Type 2 diabetes is a prevalent and chronic metabolic disorder that arises when the body cannot use insulin properly, resulting in elevated blood sugar levels. This form of diabetes is largely associated with lifestyle factors like eating foods that are highly processed or highly refined, poor diet, poor meal timing, being overweight or obese, a sedentary lifestyle (too much sitting), chronic stress, poor sleep. Although medications are frequently prescribed to manage the condition, growing evidence suggests that exercise can be a potent tool in both the prevention and reversal of type 2 diabetes. This article will explore how exercise can aid in reversing type 2 diabetes and its numerous associated benefits. [1]

The Role of Exercise in Blood Sugar Regulation

At the core of type 2 diabetes is insulin resistance, where the body's cells no longer respond adequately to insulin. Insulin acts as a gatekeeper, helping glucose enter cells where it's used as energy. Without this efficient mechanism, glucose remains in the bloodstream, resulting in high blood sugar levels.

Exercise, however, can mimic the role of insulin. When muscles contract during physical activity, they consume glucose for energy, which leads to a decrease in blood sugar levels. A simple way to think of it is that “active working muscles are blood sugar sponges.” This happens regardless of insulin's presence, thus giving exercise an inherent advantage in managing blood glucose levels. [2]

Types of Exercise Beneficial for Type 2 Diabetes

Aerobic Exercise: Aerobic exercise is rhythmic physical activity that raises the heart rate, breathing, and circulation for a sustained period. Examples include walking, jogging, swimming, cycling, and dancing. The primary energy source during aerobic activities is carbohydrates, initially in the form of blood glucose and later stored glycogen, with fat metabolism also contributing when the duration extends. [3]

During aerobic exercise, the body demands more energy. The muscles respond by upping their uptake of glucose from the bloodstream. This action lowers blood sugar levels.

Moreover, the increased sensitivity to insulin during and post-exercise means that cells can absorb and use glucose more effectively. In essence, aerobic exercise acts as a temporary insulin substitute, bypassing the body's resistance to its own insulin in type 2 diabetes.[4]

Resistance Training: Resistance training, also known as strength training or weight training, encompasses exercises that force muscles to contract against an external resistance, such as dumbbells, kettlebells, resistance bands, or even one's own body weight. Over the years, the benefits of resistance training for individuals with type 2 diabetes have become increasingly clear. This is mainly due to the profound effects it has on improving muscle mass, strength, and overall metabolic health. [5]

Just like aerobic exercise, resistance training also enhances insulin sensitivity. When insulin sensitivity is improved, muscle cells can better uptake glucose from the bloodstream, reducing overall blood sugar levels. Regular resistance training leads to increased glucose transporter type 4 (GLUT4) protein in muscles, which plays a significant role in glucose uptake.

Muscle is metabolically active tissue. This means that the more muscle you have, the higher your resting metabolic rate. By increasing lean muscle mass, resistance training helps the body burn more calories, even at rest. This aids in weight management, which is crucial for those with type 2 diabetes, as obesity is a key risk factor. [6] Increasing the metabolic rate helps keep weight in a healthy range.

Several studies have shown that resistance training can lead to reductions in Hemoglobin A1C (HbA1C) levels, a long-term measure of blood glucose control. A reduction in HbA1C signifies better management of blood sugar over an extended period.

Although resistance training is not as efficient as aerobic exercise in burning calories during the activity, the increased muscle mass can boost resting energy expenditure. Additionally, resistance training can specifically target and reduce visceral fat, the deep abdominal fat associated with increased diabetes risk. [7]

Benefits of Exercise in Reversing Type 2 Diabetes

Improved Insulin Sensitivity: Exercise plays a pivotal role in enhancing insulin sensitivity. When we engage in physical activity, our muscles require energy, sourced predominantly from glucose. To meet this demand, muscle cells increase their uptake of glucose from the bloodstream.

Simultaneously, exercise activates various cellular pathways in muscles, promoting the efficient use of insulin to transport glucose into cells. Over time, regular exercise trains our cells to respond better to insulin, reducing the amount needed to maintain optimal blood sugar levels. Consequently, this improved insulin sensitivity helps in the prevention and management of type 2 diabetes, showcasing the profound metabolic benefits of consistent physical activity. [8]

Weight Management: Weight management is crucial in addressing type 2 diabetes. Excess body fat, especially around the abdomen, can promote insulin resistance, where the body's cells don't respond properly to insulin.The cells become more efficient at storing fat than burning fat and glucose for energy.

Restoring or maintaining a healthy weight can improve insulin sensitivity, ensuring that glucose is efficiently absorbed from the bloodstream into cells. This not only aids in stabilizing blood sugar levels but also can reduce the need for diabetes medications, ultimately helping to prevent and manage the disease, and reverse it where possible. [9]

Heart Health: Exercise bolsters heart health in numerous ways. Regular physical activity strengthens the heart muscle, enabling it to pump blood more efficiently throughout the body.

It also aids in maintaining optimal blood pressure levels and improving cholesterol profiles. By enhancing blood circulation and promoting the elasticity of blood vessels, exercise reduces the risk of cardiovascular diseases, such as heart attacks and strokes. Overall, consistent exercise is a keystone for a healthy and resilient cardiovascular system. [10]

Mental Health and Well-being: Exercise offers profound benefits for mental health and well-being. Engaging in physical activity releases endorphins, and natural mood elevators, which combat stress, anxiety, and depression. [11]

Regular exercise also promotes better sleep, a vital component of mental health. Furthermore, it fosters a sense of accomplishment, boosting self-esteem and resilience. By offering a constructive outlet for stress and a means to experience social connection, exercise serves as a holistic enhancer of mental wellness. [12]

Reduction in Medication: Exercise positively impacts blood sugar regulation by enhancing insulin sensitivity and promoting glucose uptake by muscles. As a result, individuals with type 2 diabetes who engage in regular physical activity often experience better glycemic control. 

Over time, with consistent exercise and improved blood sugar levels, many diabetics can decrease, or in some cases, even eliminate the need for certain diabetes medications, under the guidance of their healthcare provider. [13]

Enhanced Energy Levels: Exercise stimulates circulation and facilitates better oxygen and nutrient delivery to cells, leading to improved cellular energy production. For diabetics, regular physical activity also aids in more efficient glucose metabolism, a primary energy source. As blood sugar is better regulated, energy fluctuations decrease. 

Consequently, diabetics who exercise consistently often report enhanced vitality, reduced fatigue, and a more stable energy balance throughout the day, fostering an overall sense of well-being. [14] This helps reduce feelings of blood sugar crashes, feeling “hangry” and being on a blood sugar rollercoaster.

Prevention of Complications: Exercise stimulates circulation and facilitates better oxygen and nutrient delivery to cells, leading to improved cellular energy production. For diabetics, regular physical activity also aids in more efficient glucose metabolism, a primary energy source. As blood sugar is better regulated, energy fluctuations decrease. Consequently, diabetics who exercise consistently often report enhanced vitality, reduced fatigue, and a more stable energy balance throughout the day, fostering an overall sense of well-being. [15]

Challenges and Considerations

While the benefits of exercise are undeniable, there are challenges to consider. People with diabetes need to monitor their blood sugar before, during, and after exercise. Exercise can sometimes lead to hypoglycemia (low blood sugar) or, in some cases, hyperglycemia (high blood sugar).

It's crucial for individuals with diabetes to work closely with healthcare professionals. Starting an exercise regimen should be gradual, considering individual capacities and health conditions.

Reversing or managing type 2 diabetes with exercise is a promising approach. The benefits are manifold, from improved glucose regulation to enhanced quality of life. However, it's not just about adding exercise, but also about making it a consistent, lifelong habit.

As with any significant lifestyle change, the journey of integrating exercise into daily routines requires commitment, patience, and often a dash of perseverance. With these in tow, reversing type 2 diabetes becomes a real and attainable goal.

So, what is the best exercise for blood sugar control? The answer is: the best exercise is the one you can do and will do! Have fun wherever possible while exercising. It all adds up to a healthier you.