TYPE II DIABETES: WHAT YOU CAN DO

Guy Leahy

A recent article in the journal Diabetes Care reports the incidence of Type II Diabetes has skyrocketed in the 1990's. Between 1990 and 1998, the percent of Americans diagnosed with diabetes jumped from 4.3% to 6.5%, a 33% increase. For 30-39 year olds, the increase was a stunning 70%. Nationwide, 16 million Americans have diabetes. This probably represents an underestimate, since perhaps one third of diabetics do not know they have the disease. Approximately 180,000 Americans die from diabetes every year.

There are two types of diabetes. Type I diabetes accounts for 5-10% of all diabetes cases. It is caused by the inability of the pancreas to make the hormone insulin. Type 1 diabetics usually need to take regular insulin shots to help control their blood sugar, or blood glucose. Type II diabetes accounts for 90-95% of diabetes cases. With Type II diabetes, the pancreas can make insulin, but the body does not respond to it, a characteristic known as insulin resistance. Normally, release of insulin by the pancreas stimulates body tissues (primarily skeletal muscle) to pull excess glucose out of the blood and either use it for energy or store it as fat or glycogen (glycogen is a form of carbohydrate which is stored in muscle and liver tissues). With insulin resistance, though, body tissues do not "get the message" there is excess blood glucose, so glucose levels in the blood build up. High blood glucose appears to be linked to increased production of free radicals, substances which promote oxidation of body tissues. Type II diabetes is strongly associated with increased risk of heart disease, hypertension, stroke, kidney failure and blindness.

OK, so what's responsible for the dramatic increase in Type II diabetes? Though some of the increase could be due to better reporting, the primary cause appears to be physical inactivity and an increase in the number of overweight and obese individuals. Incidence of Type II diabetes is strongly related to physical inactivity and overweight/obesity. According to the National Institutes of Health, only 23% of Americans engage in physical activity five days a week. Over 80% of Type II diabetics are overweight. Nationwide, approximately 55% of Americans are overweight.

The solution? Exercise! Undertaking a regular program of physical activity significantly reduces the risk of developing Type II diabetes. In addition, physical activity can help to reduce or even eliminate Type II diabetes in people who already have it. Exercise helps control Type II diabetes in several ways. Exercise increases the body's response to insulin, so excess blood glucose can be readily disposed of. Increases in muscle mass provide a greater glucose "sink" to store/use up blood glucose. Muscle and other tissues also can remove glucose from the blood more effectively. A reduction in body fat from exercise increases the amount of glucose uptake from the blood, and simultaneously produces a reduction in glucose production.

Does the exercise have to be hard? No! A regular program of brisk walking will show significant improvements. The American College of Sports Medicine recommends a minimum of 1,000 calories burned per week from physical activity to treat Type II diabetes. This is equivalent to about 10 miles of vigorous walking a week. The exercise doesn't have to be in one lump sum, either. Three 10 minute bouts of exercise interspersed throughout the day works almost as well as one 30 minute session. Jogging, cycling, swimming, water/land aerobics, weight lifting and racquetball are examples of activities which will improve fitness, reduce body fat and reduce the risk of developing Type II diabetes. If you'd like more specific information on how to design an exercise program, just contact the Health & Fitness Lab at 745-6531. We'll be glad to help!