Type 2 Diabetes Mellitus (T2DM) is a chronic condition developed as a result of varying levels of insulin resistance which causes hyperglycaemia (elevated blood glucose levels [BGL’s]). People who are at risk of developing T2DM with slightly lower levels of insulin resistance and hyperglycaemia are often diagnosed with impaired glucose tolerance (IGT) or impaired fasting glucose (IFG), both of which are known as Pre-diabetes.
T2DM is a progressive disorder in the sense that it generally develops over several years before the damage and symptoms begin to really take shape. During this time, insulin resistance begins whereby the insulin starts to perform worse and worse, resulting in the ineffective management of BGL’s (i.e. too much glucose building up in the bloodstream). This insulin resistance then results in the pancreas working tirelessly to produce even larger amounts of insulin to try to achieve a certain degree of BGL management. Over time, the cells in the pancreas responsible for producing insulin start to wear out and destroy themselves, meaning that significantly less insulin is being produced. Generally, people have lost 50-70% of their insulin producing cells by the time they are diagnosed with T2DM.
Are you at risk?
The cause of T2DM remains largely unknown, however, it is associated with several modifiable risk factors. i.e. lifestyle factors and behaviours that we can willingly change to improve our health.
Modifiable risk factors that can contribute to the development of T2DM include:
The link to that is:
DID YOU KNOW?
280 Australians develop diabetes every day. That’s one person every five minutes!
What are the signs and symptoms of this disease?
National Diabetes week was last week, and the campaign for 2019 was “it’s about time”. T2DM (and diabetes in general) is often diagnosed several years after the disease has already taken shape in the body, and unfortunately, unmanaged diabetes can result in the development of many other serious health issues such as heart disease, kidney failure and even blindness. The slogan “it’s about time” was to reinforce the idea that we need to put our health first and take the time to learn about the symptoms of diabetes, as well as visit our GP or relevant health professional for a check-up, so that we can prevent more complicated health issues from developing.
These symptoms can sometimes be passed off as a ‘sign of getting older’, and while yes, the presence of these symptoms doesn’t necessarily mean you have diabetes and really could just be a result of getting older, it isn’t going to hurt to visit your GP and double check.
Prevention is always better than cure!
What can mismanagement or late diagnosis of this disease lead too?
As mentioned, unmanaged diabetes can lead to various other health complications. Here are some facts from the Diabetes Australia website about diabetes and the risk of other health complications.
Diabetes Australia. (2015). Preventing Complications. Retrieved from
Most of these health complications can be prevented by early diabetes diagnosis and management, which is why it is imperative that you check in with your GP or relevant health professional if you are at risk, or concerned about your risk of developing diabetes. The sooner you know and work towards managing your diabetes, the easier it will be to prevent your health from deteriorating.
What treatment is available for this disease?
Currently there is no cure for T2DM. As such, we often use the term “managing” when talking about diabetes. Depending on how early the diabetes is diagnosed, management can be done through lifestyle modifications including a healthy diet, regular physical activity/exercise and monitoring of BGL’s.
Diet and exercise play critical roles in helping to reach/maintain a healthy body weight and managing BGL’s, with exercise improving the overall effectiveness of insulin in lowering BGL’s. Regular BGL monitoring provides a snapshot of how well your treatment and lifestyle changes are working, and can help you or your health professional decide whether other changes are necessary. People with T2DM generally need to measure their BGL’s several times a day using a blood glucose meter. As mentioned, exercise improves the effectiveness of insulin in the body by increasing the amount of glucose used by muscles as an energy source. This can significantly lower BGL’s and put people at risk of experiencing a hypo (hypoglycaemia/low BGL’s), which is why it can be extremely important for people with T2DM to monitor their BGL’s before and after exercise.
On top of personally checking their BGL’s, people with T2DM should be regularly monitored by a General Practitioner or credentialed Diabetes Educator. They will often use tests to measure your fasting BGL’s and HbA1c (glycated haemoglobin – used to give an indication of long-term glucose management) as a way of viewing how well your diabetes is being managed. The goal of diabetes management is to keep BGL’s as close to the healthy range of between 4 to 6mmol/L (fasting), which will minimise the risk of both short and long-term health complications.
As diabetes is a progressive condition, meaning it worsens over time, it may also be necessary to take tablets to help manage BGL’s. If insulin levels drop too low, it may also be necessary to start taking insulin in combination with tablets for proper diabetes management.
Requiring medication as treatment is a normal process due to the natural progression of the disease. It’s important to remember that medications are only one piece of the puzzle and should be used together with healthy eating and regular exercise!
How can NExT help?
As we have mentioned, exercise plays a big role in helping to manage BGL’s by improving the effectiveness of insulin in the body. On top of this, exercise helps improve other areas of your health such as maintaining a healthy body weight, improve blood pressure and cholesterol levels, and minimising the risk of other health complications such as heart disease.
As an Exercise Physiologist, Carly is trained in how to best exercise people with diabetes, with the knowledge and skills to be able to take into account any other health complications that you may have. Carly is able to take your blood glucose measurements before and after exercise to ensure you are having a good response to your exercise program, and is able to tailor it to best suit your needs.
I hope this blog post has helped you gain a better understanding of Diabetes, and how important it is to check your risk of developing this condition!
If you have any suggestions of conditions, injuries or general topics that you'd like us to cover in our upcoming blog posts, please feel free to leave us a comment, or send us a message via email, facebook or instagram. Better yet! Why not book in a session with one of us so we can talk about everything directly? We don't bite, I promise!
Carly Rush - Exercise Physiologist