Type 2 Diabetes (D2) is not a normal aging response - no one needs to resign themselves to D2. Two of the most preventative things you can do is 1) be more active, but also 2) be less inactive overall. What? This statement seems paradoxical, so let’s break it down.
Adding some exercise to your day, though certainly helpful, is not going to counteract all the other times of the day you are sitting. The most emblematic lifestyle would be that of a computer-screen worker who does an intense 30-45 minute peloton or boot camp class every day at lunch, but sits the rest of the time (drives to work, sits in office chair, drives home, sits on couch watching TV, goes to bed).
So, how to approach this?
1) Firstly, know where you stand. Get your blood glucose (short view) and HbA1c (long view) levels checked yearly. Type 2 Diabetes (D2) can creep up asymptomatically until one is in the danger zone, so these markers are helpful indicators. D2 is an insulin resistance issue. Though there is plenty of insulin in the blood to chaperone glucose in to fuel the cells, the problem lies in increasingly deaf insulin receptors on the outside cell wall. Because the insulin receptors cannot ‘hear the doorbell’, more glucose is called for by fuel-starved cells. This scenario increases glucose levels in the blood, and stresses the kidneys who are trying to filter it all out into the urine.
2) Second step, get those blood glucose levels down. The best way to manage too much blood-borne glucose is to burn it off. And not just during that 30 minute boost at lunch. A healthy way to lower blood sugar levels is to train your body to move, or think it’s about to move - it’s like priming the pump. Certainly do your mid-day fitness class, but also find ways to move more through out the day. Get a standing desk. Move every 30 minutes, sit on a stability ball, balance while you are on the phone, park further away from the destination, drive less, put timers on your computer to jog your memory… get creative here, but MOVE MORE OVERALL. (As I type this I notice the irony, and so have stood up from my chair to hold a medium isometric squat position.)
3) Third step, boost your fitness levels and reach a healthy body weight. Aerobic exercise or strength training have been shown to decrease D2 risk, so do both! Intensity and duration correlate with improved insulin sensitivity. And exercise is less expensive than the medication route! One 60 min bout of exercise will reduce your blood glucose by 10 - 20% for up to 24 -48 hrs. So the every-other-day approach works well. What works better is to do something every day, and mix and match a variety of enjoyable activities. The American Heart Association recommends a minimum of 150 minutes a week for basic health. You’ll need to do more if you’re looking to lose weight. Maintaining a healthy weight decreases risk for not only D2, but also other metabolic disorders and many cancers.
4) Decrease sedentary/screen time. Even folks who are very active increase their risk for D2 if they have more than 5 hrs/day of screen time. Do your best to reduce the amount of time you stare at any screen, small or large. Don’t lose the benefit of your activity! And protect your precious non-screen time.
Taking these 4 steps will break a downwards spiral into increased D2 risk. Increasing fitness and decreasing central adiposity has been clinically proven to be twice as effective in reducing D2 risk than medication (Metformin). It may be ‘easier’ initially to just take a pill, but it’s more beneficial long-term to modify the lifestyle, and create sustainable habits that not only decrease your D2 risk, but have other desirable side-effects. Find a dance class, join a hiking club, grab a walking buddy… Boosting your fitness level with enjoyable movement not only decreases risks for illness, but has the upside pills can’t give. Moving more and sitting less is just plain fun, improves your sleep, connects you to others, gives you more energy and creates an overall healthy happy lifestyle!
