27 Oct Can a healthy lifestyle reverse type 2 diabetes?

Diabetes is a condition that impacts the ability to regulate blood sugar levels. People living with type 2 diabetes have an increase in insulin resistance that results in an inability of insulin to play its role within the body. In Australia, diabetes contributed to 11% of deaths (16,700) in 2018, with 4.9% of the population (1.2 million) living with the condition.

How does type 2 diabetes affect the body?

When we eat a meal, carbohydrates are broken down into glucose molecules which in ideal circumstances enter the muscle cells with the assistance of insulin. In healthy circumstances a large proportion of the carbohydrates we eat are stored in the muscle as glycogen.

With type 2 diabetes, there’s an inability to get these glucose molecules into the muscle, so blood sugars rise. This increases the risk of related complications like tissue injury to nerves, blood vessels, and vital organs such as the eyes, kidneys, or heart and its blood vessels. The energy that is unused can accumulate as adipose tissue which increases the risk of metabolic disease and associated co-morbidities.

Are you at risk of developing diabetes?

Aside from the vast number of diagnosed cases of type 2 diabetes in Australia, there is also around 2 million at risk of developing the condition. In isolation there is no single cause for type 2 diabetes, however, there is a set of well-established risk factors that can significantly increase your risk of developing the condition.

Modifiable risk factors such as diet and exercise are things that we can influence. Alternatively, non-modifiable risk factors including age, gender, and family history cannot be altered. A combination of these factors are taken into consideration with the AUSDRISK tool, which is specifically utilised for screening diabetes risk.

Changing your lifestyle to manage type 2 diabetes

A healthy lifestyle is the cornerstone to the management of type 2 diabetes. Learning about portion sizes and carbohydrate counting can have a significant impact on blood glucose fluctuations throughout the day. Individuals living with type 2 diabetes will also be required to take insulin injections or sulphonylureas as the risk of hypoglycaemia is ever-present.

Eating well for diabetes

People with diabetes need to have an understanding of how much insulin or carbohydrate is required to balance blood glucose levels in the presence of other lifestyle variables such as physical activity, stress and busy schedules. Using metric cups or scales to ensure accurate portion sizes and carbohydrate quantities is necessary to establish this balance, as much as possible planning can have a substantial impact. A well-balanced meal should consist of starches or grain-based carbohydrates, along with some protein and fat (preferably unsaturated fats).

Carbohydrate foods that have more than 5 grams of fibre per 100 gram serve typically have a low glycaemic index and subsequently provide a steady supply of glucose over time reducing the risk of large spikes and drops in blood glucose levels.

Similarly, unsaturated dietary fats should be prioritised as opposed to large amounts of saturated fats. Saturated fats are typically found in animal sources such as cheese, cream, butter or lard and contribute to the increase in LDL cholesterol and increasing insulin resistance. Choosing mono or polyunsaturated fats like that found in olive oil, avocados, salmon or unsalted nuts are examples of heart-healthy fats that promote HDL or ‘good’ cholesterol, these promote good cardiovascular/metabolic health.

The role of exercise

Regular physical activity, inclusive of incidental activity and structured exercise is vital for effective diabetes management. When you exercise your muscles use glucose to fuel muscle contraction, regular physical activity helps the body to use insulin more efficiently. Even breaking up periods of sedentary behaviour frequently with light activities such as housework and gardening can have an immense impact on mitigating the rise in blood glucose levels, particularly post-prandially following the consumption of a meal containing carbohydrates.

Starting a discussion with your general practitioner to commence a team care arrangements plan with an Accredited exercise physiologist can ensure you have a specific routine. Regular monitoring is also really important along with ensuring optimal hydration, while having a treatment plan in place in the event of a hypoglycaemic episode or sickness/illness.

Can type 2 diabetes be reversed?

Whilst there isn’t a cure for type 2 diabetes, studies show it is possible to reverse the condition through dietary modifications and weight loss whereby you can achieve normal blood glucose levels without the need for insulin or medication. An important point is that this doesn’t mean your type 2 diabetes is completely gone. It relates to the ability to manage the condition living a life free of the implications or need for medication and insulin injections.

Getting the right advice

If you’re living with type 2 diabetes and need some advice on exercising safely or want to learn more about the reversibility of type 2 diabetes, an Accredited Exercise Physiologist or Credentialled diabetes educator (CDE) can help. They are university-qualified health professionals who understand the complex relationship between exercise, carbohydrate, insulin, stress, illness, and blood glucose. They will help to provide you with individualised advice to ensure you’re exercising in a way that’s right for you to achieve your health and well-being. To find a qualified professional near you click here. 

Written by Hayden Kelly. Hayden is an Accredited Exercise Physiologist at Diabetes NSW and ACT.