Disco and Diabetes: Can Dance be Used to Manage T2D?
Type 2 Diabetes also known as Type 2 diabetes mellitus and adult-onset diabetes, is a chronic disease that is characterized by persistently high fasting blood glucose levels (hyperglycemia).
According to the Center for Disease Control (CDC) there are around 38 million people within the U.S. who have diabetes, and of those 38 million, 90–95% of those have Type 2 Diabetes (T2D) [11]. Over the years, there has been a steady increase in the prevalence of T2D, leading to an abundance of concern. While T2D has been mainly known to develop within individuals over the age of 45, recent studies have shown that minority populations such as adolescents and young adults are becoming increasingly at risk. It has been projected that between 2017–2060 that there will be a 69% increase in the prevalence of cases of T2D within youth [10]. Some risks associated with T2D include prediabetes, obesity, age, and genetics [11].
While the prevalence of this disease cannot be easily resolved (unless there is a major culture shift surrounding health), there are ways that T2D can be managed. Conventional treatments for T2D include therapies surrounding “exercise, weight control, medical nutrition, oral glucose lowering drugs, and insulin injections” [5].
Upon investigating T2D therapies, I wondered if there was a way to manage blood glucose levels in a way that was not only fun but appealing in comparison to conventional treatment. Dance, while seeming to be rarely talked about, has been shown to improve glucose metabolism. For this reason, I will be discussing the literature surrounding dance and how it can possibly be used as management for T2D.
While the literature does support the theory that dancing can help with glucose metabolism, it is still recommended that it should be treated as a supplement to existing conventional treatment for someone with T2D. Management should always be discussed with a licensed healthcare provider, before implementation.
Article Outline
- What is T2D?
- Why Dancing?
- Conclusion
- Resources
1. What is T2D?
As mentioned prior within the article, T2D is a chronic condition characterized by hyperglycemia. But one may wonder…
What exactly is driving hyperglycemia, which is a characteristic of T2D?
The answer all lies with the pancreas and a hormone it releases named insulin. The pancreas, which can be found in the abdominal region, right behind the stomach, is an organ that has both digestive and endocrine properties (releasing hormones that affect an organism). When we eat, food travels throughout our digestive tract where it is broken down by enzymes and acids and eventually converted to glucose to provide energy for the body. The liver also stores and releases glucose, when energy is needed in the presence of lack of food. This release of glucose leads to a spike in the circulating glucose within the blood.
Within healthy individuals, insulin is secreted from the pancreas in response to this elevation of glucose [3]. The release of insulin allows for glucose to enter cells, lowering blood sugar. Insulin is produced by β-cells within the pancreas islets (cluster of cells within the pancreas). Once released into the bloodstream, insulin binds to its receptors which can be found in muscles, fat, and the heart in order to allow for uptake of glucose within cells [6]. In the presence of insulin binding GLUT4 (an insulin dependent transporter of glucose) translocate to the surface of the cell membrane, allowing for the transportation of glucose into the cell. This is not the case in T2D individuals, where this mechanism is faulty. Normal fasting blood glucose levels are around 80–90 mg per 100 ml [3], but within individuals with T2D fasting blood glucose levels is around 126 or higher mg per 100 ml. Extended periods of hyperglycemia can lead to the damaging of blood vessels and various forms of organ failure.
Two Main Causes of T2D
- Decreased Production of Insulin From Pancreas
- Insulin Resistance
1. Decreased Production of Insulin From Pancreas
Within conditions such as T2D, the β-cells can become fatigued leading to less production of insulin, which leads to less efficacy. Less insulin at the site of insulin receptors results in minimal translocation of GLUT4, which lessens the amount of glucose entry. Blood glucose levels remain high for longer periods of time.
2. Insulin Resistance
Insulin resistance is the state of insulin receptors becoming desensitized to insulin. Desensitization of the receptor means that GLUT4 transporters cannot be translocated, which means no entry of glucose within the cell.
2. Why Dancing?
Exercise has the potential to improve glucose metabolism by way of exerkines that mediates the entry of glucose within cells[9]. Exerkines are signaling molecules that are released from various organs in response to exercise. Exerkines such as brain-derived neutrophic factors (BDNF) and irisin are implicated in the possible stimulation of β-cells, leading to increased insulin function [9]. Dance, a form of exercise, has the potential to improve blood glucose levels. Dance can be considered anerobic or aerobic.
According to a literature review conducted in 2019, dancing was shown to improve metabolism of older adults population (~>55) [8]. Within the literature review there were six different studies that took measurement of resting glucose levels within a control (non-dancing group) and experimental group (dancing group). All studies were performed over the course of weeks and consisted of varying cultural dance styles. Of those six studies only four of them showed a significant decrease in resting blood glucose levels of the experimental group compared to the control.
A 2019 study, investigating the effects of dance training on cytokine (proteins that affect immune health) and neutrophil (immune cells) secretion in T2D individuals, found that there were no significant differences between control and experimental groups regarding blood glucose levels [1]. While this may be the case there was a significant difference found between neutrophil and cytokine production within control and non-control groups.
A study that focused more specifically on T2D outcomes within African American women after weeks of dancing, showed reduction in those outcomes [4]. More specifically, the 12-week intervention led to reduction in A1C levels. A1C levels are important as it tests the average amount of hemoglobin that attaches to glucose over the span of months. Lower A1C levels are associated with lower blood glucose. The study seemed be more promising as the study focused on the outcomes of young adults all the way up to elderly women with T2D.
Lastly, Folk dance improved glucose metabolism within elderly people with T2D who were involved in a 12-week intervention [9]. Insulin resistance was seen to significantly decrease within groups with this intervention.
While there seems to be abundant evidence to support the idea that dancing has a positive effect on glucose metabolism, there are also studies that seem to be inconclusive. After reviewing the literature, it seems like there will need to be more research surrounding dance and it’s effect on T2D patients. There will also need to be research on how the age of T2D individuals can have an effect on outcomes after dance intervention. The type of dance that is implemented may also be important for outcomes. In the future it would be nice to see comparative studies of different dance styles effects on glucose metabolism to see which is most effective. All in all, it seems like dance, while not the most effective for management, can promote “fun” physical activity for those at risk. Using dance as a supplement to conventional therapies seem viable.
3. Conclusion
There has been a steady increase in T2D cases, and the prevalence is only projected to get worse, not only affecting those over 45, but also the youth. Dance, a form of exercise, has been shown in some studies to improve glucose metabolism, and decrease blood glucose levels. While research has substantiated the benefits of dancing, more needs to be done to make sure that is an effective form of management. Dancing can provide those with T2D a means of physical activity that is fun and engaging that can supplement other therapies.
4. Resources
Here are some resources to learn more about diabetes and management.
[1] Borges, L., Passos, M. E. P., Silva, M. B. B., Santos, V. R., Momesso, C. M., Pithon-Curi, T. C., Gorjão, R., Gray, S. R., Lima, K. C. A., De Freitas, P. B., & Hatanaka, E. (2019). Dance training improves cytokine secretion and viability of neutrophils in diabetic patients. Mediators of Inflammation, 2019, 1–8. https://doi.org/10.1155/2019/2924818
[2] Greene, M. (2016). Glucose metabolism. In Springer eBooks (pp. 1917–1922). https://doi.org/10.1007/978-3-662-46875-3_7118
[3] Insulin synthesis and secretion. (n.d.). http://www.vivo.colostate.edu/hbooks/pathphys/endocrine/pancreas/insulin.html
[4] Murrock, C. J., Higgins, P. A., & Killion, C. (2009). Dance and peer support to improve diabetes outcomes in African American women. The Diabetes Educator, 35(6), 995–1003. https://doi.org/10.1177/0145721709343322
[5] Pandey, A., Poonam, T., Pandey, R., Srivatava, R., & Goswami, S. (2011). Alternative therapies useful in the management of diabetes: A systematic review. Journal of Pharmacy and Bioallied Sciences, 3(4), 504. https://doi.org/10.4103/0975-7406.90103
[6] Physiologic effects of insulin. (n.d.). http://www.vivo.colostate.edu/hbooks/pathphys/endocrine/pancreas/insulin_phys.html
[7] Prevalence — Health, United States. (n.d.). https://www.cdc.gov/nchs/hus/sources-definitions/prevalence.htm
[8] Rodziewicz-Flis, E., Kawa, M., Kaczor, J. J., Szaro-Truchan, M., Flis, D. J., Lombardi, G., & Ziemann, E. (2023). Changes in selected exerkines concentration post folk-dance training are accompanied by glucose homeostasis and physical performance improvement in older adults. Scientific Reports, 13(1). https://doi.org/10.1038/s41598-023-35583-w
[9] Tönnies, T., Brinks, R., Isom, S., Dabelea, D., Divers, J., Mayer‐Davis, E. J., Lawrence, J. M., Pihoker, C., Dolan, L. M., Liese, A. D., Saydah, S., D’Agostino, R. B., Hoyer, A., & Imperatore, G. (2022). Projections of Type 1 and Type 2 Diabetes Burden in the U.S. Population Aged <20 Years Through 2060: The SEARCH for Diabetes in Youth Study. Diabetes Care, 46(2), 313–320. https://doi.org/10.2337/dc22-0945
[10] Type 2 diabetes. (2023, April 18). Centers for Disease Control and Prevention. https://www.cdc.gov/diabetes/basics/type2.html#:~:text=Healthy%20eating%20is%20your%20recipe,adults%20are%20also%20developing%20it.
