Insulin Matters: The Connection Between Diabetes and Exercise
Insulin in Blood Test - By Daniel Reynen and Leigh Pujado
Making the most out of your workout time is one of the jobs of a personal trainer. We check with our clients to make sure they’ve had enough sleep and that they’ve eaten. We monitor what they drink and ensure they’re pushing themselves appropriately.
When a client has a medical condition, we work with doctors and therapists to map the best approach. One of the most common conditions we see are clients with diabetes.
Here are the numbers. Approximately 1 in 10 people in America have diabetes. As of 2023, that’s about 37.3 million people. Surprisingly, about 1 in 5 people with diabetes don’t know they have it.
Then there are all the people with prediabetes. In 2022 the Centers for Disease Control estimated that 96 million people 18 or older have prediabetes. That’s 38% of the adult US population.
Why does this matter to a personal trainer? Because research published in 2020 showed that cardio workouts aren’t nearly as effective for people with higher-than-normal blood sugar levels.
In a clinical trial, people with the worst blood-sugar control had the lowest endurance. Their bodies were building collagen rather than blood vessels that would help them become more aerobically fit and live longer.
If you don’t know you have a problem, you can’t get it under control. And one of the reasons many people may not realize they’re at risk (or have a problem) is how we test for diabetes.
When doctors diagnose diabetes, they use blood tests to determine which type someone has. Unfortunately, doctors often don’t check insulin levels in their routine blood tests.
Insulin plays a crucial role in how our bodies process food for energy. It’s a hormone that helps keep our blood sugar levels in check. Sometimes, even when blood sugar levels seem normal, it’s because the body is working extra hard to keep them that way.
The pancreas releases extra insulin to ensure blood sugar levels stay below 100. Someone may seem fine based on blood sugar levels alone, but still have an overworked pancreas producing excess insulin. As the condition progresses, your body becomes “resistant” to insulin, so you have to make more and more to do the same job. This is called insulin resistance.
Insulin resistance often happens before type 2 diabetes. At first, your body makes more insulin to compensate for the insulin not working correctly. But as the condition progresses, insulin resistance worsens, and your body eventually can’t make enough insulin. When insulin levels drop, blood sugar levels rise. If they don’t go back to normal, you may develop type 2 diabetes.
To fully understand the condition, both fasting glucose and fasting insulin tests are necessary.
The lack of emphasis on insulin testing can be attributed, in part, to the guidelines provided by influential organizations like the American Diabetes Association (ADA). In their 2022 guidelines, the ADA fails to mention “carbohydrates” or “sugar” in the nutrition section. This omission reflects their previous stance, advocating for unrestricted carbohydrate consumption as long as insulin doses are adjusted accordingly.
This advice is concerning considering the influence of the beverage industry on the ADA. Former chief science officer Dr. Richard Kahn, who had close ties with the industry, claimed that added sugar does not play a significant role in obesity and diabetes development. The ADA’s sponsorship deals with processed food companies raise questions about their impartiality.
Unfortunately, the problem of disregarding insulin testing is not unique to the United States. Organizations like Diabetes UK have also downplayed the role of sugar in diabetes. Their sponsorship deals with sugary beverage companies further raise concerns about conflicts of interest.
If you do not see results from your cardio program, you may be dealing with elevated blood sugar levels. To figure it out, make sure your doctor checks your fasting insulin levels along with all the other standard blood tests. The sooner you know, the sooner you can treat it, and the more effective therapies (and your workout programs) will be.
Reference Links:
Diagnosis and treatment of type 1 diabetes at the dawn of the personalized medicine era
Ammira Al-Shabeeb Akil, Esraa Yassin, Aljazi Al-Maraghi, Elbay Aliyev, Khulod Al-Malki & Khalid A. Fakhro
Journal of Translational Medicine, Published 01 April 2021
Management of hyperglycaemia in type 2 diabetes, 2022. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD)
Melanie J. Davies, Vanita R. Aroda, Billy S. Collins, Robert A. Gabbay, Jennifer Green, Nisa M. Maruthur, Sylvia E. Rosas, Stefano Del Prato, Chantal Mathieu, Geltrude Mingrone, Peter Rossing, Tsvetalina Tankova, Apostolos Tsapas & John B. Buse
Diabetologia, Published 24 September 2022
Are HOMA-IR and HOMA-B good predictors for diabetes and pre-diabetes subtypes?
Davood Khalili, Marjan Khayamzadeh, Karim Kohansal, Noushin Sadat Ahanchi, Mitra Hasheminia, Farzad Hadaegh, Maryam Tohidi, Fereidoun Azizi & Ali Siamak Habibi-Moeini
BMC Endocrine Disorders volume, Published 14 February 2023
Hyperglycaemia is associated with impaired muscle signalling and aerobic adaptation to exercise
Tara L. MacDonald, Pattarawan Pattamaprapanont, Prerana Pathak, Natalie Fernandez, Ellen C. Freitas, Samar Hafida, Joanna Mitri, Steven L. Britton, Lauren G. Koch & Sarah J. Lessard
Nature Metabolism: Published: 20 July 2020
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6/29/2023
