T Nation

Type 2 Diabetes

My mom has type 2 diabetes. I want to get her started on a exercise routine and diet plan, but I know very little about diabetes so I want to be careful of what I recommend. Anybody out there dealing with this or know how to deal with it? Any help is appreciated.

NOTE: This is NOT my specific area, but I’ll give it a shot.

When you eat a carbohydrate (i.e., sugar, oatmeal, rice) your body releases insulin. The purpose of the insulin is to tell your muscles (among other things) to uptake the glucose from the blood. Type 1 diabetics don’t produce enough insulin and they have to inject it so the muscles take take up glucose. Type 2 diabetics do produce insulin. Unfortunately, the muscle cells have a decreased sensitivity to it and don’t take up glucose from the blood as they should.


There are drugs to help with this so please let us know if your mom is taking any.

One example is Metformin:
Metformin is used to regulate blood glucose levels. Metformin works in three ways: first, it reduces the amount of glucose produced by your liver; second, it reduces the amount of glucose absorbed from food through your stomach; and third, it makes the insulin that your body produces work better to reduce the amount of glucose already in your blood.

As far as exercise, it is a great way for her to increase her insulin sensitivity. Both weight training and cardiovascular training are beneficial. As a bonus, during (and immediately post-exercise) the increased blood flow to the muscles results in an increased uptake of glucose even in the absence of insulin!!!

All in all, I think the usual rules apply for training. Start her off slow and ease her into the gym. I’ll help with more specific advice on this if you like.

From a diet standpoint, you’ll can set her up on a diet as you would if she weren’t diabetic. Even the high carb PWO shakes shouldn’t be a problem as she’ll have increased uptake at this time. (I’ve trained a type 1 diabetic and a type 2 and this worked fine). Until she’s adjusted to the plan I’d have her keep track of her blood sugar after eating and make changes from there.

Hey big guy.

I not only covered this yet again in my physiology class today, but my dad has type II diabetes as well.

What I did with him was follow JB’s massive eating protocol regarding the food combinations (definitely not the caloric calculations!). This combination, in combination with a higher fiber, vegetable and protein intake has definitely improved his insulin sensitivty. (He was at the point where he was going to need injections, but now he just uses glucophage)

Regarding exercise, use the principles of “How to make a T-Vixen” to get her started. Stick to machines with compound exercises and maybe an aerobics class at first; circuit training is a plus. I have been a personal trainer for years, and over and over I see people fail when they don’t take it slow coming in.

She isn’t having any very major problems regarding her health due to the diabetes yet, is she? If she is, that could change everything (I’m thinking renal problems mostly) and you would need to address those with somebody qualified in that area. If she just has been diagnosed with Type II diabetes, though, this has been the result of eating bad for years and years. Fix her diet, first and foremost. Think healthy.

I hope this helps you out man. Feel free to ask me anymore questions!

Thanks for the feedback guys. For additional info, my mother is taking Metformin (not sure of the exact dosage). Her doctor also has her on Lisinopril. Initially she was taking it for high blood pressure, and even thought its since stabilized he’s keeping her on it to help protect her organs from potential damage from diabetes. She’s also on Lipitor to help control cholesterol.

As far as exercise goes, she rides a stationary bike for 35 min. in the morning.

She hasn’t yet experienced any major additional complication from her diabetes yet. Thanks again for the advice.

I am in the type 2 club as well. While insulin production/usage defficiency is the actual physical problem the big picture problem is a breakdown in the body’s ability to store energy. So IMO the best approach to stabilize blood sugar levels is to keep the body out ‘storage’ mode as much as possible.

This is accomplished by breaking down food intake into as many smaller meals as possible (8 per day for me) and keeping the overall GI low. This regularly tops up the body’s energy (ie caloric) needs. Opposed to the person who eats 3 large meals per day who requires large insulin levels to store the large energy intake. Then goes catabolic for the next 5-6 hours breaking down the recently stored fat till the next big meal. I recommend splitting your carb intake up over all your meals - not a P+C and P+F split unless you are doing moderate/intense exercise and using PWO nutrition protocol.

However to do this, one has to plan meals and keep a food log . Otherwise you are only guessing what you are eating. Once you switch to this type of a plan blood sugar levels should stabilize but the level will depend on total calorie intake. If you are eating above maintenance calories your body will need more insulin; at or below maintenance, less is needed. The more your energy intake is spread out during the day, the more a calorie becomes a calorie; meaning the less difference between carbs, fats, and proteins energy-wise.

Exercise is important but IMO is secondary to the diet part. When you work out your appetite tends to increase to accomodate the extra energy expenditure. Im sure you have seen lots of overweight people in the gym who train hard…

Unless your mother is after a certain body composition it doesnt matter form of exercise she does. Running, swimming, weights, etc. Just as long as she achieves a comparable increase in energy ouput.

HTH

If cholesterol is a problem make sure she is eating plenty of fiber. She get get this from fruits, veggies, and there are many good fiber supplements out there.

Good advice above as well. Get her lifting as well as the bike to improve her health. This has implications for many reasons other than diabetes.

[quote]super saiyan wrote:
She’s also on Lipitor to help control cholesterol.

[/quote]

That’s not very good… http://www.westonaprice.org/moderndiseases/statin.html
http://www.westonaprice.org/moderndiseases/benefits_cholest.html
http://www.westonaprice.org/moderndiseases/bpdrugs.html
http://www.westonaprice.org/moderndiseases/diabetes.html