Diabetes - Natural Things You Can Do
By Alisha Durtschi
There are over 17 million individuals in the United States who are inflicted with diabetes. More than 90% of these people have diabetes type 2. One of the characteristics of this disease is the tissues of the body can not adequately take up glucose from the bloodstream. There are many risk factors that contribute to this disease; some are genetic and some are caused by environmental factors. One of the factors that can be controlled is sedentary living. Exercise greatly decreases the risk of getting diabetes as it makes the cells more sensitive to insulin in turn making your insulin stretch further. The same amount of insulin will convert more glucose. Exercise essentially provides an alternate method to get glucose from the blood into the skeletal muscles as well as decrease fat in the body which is also a diabetes risk factor. Exercise can also deter diabetes from setting in when you are at risk.
Everyone that has type 2 diabetes first went through a stage called impaired glucose tolerance (IGT). Not everyone that has IGT will get diabetes, though. In some cases , IGT has been shown to correct itself within a few years. IGT is determined by plasma glucose values ranging from low levels of risk for diabetes, to those with high levels of risk for diabetes. The most significant determinant as to whether a person with IGT will develop diabetes is how intolerant they are to glucose. Every year 2%-14% of all people with IGT develop diabetes. It is known that most individuals with diabetes first had hyperglycemia for five to ten years. This means that there is a window of time when your glucose intolerance is not as dangerous and is more manageable. When you have IGT, you are not doomed to a life of no sugar; there are some measures you can take to help reverse the process. One of these is exercise.
The four year long Kaopio Ischemic Heart Disease Study put 1038 people with IGT on a moderate exercise program. The subjects exercised intensely for forty minutes a week. At the end of the period, the study results showed a significant decrease in progression toward diabetes.
We understand some of the biochemistry behind this. Glucose is transformed from the bloodstream into your cells by facilitated diffusion. Your cell membrane has specific proteins that transport glucose into each cell while not expending any energy. These transport proteins are not always in your cell membranes. Many are kept inside the cell in small organelles. When insulin from the blood attaches to the insulin receptors on the cell, it simulates a set of reactions that cause the glucose transport proteins to migrate to the cell membrane. These glucose transport proteins are called GLUT 4. The problem with diabetes type 2 people are the insulin receptors on the cell membrane are not sensitive enough to receive and hold to the insulin. This hinders the reactions that stimulate GLUT 4 to translocate to the cell membrane, making it difficult if not impossible for the chemical reaction to take place.
Lucky for us, insulin is not the only means our body has in translocating GLUT 4. When the body's muscles are used rigorously, it also stimulates the migration of glucose carrier proteins. These proteins are kept in different organelles, but have almost the same structure. They perform the same function as insulin stimulating GLUT4, but are stimulated by calcium.
Calcium is released from the sarcoplasmic reticulum. This is a structure that surrounds the actin and myosin filaments in our muscle cells. The sarcoplasmic reticulum has a permeable membrane that lets certain chemicals in and out. One of the chemicals it releases is calcium. When this happens, the actin and myosin filament contracts. There are many action and myosin filaments in a muscle cell, and many muscle cells in one muscle. When all of these tiny filaments contract, it creates a great force. This is how our body moves and is able to do work. After the calcium is released and our muscles contract, some of the leftover calcium stimulates a set of reactions. These reactions cause GLUT 4 stored in transverse tubules inside the cell to migrate to the surface: the cell membrane. Once there, they transport glucose from the blood to the inside of the cell very efficiently.
There are different pools in the cell that store GLUT 4. Some are stimulated by insulin and some are stimulated by exercise. Whether your cells respond to insulin or not they will respond to exercise. A study was done on women aged 55-69. They all participated in high levels of physical activity and reduced their chances of developing diabetes by 50% compared to women of the same age and low activity level. Male college alumni participated in research that found for every 500 kcal of extra exercise done per week, a man could lower his chances for developing diabetes by 6%. Male physicians lowered their risk of developing diabetes by 29% when engaged in vigorous exercise. Twelve subjects had a number of skeletal muscle cells analyzed for GLUT 4 count. Then they were all put on a rigorous exercise-training program. At the end of training, nine subjects increased their GLUT 4 count, and six increased their count dramatically. These people’s chances for developing diabetes greatly decreased because their skeletal muscles were getting adequate, or near adequate glucose supplies.
Though being on an exercise program helps immensely, it's not the steady amount of it that increases your health the most: it is the individual exercise done each time. When an individual with diabetes is on an exercise program then goes off of it, the beneficial effects disappear in seven to ten days. It is important to exercise regularly, though, so your body can keep stimulating the migration of GLUT 4 from the inside of the cell to the cell membrane.
People without diabetes also benefit from regular exercise. Those who are active have far lower blood glucose levels than those leading a sedentary life. Individuals who exercise have a better response to insulin than those who do not. A person with high activity levels would not produce as much insulin in response to a glucose overdose as would a person with low activity levels. Despite the discrepancy, the individual’s body with high activity levels will respond better to the insulin than will the body with low activity levels. This means that the tissues in an active body are more sensitive to insulin. This helps the body immensely in the prevention of diabetes. You can see why exercise is so important when you have IGT (Impaired Glucose Tolerance).
Exercise has another important function in the prevention of diabetes: it burns fat. It has long since been known that obese people are more likely to develop diabetes. A study on obese rats was done and showed that their muscle cells could not translocate GLUT 4 very well. Periods of high-fat feeding and/or sedentary living, hinders the proper use of insulin in the skeletal muscle cells. This problem can be fixed with exercise, though. When an obese rat exercises and a healthy rat exercises, the same amount of GLUT 4 is found in the cell membrane. In humans, we have learned that the reason the GLUT 4 cannot be translocated properly is because of a malfunction in the chemical reactions that stimulate the GLUT 4 migration. When an obese person exercises, the same result occurs as did in the rat. The benefits are just as great if you are obese or thin. Do not feel you will not gain health benefits from exercise until after you become more lean and mean. The effects of exercise will continue for hours after the cessation of exercise. Through exercise, glucose carrier proteins increase and reach normal healthy levels. With a regular exercise program you could keep them close to that way.
There are other risk factors that cannot be controlled. Diabetes runs in families. This is something you cannot do anything about. If you fall into this category you will always be at a higher risk for diabetes. The situation is not hopeless however. Exercise can help here too.
The offspring of diabetes were put on a schedule of exercise for six weeks. All of the individuals were insulin resistant. At the end of the study, their conditions were reversed and they were no longer insulin resistant. In short, they avoided diabetes. They also doubled the amount of glucose their bodies could convert into stored glycogen. This is one of the main problems with diabetes, and this too was reversed.
Over the past four decades the incidence of diabetes has increased at steady and alarming rate. More money is spent on it every year than even cancer and heart disease. In 1995 the U.S spent over $105 billion. That’s a lot of money! This is a terrible disease with many disheartening side effects. You can greatly help your chances of not getting diabetes by involving yourself in exercise. Even a small amount of exercise can decrease your risk immensely. Don’t wait for the problem to invade your life; protect yourself against it now. There have been so many studies done that prove exercise benefits you, not only in protection against diabetes, but from many other dangerous diseases as well. Do not be one of the 16 million Americans that Suffer.
References; Goodyear,L.J RhD; Kahn, B.B MD (1998) Exercise, Glucose Transport, and Insulin Sensitivity. Annual Review of medicine, vol49 pp.235-261
Goldberg, R.B. MD (1998) Prevention of Type 2 Diabetes. The Medical Clinics of North Americaa, vol. 82 pp.805-821
Bray, G.A.; Culbert,I.W. (apr.1999) The Diabetes Prevention program, Diabetes Care. Pp. 623-634
Lehmann, R.; Kaplan, V.; Bingisser, R.; Bloch, K.E.; Spinas,G.A. (oct. 1997) Impact of Physical Activity on Cardiovascular risk Factore in IDDM Diabetes Care pp.1603-1611
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