if not nullify our condition. However, this recourse is not for everyone. Even I who exercise a lot balk at all the measures you talk about. We need something simpler and quicker. Fat chance I suspect.

To me it seems a lot of effort for just 1 mmol/l. Plus it would not help my pathetic attempts to restore my weight.

I wonder how this compares to meds. Metformin is only of limited use I believe, better to adjust your diet and do some exercise (as well).
Cheers 8)

 

[phoenix]

Cowboy Jim, in general I think that aerobic exercise rather than weights is more likely to cause instant reductions in glucose levels.
The results of the big blue test this yearshowed a median 1mmol/l drop with just 14 min of exercise (all types)
Total Participants 1156
.
Median Blood Sugar Before 133.6 mg/dl
.
Median Blood Sugar After 111.6 mg/dl
.
Median Change -18.5 mg/dl

Now Christmas food shopping in Tescos today dropped my glucose levels from 8.5mmol/l to 3.6mmol :lol:

 

[phraedus]

Just did a test on myself with resistance training.

Ate 1 mince meat tart and 1 slice of Christmas cake

45 min later 9.5mmol/l ~171mg/dl

2 min aerobic on mini trampoline
10 crunches with 30 lb weight
10 bench press with 100lb weight
10 inclined press 80 lb weight
10 leg lifts with 80 lb weight

retest shows 10 mmol/l ~180 mg/dl
believe this to be the meal still digesting

Redo exercise routine 15 min later
retest shows 7.8mmol/l ~140mg/dl

Total BG lowering 2.2 mmol/l ~39.6 mg/dl ;exercise time ~10 min

I think any type of exercise helps but the harder the better if the muscle goes hypoxia ( lacking oxygen) you pick up a lot of BG very quickly if you do very moderate exercise such as walking BG is still picked up but much slower aerobic and weight training cause hypoxia both are good; together they are better.

 

[Cowboyjim]

Genius!
Proof at last.
But all that effort for a couple of tarts.... 8)
Something psychological here... punish me oh punish me for my self indulgence!
That has great appeal.
Maybe I will try something similar soon.

 

[Cowboyjim]

Sorry to be thick but what do you mean by "pick up a lot of BG"?
Cheers 8)

 

[HpprKM]

Great fun after dinner at Christmas

 

[phraedus]

New postby Cowboyjim » Today, 1:35 am
Sorry to be thick but what do you mean by "pick up a lot of BG"?
Cheers 8)

BG = blood glucose
There are two ways to take blood glucose into the muscle ;glut4 is translocated to the cell membrane by insulin and it picks up glucose. The second way is muscle contraction glut4 is translocated to the cell membrane without the need of insulin and it picks up BG. The physiological response of muscle contraction translocating glut4 is not well understood but it does happen.