Posted: April 17, 2007

Sportsmedicine: Diabetes and Exercise

Diabetes is a growing epidemic worldwide. The increasing weight of the population and the prevalence of high sugar, processed foods have led to an increase in the incidence of diabetes. There are millions of people diagnosed with this condition and millions more living with it undiagnosed. Due to the lack of strong symptoms at the onset it often goes undiagnosed and untreated until something else forces the person to the doctor. Testing of the blood for blood glucose levels is the only reliable way to diagnose diabetes.

What is diabetes?
Diabetes is a condition related to the body's inability to utilize glucose. Glucose is necessary for energy in the body.  Most of the cells in the body require glucose for energy production. The body uses insulin to transport the glucose to the cells that need it. Insulin is produced and secreted by the pancreas.

Diabetes can be caused by the body's inability to produce insulin, or enough of it, to carry the glucose to the cells. It may also be a result of the inability of the insulin to reach the receptor sites that receive it to pass the glucose on.

Types?
Type I diabetes, often referred to as juvenile or insulin dependent diabetes, is caused by the body's inability to produce insulin in adequate quantities to transport glucose. When more glucose is circulating in the blood than there is insulin, this places a stress on the body. The lack of glucose getting to the cells, especially the brain cells, can cause serious problems with energy production and the normal cellular functions. Type I diabetics must take insulin due to the body's lack of production. Without this extrinsic insulin the body would be unable to utilize any of the glucose circulating in the blood which would lead to cell death.

Type II diabetics may produce insulin in sufficient amounts, or they may not, but that insulin may not get to the receptor sites. The pancreas will produce insulin, but it may not be enough. This is often referred to as adult onset diabetes, although it is becoming increasingly more prevalent in teens. Individuals with type II diabetes may be able to control the condition with proper nutrition and exercise. Some of these diabetics may require medications to assist their bodies own production of insulin.

Gestational diabetes is the development of diabetic symptoms during pregnancy. This condition often reverses itself after the pregnancy. Pre-diabetes is another condition that may reverse itself, although not as common as in gestational diabetes. Pre-diabetics have blood sugar levels that are elevated but not high enough to be diagnosed as diabetic. Many older individuals are diagnosed as pre-diabetic.

What causes it?
Type I diabetes often has genetic causes. This type of diabetes is considered an auto-immune disease because the body's immune system attacks the beta cells in the pancreas that produce insulin. It is not clear what actually causes this type of diabetes.

Type II diabetes is commonly caused by obesity and poor nutrition. Abuse of some drugs and alcohol may lead to the onset of type II diabetes. Hyperglycemia (high blood sugar), which is an early sign of diabetes is often seen in older people and may or may not be caused by diabetes mellitus. Gestational diabetes is often a result of the hormone fluctuations that accompany pregnancy. Pre-diabetes is due to the body's developing resistance to insulin.

Signs, Symptoms and Risk Factors?
Hyperglycemia is a symptom of all types of diabetes. This is also the symptom used to diagnose this disease. The inability of the body to use glucose, due to the absence of, or inability to use, insulin, causes more glucose to circulate in the bloodstream. This symptom leads to the other signs and symptoms of this disorder.

Type 1: Symptoms often appear after a flu-like condition and gradually worsen.

• Increased thirst and frequent urination. Excess glucose in the bloodstream pulls water out of the cells and causes increased thirst. This increased fluid intake and loss of fluid causes more frequent urination.
• Extreme hunger. The inability of the body to utilize glucose causes the cells and muscles to be energy starved, triggering the hunger response.
• Weight loss. Due to the decrease in glucose utilization the cells of the body die before they can divide and reproduce. This leads to a loss of fat and muscle cells.
• Blurred vision. The fluid that the glucose robs from the body's cells is also taken from the eyes causing a decrease in the ability to focus.
• Fatigue. The lack of glucose for energy production leaves the body fatigued and the brain starving for energy.

Type 2: Since type II diabetes develops slowly, the symptoms may come on gradually and go unnoticed at first.

• Flu-like symptoms. A decrease in glucose utilization may lead to a tired, weak feeling.
• Weight fluctuations. The lack of glucose for energy at the cellular level may increase the hunger response causing an increase in appetite and a subsequent weight gain. This same lack of glucose may also lead to an inability of the muscle cells to build and grow causing weight loss.
• Blurred vision. This is due to the same causes as with type I.
• Slow healing sores or infections. The high level of glucose circulating in the blood interferes with its ability to carry disease fighters to the infection site.
• Nerve damage (neuropathy.) The high concentration of glucose in the blood damages the small blood vessels feeding the nerves. This is especially noted in the hands and feet.
• Swollen, tender gums. This is due to the same lack of disease fighters in the blood that causes slow healing sores.

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