Research Paper Sample: Physical Exercise as Therapy for Type 2 Diabetes
Diabetes results when the pancreas lacks or insufficiently produces insulin. Type II is non-insulin-dependent and is referred to as type 2 diabetes mellitus, T2DM, or sometimes adult-onset diabetes (The Cambridge historical dictionary of disease). According to the International Diabetes Federation, in 2019 approximately 463 million adults were living with diabetes and type II accounted for 90 percent of them (CITATION). Currently, there is no cure for the condition; instead, there are ways to prevent and maintain this chronic disease that affects millions of people around the globe. If left untreated or unmanaged, T2DM can lead to blindness, limb amputation, kidney failure, and vascular and heart disease (Pippett et al., 2016). Moderate intense exercise prevents or delays type two diabetes, because it lowers blood glucose levels, increases insulin sensitivity, and helps with weight regulation.
Regulating blood glucose levels is an essential aspect of regulating diabetes. Glucose is the scientific term for sugar and to function daily, the body uses it as an energy source. As more glucose becomes present in the bloodstream, the blood glucose level rises, in contrast; the blood glucose level drops when less sugar is detected. The pancreas plays a vital role in regulating these levels by producing and releasing insulin into the bloodstream. Insulin is a natural hormone that acts as a drug for the body. Type II diabetics typically experience higher blood glucose levels because their body either lacks insulin or is unable to efficiently use insulin from the pancreas (Hand answers series: The handy diabetes answer book). When the blood sugars go high, it is often referred to as hyperglycemia. This condition causes short-term conditions like vomiting, hyperventilation, and coma, but it can have long-term effects on organs and even cause blindness (CITATION). Many factors influence these levels and exercise is one of them.
Exercise can play a vital role in regulating blood glucose levels. In 2018, the Tri-Service General Hospital in Taiwan funded a study to evaluate blood glucose levels in response to moderate-intensity exercise. In this experiment, 20 eligible individuals with T2DM participated in 36 sessions over 12 weeks of a moderate-intensity exercise training course. Each of the sessions was thirty minutes long and the patients were randomized to three different times of the day including morning, afternoon, and evening. Their blood glucose level was recorded before and after each session. The experimentalists used the data collected over the three months to concluded that exercise was a feasible way to progressively reduce blood glucose levels in T2DM (Chang et al., 2019). By performing this experiment, they were also able to provide scientific data to support that moderate-intensity exercise is safe for T2DM patients. They were able to question the notion that moderate to strenuous activity in people with T2DM will result in hypoglycemic events either during or after exercise because none of the participants experienced exercise-induced hypoglycemia (Chang et al., 2019).
Exercise also plays a role in increasing insulin sensitivity. Insulin sensitivity and insulin resistance correlate to each other. If a person has low insulin sensitivity, their body is not detecting or responding to insulin, therefore, they are insulin resistant. Insulin resistance contributes to type two diabetes mellitus but also increases the risk of other cardiovascular diseases and cancer. It is accepted that exercise training improves blood glucose control and enhances insulin sensitivity (Way et al., 2016). Regular exercise has significant benefits on insulin sensitivity that may persist beyond 72 hours after the last session, but they should undertake exercise no less than every 48 hours to manage glucose levels and insulin resistance (Way et al., 2016).
In a study funded by the National Heart, Lung, and Blood Institute, over eight months, 163 adults participated in a supervised aerobic exercise training program that evaluated the relationship of exercise with and without weight loss on insulin sensitivity. The participants were randomized into four different groups being low amount moderate intensity, low amount high intensity, high amount high intensity, and a non-exercise control group. Many factors were measured at baseline and follow-up including insulin sensitivity. This was measured by doing an Intravenous glucose tolerance test with the last test occurring 24 hours after the final training session. It was concluded that there was an increase in insulin sensitivity regardless of weight loss, but the largest increase in sensitivity was in the participants who achieved the least modest weight loss at a low amount and moderate intensity. Overall, the results suggest that in overweight or obese adults who exercise, at least a three percent weight loss promotes greater improvements in insulin sensitivity compared to those that did not (Swift et al., 2018).
Exercise maintains weight regulation of the body. Overweight and obesity occur when the body has an excess amount of fat. It is well known that exercise can reduce fat in the body, especially when it is combined with other healthy habits. Worldwide, obesity has doubled since 1980 because of high-calorie or high-fat foods, failure to meet physical activity guidelines, and a well-developed sedentary lifestyle (Leitner et al., 2017). Consequently, obesity is the largest global chronic health problem that has reached global epidemic proportions (Leitner et al., 2017). This new lifestyle is causing harm to a large population of humanity. Excess of body weight is a major risk factor for cardiovascular disease, type two diabetes mellitus, hypertension, coronary heart disease, or certain types of cancer (Leitner et al., 2017). Not only are these conditions long-term, but they are also fatal. While obesity has been increasing, so has T2DM. Within this escalating healthcare problem, obesity-associated type two diabetes accounts for 90 to 95 percent of all diagnosed diabetes in adults (CITATION). Bodyweight and type II diabetes are interconnected and often contribute to each other. Many times, people with type two diabetes mellitus are overweight or obese, which has developed the new word diabesity (Leitner et al., 2017). It is essential to treat the evolving condition of diabesity.
Treatment of obesity is not only important for diabetes but overall health as well. There are always procedural and pharmaceutical ways to achieve weight loss, but an effective major weight loss strategy is lifestyle interventions such as diet and exercise. Exercise is a more affordable treatment for weight loss and T2DM. Diet and behavior modification are the basis of T2DM and obesity prevention programs and exercise is often one of the first treatments recommended to newly diagnosed type II patients (Kirwan et al., 2017). In the study funded by the National Heart, Lung, and Blood Institute, the researchers concluded that clinicians should advocate for patients who are overweight or obese to exercise and obtain modest weight loss for improved cardiovascular benefits (Swift et al., 2018). In the other study funded by the Tri-Service General Hospital, the participants who took antidiabetic medications such as Metformin predicted a higher post-exercise blood glucose level than those not receiving Metformin (Chang et al., 2019).
