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The dangerous combination of type 2 diabetes and obesity is a national health-care crisis. One of the cures? Exercise. Here’s the prescription for getting healthy. Believe it or not, diabetes is one of only two main causes of death in the United States that continues to increase while all other major causes are declining. According to the CDC’s National Center for Chronic Disease Prevention and Health Promotion, 23.6 million adults and children in the U.S. have diabetes.

At issue is type 2 diabetes, which is linked to physical inactivity and obesity. Formerly called non-insulin dependent or adult-onset diabetes, type 2 diabetes accounts for 90%-95% of all diabetes cases. Alarmingly, experts estimate that as many as 5.7 million Americans are unaware that they have type 2 diabetes. In all, type 2 diabetes affects an estimated 246 million adults worldwide and accounts for 6% of all global deaths.

It’s no wonder why the medical community is so alarmed by the epidemic proportion of diabetes that’s sweeping our nation. The good news is that type 2 diabetes is preventable. That’s because the disease can be directly linked to being overweight. Regular physical activity and dietary modifications help to reverse type 2 diabetes. In fact, the correlation between type 2 diabetes and obesity is so well established that many researchers now refer to the two collectively as “diabesity.”

Here’s how diabesity develops: when you gain weight, fat cells grow more biochemically active, churning out inflammatory compounds. This inflammation, in turn, promotes insulin resistance (why inflammation leads to insulin resistance is unclear). Insulin is a critical hormone that helps regulate blood sugar. When your body becomes insulin-resistance, it loses the ability to process sugar properly, causing life-threatening consequences. This dangerous sequence of events that leads to insulin resistance is also knows as the “metabolic syndrome.”

It’s no secret that lifestyle factors are the major culprits for the diabesity epidemic. Over generations, our lifestyle and eating habits have changed dramatically, explains Francine Kaufman, MD, former president of the American Diabetes Association and current Head of the Center for Endocrinology, Diabetes and Metabolism at Children’s Hospital Los Angeles.

“These days, we are accustomed to getting out food by driving up to a drive-through window and placing our orders for ‘super-sized’ portions, says Kaufman. “But our cavemen ancestors had to work for their food. Men went out and hunted, and women foraged for nuts, berries, fruits, vegetables and roots. It was a full-time job with lots of legwork. The men often trekked great distances in their search for game.”

Diabesity is what can result when the genes that were supposed to protect us from famine collide with a sedentary lifestyle—a lifestyle that includes a neighborhood with bacon cheeseburgers on every corner.

Thankfully, many street corners also have health clubs. And that’s where an important part of the diabesity cure can be found.

Many studies have confirmed exercise’s benefits in reducing the dangers of diabetes. The Diabetes Prevention Program found that intensive lifestyle changes that include diet and exercise were more effective than the diabetes pill metformin in preventing the onset of type 2 diabetes. Other studies have similarly shown that exercise and an improved diet are more effective than medicine for people with type 2 diabetes.

What kind of exercise should type 2 diabetes consider? New data have identified specific workout routines that are especially effective against diabesity. The American College of Sports Medicine (ACSM), as part of their “Exercise is Medicine” initiative, has created an exercise protocol specifically for diabetes and other diseases

In short, both resistance training and aerobic exercise play a role in reducing diabesity. A study published in the Annals of Internal Medicine found that people with type 2 diabetes who performed aerobic exercise and also lifted weights had the biggest improvement in blood-sugar control.

Research shows that the increased muscle developed through weight training aids in the management of diabetes. As lean body mass increases, additional blood glucose is cleared from the blood. The greater the muscle mass, the more calories you burn at rest, which equates to greater weight loss. It is also important to note that losing abdominal fat is a key factor to improving insulin sensitivity.

In a study published in Diabetes Care, one group of subjects trained with weights, while a second group did stretching exercises. The weightlifters did nine different exercises three times a week that worked the major muscle groups in their upper and lower bodies.

A test of blood glucose showed significant improvements in the weightlifting group after three months of exercise, and continued to improve six months later. Subjects in both groups lost weight and fat, but the weightlifters showed gains in lean body mass, while those who didn’t lift weights showed muscle mass losses. Researchers concluded that by encouraging high-intensity weightlifting for people with diabetes, complications could be reduced in the long run.

A similar study, also published in Diabetes Care involving people with type 2 diabetes, showed that subjects assigned to the weight-training protocol had a reduction in the dose of prescribed diabetes medications after only 16 weeks of training. For those in the non-weight training group, a 42% increase in prescribed diabetes medication was noted.

A team of researchers from Heriot-Watt University in Edinburgh, Scotland, investigated the effects of high-intensity interval training (HIT) on diabetes. The subjects used exercise bikes to perform 30-second sprints at their highest possible intensity level four times daily for two days a week. After two weeks, the young men had a 23% improvement in how effectively their body used insulin to clear glucose (blood sugar) from the bloodstream.

The scientists noted that the risk of developing cardiovascular disease and type 2 diabetes is substantially reduced through regular physical activity. Unfortunately, many people feel they simply don’t have the time to follow a structured program. The results of this study showed that just seven minutes of exercise each week helped a group of men control their insulin.

Current exercise guidelines recommend that people should perform moderate to vigorous aerobic and resistance exercise for several hours per week. While these guidelines are a widely accepted standard, a lack of compliance indicates the need for an alternative. This novel approach may help people to lead a healthier life simply by making it easier for people to find the time to exercise.

The true test of a change in lifestyle is not whether it works quickly but whether it can be followed successfully over the long term. Whether it’s a 20-minute walk around the neighborhood, taking the stairs at work or setting the morning alarm early enough to get to the gym, it’s all about taking the first steps to create a new healthy habit. “You need to set realistic goals—ones you can accomplish. If you do that, over time you will not only lose weight and become more fit, you will help prevent obesity and many of the complications it brings, such as type 2 diabetes,” says Kaufman.

Establishing a new lifestyle pattern isn’t easy, but if the overall outcome is health and longevity, it’s well worth it.

Get Active! By the Editors. The Active Life. Exercise and Fitness.

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