Why borderline diabetes can be a positive wake-up call.
Type 2 diabetes mellitus (T2DM) is serious metabolic condition in which the sufferer is unable to control the level of sugar (glucose) within the blood (BG) which can result in the levels becoming dangerously high. Therefore, T2DM requires life-long maintenance through medication. Obesity and not being regularly active are major risk factors that contribute to the development of T2DM. Changes in lifestyle’s and diet over the past few decades has meant T2DM has become a major health concern; In the U.K alone over 1.9 million adults have the diagnosis with a suspected 600,000 being labelled as ‘borderline’ diabetics i.e. those at high risk of developing the disease. Without intervention, it has been estimated that the number of diabetics worldwide will rise to 366 million by the year 2030 (Wild et al., 2004).
Receiving a referral for a patient for newly diagnosed borderline or pre-diabetes brings me a sense of enthusiasm and almost a bit of excitement for those that have been referred. Although, understandably, it is alarming to be informed that continuing with your current lifestyle means you are likely to develop a life-threatening condition, it can also be viewed as a positive and motivating wake-up call, perhaps the kick they needed to start taking control of your health. Through referring to the Exercise for Health scheme they not only have been provided with the best means to prevent the development of T2DM but are gaining a sort of package deal that significantly improve all aspects of their health and wellbeing; Increasing their physical activity can prevent a whole host of other non-communicable diseases and possibly reduce the need for multiple medications.
Physical activity for the treatment of borderline diabetes and the prevention of T2DM is heavily supported by scientific research; In fact, a review of the literature found those that engage in regular physical activity have up to 50% reduced risk of developing T2DM compared to those who do not engage in any (Routen, 2010). Research has discovered a number of different ways that activity works to maintain good metabolic health. One key example is via increased muscle contraction during movement, which requires more energy. This stimulates processes that enable sugar (glucose) to be transported from the blood into various cells that need it. These cells become more sensitive and efficient in this process, which helps maintain a more stable level of blood sugars even when the body is at rest and not moving. Physical activity could be the frontline when it comes to treatment and management of borderline diabetes, ideally, prior to the prescription of medications such as Metformin, a pharmacological aid for reducing and controlling the amount of sugar that is in the blood. Medications are effective but come with a cost both to the individual and to society. Side effects include, ironically, weight gain, nausea and fatigue which of course, is likely to reduce the amount of activity that person does. Additionally, diabetic medication places a huge economic burden on healthcare systems, a cost that can be significantly reduced if more patients were to increase their daily physical activity. What’s more, medications have been developed to work via similar physiological processes within the body during increased physical activity, which highlights how fundamental it is for our metabolic health (Ghody, Shikha, Karam, & Bahtiyar, 2015; Perreault et al., 2012)
The wonder of prescribing physical activity over medication for the treatment of borderline diabetes is that the benefits don’t just focus on the levels of sugar in the blood. In fact, by taking up some exercise and doing regular activity — even daily walks to the shops, you are improving your physical and psychological health to such an extent that it significantly reduces the risk for all of today’s most common deleterious health conditions, without the negative side effects of medication. The heart and blood vessels get stronger, cholesterol and blood pressure are reduced which lowers the risk of having a heart attack or a stroke. Bones, muscles and joints get stronger which prevents many age-related conditions such as osteoporosis, arthritis and muscle loss. Regular physical activity also has positive effects on mood, motivation, memory and cognition, helping to keep us focused, energised and productive, all of which are reduced when we spend long periods of time being sedentary.
Prediabetes rarely has any symptoms, therefore those diagnosed would have needed a blood test to confirm this. I have seen patients transform their lives after receiving the news that they or a family member has prediabetes. What’s more is that they now have healthy blood sugar levels and have effectively reversed their prediabetes and averted the need for medication. Receiving a diagnosis has been a positive alarm call that has given then the drive they needed to uptake regular activity and lead healthier, positive lives. However, why wait for this crossroads to start walking? wouldn’t it be great to cut out the middle man and avoid any diagnosis altogether?
Ghody, P., Shikha, D., Karam, J., & Bahtiyar, G. (2015). Identifying prediabetes — Is it beneficial in the long run? Maturitas, 81(2), 282–286. http://doi.org/10.1016/J.MATURITAS.2015.03.022
Perreault, L., Pan, Q., Mather, K. J., Watson, K. E., Hamman, R. F., & Kahn, S. E. (2012). Effect of regression from prediabetes to normal glucose regulation on long-term reduction in diabetes risk: results from the Diabetes Prevention Program Outcomes Study. The Lancet, 379(9833), 2243–2251. http://doi.org/10.1016/S0140-6736(12)60525-X
Routen, A. C. (2010). THE ROLE OF PHYSICAL ACTIVITY IN THE PRIMARY PREVENTION OF TYPE 2 DIABETES VIA THE AMELIORATION OF INSULIN RESISTANCE. Journal of Physical Education and Sport, 28(3). Retrieved from www.efsupit.ro
Wild, S., Bchir, M. B., Roglic, G., Green, A., Sci, M., Sicree, R., & King, H. (2004). Global Prevalence of Diabetes Estimates for the year 2000 and projections for 2030. Retrieved from http://care.diabetesjournals.
