Working with type 2 diabetes

PT Magazine - November 2014
PT Magazine – November 2014

T2DM is an increasingly common condition here in the UK, and is set to increase due to its close correlation to obesity and negative lifestyle factors. Currently there are around 3 million type 2 diabetics in the UK. Many of these have lifestyle interventions such as improved diet and exercise as a key part of their treatment plan. This means that as an fitness professional you are in a key position to help with this disease and help sufferers reduce the effects of type 2 diabetes.


Type 2 diabetes is a condition where blood sugar rises; this is caused by two key factors. Firstly the bodies cells have become resistant to insulin, one of the key hormones involved in the regulation of blood sugar. Alternatively the pancreas does not produce enough insulin to cope effectively with demand. Both these situations leads to the sufferer having high levels of glucose circulating in their blood, which has a damaging effect on the body.


Exercise is important to a diabetic as it helps to improve blood glucose control, as exercise has an insulin type effect. It also helps to reduce excess body weight and then keep it under control. Exercise also helps to reduce blood pressure, resulting in a knock on effect on overall health risk. All these factors greatly reduce the risk to a diabetic from further diabetic complications and greatly reduce the effect of this disease on the sufferers life.


There are not many signs and symptoms when the client is in a pre-diabetic state, but as the condition progresses the following may be observed:-


  • excess thirst and urination
  • hunger
  • weight loss or gain
  • blurred vision
  • slow healing of wounds
  • recurrent infections
  • silent angina or myocardial infarction
  • hypertension
  • hypercholesterolemia


It is recommended that T2DM clients take part in aerobic activity 3 times per week, building up to 30 minutes, at an intensity of around 50-70% of heart rate maximum. In early stages of exercise it may be necessary to split the training time across two sessions in the day, allowing clients to slowly build up to this 30 minute target. In many cases sufferers may have been inactive for a number of years so it is important to consider what type of activity would be most likely to be adhered to. This means that the use of activities of daily living should be considered first.


In terms of resistance training a full body resistance programme should be implemented 2-3 times per week. The client should aim to work in the hypertrophy zone using a single set of 8-12 reps. This type of activity will help to improve lean muscle mass and this will then have an effect on overall metabolic rate, helping to control weight.


A general stretching routine (done 2-3 times per week) would also be very beneficial, this should cover the full body and stretches should be held for 15-30 seconds.


Generally when training clients with T2DM the following precautions should be taken:-


  • If the condition is currently considered uncontrolled, it may be wise to refer the client until they have the condition controlled.
  • Exercise 1-2 hours after meals to ensure adequate glucose/glycogen stores are available.
  • Be aware of delayed hypoglycemia which may occur 36 hours after intense exercise, the client should be made aware of this and encouraged to monitor blood glucose levels.
  • Drink plenty of water before and after the sessions.
  • Regular foot inspection to identify any potential issues and if observed refer to a medical professional.


On the whole exercise should be seen as a very positive thing for a diabetic to take part in, and greatly reduces the effect of the disease on their life. As a fitness professional you can play a key role in fighting this disease which is so easily tackled by living a healthy life.

Tom has been involved in the fitness industry for nearly 20 years. He is a specialist in rehabilitation, exercise referral and helping other fitness professionals to improve their business. He is also involved with course development, teaching, assessing and IQA of a range of training courses. He is always willing to meet other professionals so please do contact him via social media with any questions or just to say hello.

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