Can you reverse type 2 diabetes with exercise? We speak to Kate Rowe-Ham to find out why being fit and active is one way to swerve or even reverse diabetes type 2
Words: Gemma Calvert | Images: Shutterstock
Around 12.3m people are at risk of type 2 diabetes in the UK, and most of them are above the age of 40. The disease is caused when insulin – the hormone that regulates the movement of sugar into cells and controls blood sugar levels – is not used properly by the body. Damage can be caused to vision, your heart, nerves, kidneys and even your feet.
According to Diabetes UK, carrying extra weight around your midriff contributes to the risk, while weight loss promotes remission.
Of course, there’s no denying the benefits of cardiovascular exercise on weight management, but the ticket to staving off type 2 diabetes, and even reversing its impact if you already have it, is weightlifting.
Strength training five times a week can, according to research, reduce the risk of developing type 2 diabetes by a third. ‘Weight-bearing exercise helps improve and control blood sugar levels. It’s an anaerobic exercise, which means your muscles are primarily powered by glucose to undertake short bursts of activity, unlike running, which uses up fat and oxygen,’ explains Kate Rowe-Ham, a level-3 personal trainer, women’s health expert and founder of Owning Your Menopause, an app helping midlife women to thrive.
‘Staying active most days of the week will help you improve insulin sensitivity, stay healthy and reduce long-term health risks,’ she adds.
Your chances of developing chronic conditions such as type 2 diabetes, heart disease and cancer is greater when your metabolism – the process by which the body converts food and drink into energy – slows down. But strength training, insists Kate, is one of the best ways to improve metabolic health because, unlike cardio exercise, which only burns fat during the workout, lifting weights builds lean muscle mass, which uses more calories at rest than other tissues, including fat. Plenty of studies reference the so-called “after burn” effect, which lasts for up to 38 hours after weight training.
‘If we’ve got more muscle, we are likely to burn more calories and if we burn more calories, we’re unlikely to struggle with visceral fat. This is a type of fat surrounding the internal organs, which exacerbates insulin resistance so the body can’t properly use it to control glucose, increasing the risk of type 2 diabetes,’ says Kate.
Getting a grip on glucose
Effective management of cortisol, a naturally produced stress hormone that also increases insulin resistance, is another benefit to weight training. Whenever muscles are put under stress, cortisol production generates energy by releasing glucose, which makes it harder for insulin to work properly. Any excess glucose not needed for fuel becomes fat stored in the abdomen. Furthermore, when the body resists insulin, the imbalance of hunger hormones leptin and ghrelin can lead to overeating.
Especially for those with diabetes, lower-impact strength training is effective because it sparks the production of anabolic hormones, which encourage growth, repair and fat burning, and act as a counter balancer to cortisol.
Consistency is key
So how do you ensure you don’t enter high cortisol production territory during a workout? ‘As a general rule, go for slow and steady exercise where you can feel your heart rate elevating but you’re not over-stressing your body to the point where you’re out of breath and can’t speak,’ advises Kate, adding that a moderate-impact approach to exercise is advantageous to women in perimenopause and
post-menopause because high cortisol levels can exacerbate many menopausal symptoms.
While the NHS recommends 150 minutes of moderate exercise a week, rather than two or three prolonged periods of exercise, Kate suggests a weekly commitment to five 30-minute strength workouts combined with two recovery days to allow for muscles to repair. As well as curbing cortisol production, she says shorter blasts of movement make it easier to stick to a long-term exercise schedule.
‘Achievability and sustainability of a lifestyle is crucial for someone with a type 2 diabetes diagnosis because only when realistic goals are set will you optimise your wellbeing to make long-term change,’ she says, pointing out too that the time of day a person with type 2 diabetes exercises is important to consider.
‘The American Diabetes Association has described a “dawn phenomenon” where between 4am and 8am there’s a natural rise in blood glucose, which can result in higher levels during morning exercise,’ she says. ‘For those with type 2 diabetes, a workout later in the day might be less likely to result in a glucose spike.’
Eat slow – burn carbs
However, to minimise the risk of, or to manage, type 2 diabetes, along with other chronic conditions, exercise alone is not enough. ‘Type 2 diabetes can be put into long-term remission (where medication is no longer required) with weight-training workouts, in conjunction with eating a healthy diet, consuming less sugar and limiting alcohol,’ says Kate, adding that pre-workout, everyone, particularly those with type 2, should fuel up on carbohydrates to avoid dizzy spells.
‘You want to be nourished by food that will provide a continuous slow burn during exercise, and carbohydrates convert into glucose, which creates energy to drive the workout,’ says Kate. ‘By eating a low-glycaemic food, such as porridge, 90 minutes before exercise, you’ll burn energy very slowly, which will sustain you.’ It’s also important to add protein to each meal for greater satiety and to slow down the rate at which carbs are absorbed and broken down.
Full-body benefits
Encouragingly, weight training helps tackle diabetes complications, too. ‘As well as helping with balance and mobility, lifting weights improves bone health. Our bone density peaks at the age of 30, and research shows that those with type 2 diabetes are at a heightened risk of bone fracture,’ says Kate, who highlights that lifting weights can also curb age-related muscle loss, which the American Diabetes Association says is accelerated by type 2 diabetes.
‘Your muscles decline at a rate of five per cent per year after the age of 35, and because lifting weights helps you build and maintain strong, lean muscle mass, you’ll be much likely to burn additional calories, which will leave you less susceptible to visceral fat around the midriff.’
And let’s not forget there are also significant mental-strength benefits of lifting weights. ‘As well as improving body image and self-confidence, research shows strength training reduces others depressive symptoms. The benefits of weight training for everyone cannot be underestimated!’ says Kate.
‘How I transformed my diet and reversed prediabetes’
Try Kate’s simple method to reverse type 2 diabetes with exercise
Squats
- Stand with your feet shoulder-width apart, resting your arms down at your sides.
- While bracing your core and keeping your chest up and neck neutral, bend your knees and push your hips back as if you’re going to sit in a chair.
- When your thighs are parallel to the floor, pause.
- As you rise back to the top squeeze your buttocks, then repeat. You can also hold some dumbbells to create more resistance. Do 10 times.
Split squats
- Start in a split-leg position, with one leg forward and one back. Engage your core.
- Flex your knees and lower your hips until the back knee is just above the floor.
- Push back up through your front leg and return to the starting position. Do 10 on each leg.
Dead bugs
- Lie on a mat with your arms extended straight up above your chest so they form a perpendicular angle with your torso.
- Bend your hips and knees to 90 degrees, lifting your feet from the ground. Your torso and thighs should form a right angle, as should your thighs and shins. This is the starting position.
- Engage your core, maintaining contact between your lower back and the mat. You want to make sure your spine maintains this steady and neutral position throughout the exercise.
- Keep your right arm and left leg exactly where they are, then slowly reach your left arm backward, over your head and toward the floor as you simultaneously extend your right knee and hip, reaching your right heel toward the floor.
- Move slowly and steadily, breathing in as you perform the extensions, avoiding any twisting or movement of your hips and abs. Stop the movement just before your arm and leg touch the ground.
- Slowly lift both arm and leg back to the start position, then repeat on the other side.
- Do 10 on each side, moving slowly throughout to maintain engagement of your abdominal muscles.
Easy push-up
- Go into an all-four position on a mat.
- Contract your abs and pull your belly button towards your spine. Inhale as you slowly bend your elbows to 90 degrees and lower yourself to the floor. Make sure your forehead isn’t heading towards the ground. Aim your chest between your hands.
- Exhale while contracting your chest muscles and pushing back up through your hands, returning to the start position. Do 10. Work up to being able to do them from a full press-up position if you can.
