Exercise routines to lower type 2 diabetes risk

Understanding diabetes and its risk factors

‘Diabetes’ is a general term for a number of conditions where there is too much glucose in the blood. The main three are: type 1 diabetes, type 2 diabetes and gestational diabetes (which occurs in some pregnancies). When we eat, carbohydrate is broken down into glucose in the blood. In a person who does not have diabetes, their pancreas releases insulin, which transfers the glucose from their blood into the muscle cells to be used as energy.

People living with type 1 diabetes do not produce insulin. In people with type 2 diabetes or gestational diabetes, insulin is only produced in small amounts or does not work properly. This results in glucose building up in the bloodstream, which can eventually damage blood vessels and nerves.

There is an associated condition called pre-diabetes, where a person’s blood glucose levels are higher than recommended but not high enough to be diagnosed as type 2 diabetes. Pre-diabetes increases the risk of developing type 2 diabetes by between 10 and 20 times. However, in up to 58% of cases, the onset of the condition can be prevented or delayed by adopting sustainable healthy habits.

Type 2 diabetes risk factors

The exact cause of type 2 diabetes is not known. However, there are a number of factors that increase the risk of developing the condition. Some of these are modifiable (meaning that they can be changed) and others are non-modifiable (they cannot be changed).

Modifiable risk factors include:

• Having pre-diabetes
• Having excess body fat
• Having an unhealthy waist measurement
• Not doing the recommended amount of exercise
• Having high levels of triglycerides (a type of fat in your blood) and low levels of HDL-C (the ‘good’ cholesterol)
• Having high blood pressure
• Smoking

Non-modifiable risk factors include:

• Having a close relative such as a parent or sibling with type 2 diabetes
• Having an ethnic background of Aboriginal and Torres Strait Islander, Pacific Islander, Asian (including Chinese and the Indian sub-continent), Middle Eastern or North African
• Age–although diabetes can develop at any age, the risk of pre-diabetes increases after age 35
• Having Polycystic Ovarian Syndrome (PCOS)
• Having had diabetes in pregnancy or having given birth to a big baby (more than 4.5 kg)

Exercise as a key diabetes prevention strategy

Exercise can play a key role in the prevention of type 2 diabetes.

Regular exercise causes your muscles to use more glucose, which helps in the management of blood glucose levels (BGLs). It can also lower cholesterol and blood pressure, and improve heart and blood vessel health. Other potential benefits of exercise include helping to maintain or achieve a healthy body weight.

Low levels of exercise are a major risk factor for type 2 diabetes.

Types of exercise for diabetes prevention

Here are the types of exercises recommended for reducing type 2 diabetes risk:

Aerobic exercise

Aerobic exercise increases your heart rate and the amount of oxygen your body uses. It can be very beneficial for people at risk from type 2 diabetes, especially when combined with eating a healthy diet.

Australian Government guidelines recommend that adults do at least 30 minutes of moderate-intensity aerobic exercise most days. Moderate activities are at an intensity that requires some effort but doesn’t make you breathless. Examples include brisk walking, gentle swimming and social tennis.

Light-intensity aerobic exercise for diabetes prevention, which includes casual walking, doing chores and the activities of daily living, can also be beneficial in the management of blood glucose, insulin levels, blood pressure, body fat and cholesterol, especially if you work up to 150 minutes per week.

Strength training

Strength training improves musculoskeletal health (meaning the muscles, bones and joints and the tissues that connect them). It also reduces type 2 diabetes risk factors such as elevated blood glucose levels, unhealthy body weight, high blood pressure and high blood cholesterol.

Examples of strength training include exercises using free weights, weight machines and resistance bands. The Australian Government Guidelines recommend that adults do strength training activities on at least two days each week.

Flexibility and balance exercises

Flexibility and balance exercises such as lunges and flamingo stands are important for overall health, and they increase your ability to do other types of exercise. They improve movement and balance, reducing the risk of falls and injury.

Creating a personalised exercise plan

Creating a personalised exercise plan involves several key steps:

1. Assessing current fitness level

Before starting an exercise program, it’s important to assess your fitness level. You can use various methods such as measuring your heart rate before and after a walk (make sure that you consistently take this measure at the same time after your walks). You could also see how long it takes for your heart rate to return to its resting level. Alternatively, measure how long it takes you to walk a certain distance. You can also use monitors and measuring equipment to record data.

However, you are far more likely to get an accurate assessment if you consult a health or fitness professional.

2. Setting realistic goals

Setting realistic and achievable goals is crucial for maintaining motivation and managing your time efficiently. The SMART goal-setting approach is useful for this.

SMART stands for:

• Specific—goals should be clear and well-defined
• Measurable—goals should include a way for tracking progress
• Achievable—goals should be realistic and reasonable so that you’re not setting yourself up for failure
• Relevant—goals should be relevant to your aim
• Time-bound—goals should have a clearly defined timeline

3. Designing an exercise routine

When designing an exercise routine, it’s important to consider your fitness goals, likes and dislikes, and start with activities you enjoy. A balanced exercise routine should include a mix of cardiovascular activities (like walking or cycling), strength training and flexibility exercises.

The FITT principle is useful for structuring exercise programs. FITT stands for:

• Frequency—how often you exercise
• Intensity—how hard you’re going to work
• Time—how long you’re going to exercise for
• Type—the kind of exercise you’re going to do

These four variables can be adjusted so that you can design a workout routine that is tailored to your specific goals.

Staying safe during exercise

Exercise safety recommendations include wearing appropriate clothes (especially footwear), using the correct equipment and warming up and cooling down properly. Another important recommendation is to stop exercising if you experience discomfort or pain.

It’s always a good idea to consult a healthcare or fitness professional before starting any exercise program.

Motivation and overcoming barriers

Common barriers to regular exercise

Common barriers to exercising include feeling too unfit to do anything and feeling anxious or embarrassed. If you’re unfit, you could start exercising slowly with activities you’re comfortable with, such as walking. If you’re anxious or embarrassed about exercising, start in your comfort zones in terms of what you do, where you do it and the level of intensity you apply.

If you don’t have time to exercise, making a few modest adjustments to your schedule could create that time.

Strategies for staying motivated and overcoming obstacles

If you are considering abandoning your exercise routine, there are a lot of things you can do to stay motivated. These include:

• setting yourself one specific, achievable goal
• breaking your goal into small, easy tasks
• telling your friends and family about your goal and encouraging them to help keep you motivated
• regularly reviewing your goal and monitoring your progress
• reflecting on the important fundamental reason(s) why you want to be physically active, such as to have a better quality of life and/or to be able to spend more time with loved ones
• continuing to set new goals.

Importance of social support and accountability

Support systems and ‘accountability partners’ (someone who supports another person to maintain progress towards a goal) can be helpful. The benefits they bring include:

• encouragement and motivation—this can be especially valuable during challenging times
• accountability—having someone to answer to can make people more likely to stick to the process of achieving their health goals
• shared learning and experience—support systems and/or accountability partners provide a way to share experiences and learn from others

Lifestyle integration

Making time for some exercise every day sets you up to prevent type 2 diabetes and look after your health in general. Tips for incorporating exercise into your daily life until it becomes a habit include:

• plan when you’re going to exercise
• do exercise you enjoy
• be positive: any increase in the amount of physical exercise that you do is helpful.

Monitoring progress and adapting the routine

Monitoring progress is crucial as it enables you to adapt your routine as necessary.

Every aspect of creating and sustaining exercise routines to lower the risk of type 2 diabetes is easier and more effective if you have the right kind of support.

The Life! program gives you the right kind of support to guide you to understanding diabetes and its risk factors.

How the Life! program can help you

Life! is a free healthy lifestyle program that helps you improve your eating habits, increase your physical activity and manage stress. It will help you reduce your risk of developing stroke, heart disease and type 2 diabetes.

Life! is run by experienced health professionals, including dietitians and exercise physiologists, who guide and support you to make healthy lifestyle changes.

The program includes 7 sessions delivered over a 12-month period. You can choose from a group course or our telephone health coaching service. Learn more about the Life! program.

You can check your eligibility for the Life! program by taking an online test here.

For a list of sources of information throughout this blog, please see the original published blog in the Life! website.