Diabetes

What is Diabetes?

Diabetes is a chronic condition that affects the way the body processes blood sugar levels (also known as glucose). Your body uses glucose to produce energy with the help of insulin made in the pancreas. Therefore, those diagnosed with Diabetes either struggle to produce insulin and/or the cells of the body do not respond to insulin effectively – leading to increase blood sugar levels in the body. If left untreated, Diabetes can lead to severe complications to the heart, kidneys, eyes, nerves, blood vessels and in severe cases death.

Symptoms of Diabetes include increased thirst and urination, increased hunger, fatigue, blurred vision, numbness or tingling in the feet or hands, sores that do not heal and unexplained weight loss.


Types of Diabetes

There are 3 main types of diabetes;

  • Type 1 Diabetes – An autoimmune condition whereby the immune system is triggered to destroy the cells in the pancreas that produce insulin. There is no cure for type 1 diabetes, and it can’t be prevented.
  • Type 2 Diabetes – A condition whereby the body becomes resistant to the normal effects of insulin and eventually loses the ability to produce enough insulin in the pancreas. It is often associated with modifiable lifestyle factors i.e., diet, physical activity, etc.
  • Gestational Diabetes – A form of diabetes that occurs during pregnancy when higher than normal blood glucose levels are detected. It often occurs around the 24th – 28th week of pregnancy, with most women no longer having diabetes once the baby is born.

Exercise and Diabetes

Exercise training improves glycemic control, body composition, cardiorespiratory fitness, cardiovascular risk profile, physical functioning and well-being in patients with T2DM or pre-diabetes. Low levels of physical activity and physical fitness are modifiable risk factors for the development of T2DM.

Furthermore, lifestyle modification, including exercise training now represents a central strategy in diabetes prevention. The U.S. Diabetes Prevention Program reported a 58% reduction in the incidence of T2DM from a four-year lifestyle intervention that prescribed 150 min/week of moderate activity exercise and dietary change program designed to induce a 7% weight loss.

Type of Exercise

How Hard Should I
Be Going?

How Long Should I
be Exercising?

How Often Should
I be Exercising?

Aerobic/Cardio

e.g. walking, running,
cycling, swimming etc.

Moderate:
55-69% HRmax
6-7/10 Difficulty

Moderate:
210 min per week

No more than two consecutive days without exercising

Vigorous:
70-89% HRmax
8-9/10 Difficulty

Vigorous:
125 min per week

Resistance/Strength

Moderate to Vigorous:

8-10 Exercises
2-4 Sets
8-10 Repetitions
1-2 min rest intervals

60 min
(included in totals above)

2 or more times per week


Lifestyle Interventions for preventing diabetes in at-risk individuals

Overall, lifestyle interventions targeting multiple physical activity and nutritional goals simultaneously have been highly successful in preventing the onset of T2DM when compared to either usual care controls or pharmacological intervention. Some elements related to behavior change in diabetes prevention include:

  • Staging of information provision and individual tailoring of the exercise and diet program components.
  • Multiple exercise sessions, reinforcement, specified small group size; individual or group programs.
  • Written materials to reinforce verbal advice; self-management and self-monitoring through keeping physical activity, weight and diet logs.

Diet and Diabetes

Following a healthy balanced diet is essential is achieving diabetes management, promoting good blood glucose control and preventing/delaying associated chronic disease risk; including cardiovascular disease and obesity. Dietary intervention for individuals with diabetes, is focused around the Australian Dietary Guidelines, with a variety of foods consumed from the five food groups including the three key nutrients protein, fat and carbohydrates, consumed in the recommended amounts (Table 2 & 3).

Consuming a low-fat diet, particularly low in saturated fat and containing small amounts of unsaturated fat, can help control both weight and blood glucose levels (BGL’s). Saturated fat is found in animal foods such as; fatty meat and dairy products, whilst unsaturated fat is found in plant-based foods including; nuts, seeds, avocado, fish and olive/vegetables oils.

Carbohydrates are the best energy source for both our bodies and our brains and for individuals with diabetes, carbohydrate has the biggest impact on BGL’s. For this reason, carbohydrate intake is individualised based on current activity level, age, gender and body weight. Generally, however carbohydrates with a low glycemic index (GI), foods which enter the blood stream slowly and have less of an impact on BGL’s, are recommended more often.

Protein is needed by the body for growth and repair, with the main protein foods including; meat/chicken/fish and tofu, eggs, nuts/seeds and cheese, and generally doesn’t have a direct impact on BGL’s.


Standard Serving Sizes of Each of the Five Food Groups

Food Group

Vegetables/

Legumes & Beans

Fruit

Grain Foods (Wholegrain, High Fibre)

Lean Meat & Poultry, Fish, Eggs, Nuts & Seeds

Milk, Yoghurt & Cheese

Standard Serve

100 – 350KJ

350kJ

500kJ

500-600kJ

500-600kJ

½ cup cooked green or orange vegetables

1 medium apple, banana, orange or pear

1 slice of bread or ½ medium roll or flat bread

65g cooked lean meat such as beef, lamb, veal, pork, goat or kangaroo

1 cup fresh or UHT milk

½ cup cooked dried or canned beans, peas or lentils

2 small apricots, kiwi fruits or plums

½ cup cooked rice, pasta, noodles, barley, quinoa

80g cooked lean poultry such as chicken or turkey

½ cup evaporated milk

1 cup green leafy or raw salad vegetables

1 cup diced or canned fruit (no added sugar)

½ cup cooked porridge or ¼ cup muesli

100g cooked fish fillet or 1 small can of fish

2 slices of hard cheese or ½ cup ricotta cheese

½ medium potato or other starchy vegetable

125ml fruit juice (no added sugar)

3 crispbreads

2 large eggs or 170g tofu

¾ cup yoghurt

1 medium tomato

30g dried fruit i.e. 4 dried apricots

1 crumpet or English muffin

1 cup cooked or canned legumes/beans or 30g nuts/seeds

1 cup soy, rice or other cereal drink


Recommended Serves per Day of Each Food Group

 

Vegetables,
Legumes & Beans

Fruit

Grain Foods
(Wholegrain, High Fibre)

Lean Meat & Poultry,
Fish, Eggs, Nuts & Seeds

Milk, Yoghurt & Cheese

 

Male

Female

Male

Female

Male

Female

Male

Female

Male

Female

2 – 3 years

2.5

2.5

1

1

4

4

1

1

1.5

1.5

4 - 8 years

4.5

4.5

1.5

1.5

4

4

1.5

1.5

2

1.5

9 – 11 years

5

5

2

2

5

4

2.5

2.5

2.5

3

12 – 13 years

5.5

5

2

2

6

5

2.5

2.5

3.5

3.5

14 – 18 years

5.5

5

2

2

7

7

2.5

2.5

3.5

3.5

19 - 50 years

6

5

2

2

6

6

3

2.5

2.5

2.5

51 – 70 years

5.5

5

2

2

6

4

2.5

2

2.5

4

70+ years

5

5

2

2

4.5

3

2.5

2

3.5

4


Learn more about living with Diabetes

Exercise Programs & Dietary Advice should be delivered by individuals with appropriate qualifications (Exercise Physiologist/Dietitian).

All Australians diagnosed with Type 2 Diabetes are eligible to receive 8 sessions with an Accredited Exercise Physiologist each year. Email This email address is being protected from spambots. You need JavaScript enabled to view it. to see how Ripples Exercise Physiologists and Dietitian can help you.


References

  • Baker, M., Simpson, K., Lloyd, B., Bauman, A., & Singh, M. (2011). Behavioral strategies in diabetes prevention programs: A systematic review of randomized controlled trials. Diabetes Research And Clinical Practice, 91(1), 1-12. doi: 10.1016/j.diabres.2010.06.030
  • Hordern, M., Dunstan, D., Prins, J., Baker, M., Singh, M., & Coombes, J. (2012). Exercise prescription for patients with type 2 diabetes and pre-diabetes: A position statement from Exercise and Sport Science Australia. Journal Of Science And Medicine In Sport, 15(1), 25-31. doi: 10.1016/j.jsams.2011.04.005
  • Type 1 diabetes. (2020). Retrieved 19 May 2020, from https://www.diabetesaustralia.com.au/type-1-diabetes
  • Type 1 diabetes. (2020). Retrieved 19 May 2020, from https://www.healthdirect.gov.au/type-1-diabetes
  • What You Need to Know About Type 2 Diabetes. (2020). Retrieved 19 May 2020, from https://www.healthline.com/health/type-2-diabetes#causes
  • Type 2 diabetes. (2020). Retrieved 19 May 2020, from https://www.healthdirect.gov.au/type-2-diabetes
  • Eating Well With Diabetes. Diabetes Australia. (2020). Retrieved 20 May 2020, from www.diabetesaustralia.com.au
  • Healthy Eating For Adults: Eat For Health & Wellbeing. National Health and Medical Research Council. (2015). Retrieved 20 May 2020, from www.eatforhealth.gov.au
  • Healthy Eating For Children: Teach Your Children Healthy Eating For A Healthy Life. National Health and Medical Research Council. (2015). Retrieved 20 May 2020, from www.eatforhealth.gov.au
  • The Collaboration of Exercise Physiologists and Dietitians In Chronic Disease Management. Exercise & Sports Science Australia & Dietitians Association of Australia. (2014).