There is no doubt that when you have Type 2 diabetes, everything you put in your mouth is going to have some effect on your blood glucose levels. We first and foremost think about the carbohydrates or sugar we eat, however, in addition to that we have to take into consideration the effect proteins and fats have as well. An excess ingestion of protein is likely going to raise blood glucose levels. A moderate to heavy consumption of fats in a meal will slow down the rate at which glucose leaves the stomach and enters the blood. Without a doubt, nutrition plays a tremendous role in the successful management of Type 2 diabetes. The same is true for Type 1 diabetes, as insulin infusion into the body needs to basically match the amount of carbs consumed, however, for the time being I am going to limit my comments to people with Type 2.
Increased physical activity (I just go ahead and call it what it is, exercise) and maintaining a normal body weight, usually referred to as making positive "lifestyle choices," has been cited repeatedly as central to preventing and/or controlling prediabetes and diabetes. The problem with this is that it seems not enough people with Type 2 diabetes are heeding this advice, and health care professionals such as doctors, nurses and certified diabetes educators are not explaining the need for exercise in strong enough terms.
Patients newly diagnosed with diabetes commonly realize the need for eating better, which in their minds means eating fewer carbohydrates, even if they don't recognize the need for reducing their fat intake and losing some weight, but they don't often see the relationship between having diabetes and the increased need for exercise. It has been my experience that when patients are willing to make a change in their lives to better manage their diabetes, it usually has to do with limiting the number of carbohydrates they consume, not increasing their activity level.
Limiting carbohydrates is a good start, but is not at all likely to be enough to effectively manage Type 2 diabetes long-term. It's only half of the equation, only part of the solution. Exercise is vitally necessary, as well as limiting carbs, because as more and more beta cells cease to function and less insulin is produced, carbohydrate intake will out of necessity need to be at a bare minimum, which still may not allow for good management of blood glucose levels.
It is my contention that health care providers, including physicians, nurse practitioners, and diabetes educators, need to impress upon their patients with Type 2 diabetes that getting regular, almost daily exercise is equally as important as watching what they eat. Not only that, we need to take the time to explain to patients the latest exercise guidelines established by the American Diabetes Association. If patients express concern about whether or not they can perform exercise due to a health condition, every effort should be made to help the patient problem-solve their situation so that some form of exercise is possible. Exercise is too valuable a treatment for patients to simply dismiss it due to a medical problem.
I believe health care providers need to make the need for exercise more clear to patients with Type 2 diabetes and go the extra step in recommending current exercise guidelines.
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