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Exercise and the Prevention of Type Two Diabetes

Exercise and the Prevention of Type Two Diabetes

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An essay for the 2012 Undergraduate Awards Competition by Stephanie Moloney. Originally submitted for Sport and Exercise Science at University of Limerick, with lecturer Brian Carson in the category of Life Sciences
An essay for the 2012 Undergraduate Awards Competition by Stephanie Moloney. Originally submitted for Sport and Exercise Science at University of Limerick, with lecturer Brian Carson in the category of Life Sciences

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Published by: Undergraduate Awards on Aug 31, 2012
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Exercise and the Prevention of Type Two Diabetes
 Approximately 90% of all diabetes cases worldwide are type two diabetes cases. Thedisease is generally known to affect adults from the age of 40, however the disease isbecoming more prominent in a younger population due to environmental factors e.g. physicalinactivity and poor diet which in turn lead to overly high blood glucose levels. Type twodiabetes is generally characterised by fasting hyperglycaemia, insulin resistance andimpaired insulin secretion. The common symptoms associated with type two diabetesinclude polydisia, polyuria, rapid and dramatic weight loss and in severe cases visionaryproblems may present themselves. One method of testing for the presence of the disease isknown as the oral glucose tolerance test. This test has the ability to identify existing sufferersof the condition as well as those who are at risk of developing disease i.e. prediabetes.Medical treatment of the condition usually consists of antihyperglycaemic medication suchas Sulphanylureas, however it is also possible to prevent the development of type twodiabetes with the correct lifestyle alterations. During exercise, muscle glycogen and glucoselevels lower significantly which in turn causes the need for these levels to be replenished. Also during physical activity contracting skeletal muscle causes higher levels of glucoseuptake from the blood than it would at rest. Because of this, insulin sensitivity improves.Even after physical activity ceases the positives effects, the increased levels of glucoseuptake, still exist. Much of the intervention studies in relation to physical activity and itsinvolvement in the prevention of type two diabetes also feature a dietary intervention so it isdifficult to say whether it is physical activity alone that causes these positive results however it is clear that the prevention of the condition is greatly aid by the participation in physicalactivity.
Exercise and the Prevention of Type Two Diabetes
Exercise and the Prevention of Type Two Diabetes
In a study carried out by King
et al.
it was suggested that the number of worldwide diabetics,both type 1 and type 2, will increase from 135 million in 1995 to 300 million in 2025 (1998).It would appear that these estimations are correct as in 2009, there were over 100 millionknown cases of type 2 diabetes alone (Surampudi
et al 
Table 1: Table displaying demographics for estimated diabetes prevalence in Ireland.
Population(000) Prevelance(%)Male Female Age20-44 Age45-64 Age>65Total1995 2,345 1.8 21 22 3,000 18,000 22,000 4,30002000 2,488 1.8 22 24 3,000 20,000 23,000 46,0002025 2,842 2.3 32 34 3,000 28,000 36,000 66,000
(Sourced from: King et al. 1998)
 As can be seen in table 1.1, the estimated prevalence of type 1 and type 2 diabetes inIreland in 2025 is 2.3% of the population. If the population of Ireland today is approximately4,481,430 (Google Public Data Explorer 2011) and the number of type 2 diabetes cases isapproximately 129,052 (Institute of Public Health in Ireland 2006) it can be calculated thatthe estimated prevalence of type 2 diabetes in Ireland for 2011 is at least 2.8%. This figuresurpasses the estimate made by King
et al.
in 1998 for type 1 and type 2 diabetescollectively. This is a stark and shocking percentage and indicates that type 2 diabetes hasbecome an epidemic not just in Ireland but worldwide. It is clear that preventative measuresneed to be put in place to counteract the development of the disease. Before commencingthe discussion of the methods by which type 2 diabetes can be prevented it is first necessaryto explain and understand the pathophysiology of the disease.Type 2 diabetes, previously known as non-insulin dependent diabetes mellitus is the mostcommon form of diabetes as it accounts for approximately 90% of all cases worldwide.Typically, the disease affects adults from the age of 40 (Nolan 2006). As age increases,insulin resistance increases and glucose tolerance tends to decrease, which leads toincreased prevalence of the disease. As previously mentioned, the incidence of the diseasesharply rises after the age of 40, most likely identifying an alteration in glucose tolerance. It
Exercise and the Prevention of Type Two Diabetes
has previously been considered that blood glucose levels in early childhood were low andincreased progressively over time, however in the past number of decades environmentalfactors such as physical inactivity and poor diet have led to higher than average bloodglucose levels in earlier childhood leading to the development of the disease within this agegroup (Bullock 1996).Type 2 diabetes is characterised by fasting hyperglycaemia. This hyperglycaemia occursregardless of the availability of insulin (Porth 1998, p.812). It has been stated that the
development of type 2 diabetes comes about from a combination of the subject’s genetic
makeup and also from their surrounding environment. This along with increasing obesitylevels is resulting in the condition becoming an epidemic (Kahn 2003). A representation of this can be observed in figure 1. There is an expansive range of literature on type 2diabetes. Due to the fact that research in the area is constantly ongoing, there are a number of differing suggestions with regards to the main characteristics and contributors to thedisease. The characteristics which relate to the development of the disease that featuremost frequently within the literature are insulin resistance and impaired insulin secretion. For the development of type 2 diabetes to occur, these factors must be present (Sheen 2003a).The secretion of insulin occurs when levels of blood glucose drop below normative values.One of the most important functions of insulin is to aid in the transportation of glucosecontained within the blood to body cells (Bobick and Balaban 2008). Insulin resistance canbe defined as the subnormal biological response to normal or regular quantities of insulin(Temple
et al.
1992). Decreased insulin-related storage of glycogen in both the liver andmuscle is a manifestation of insulin resistance. The reasoning behind this may be due toabnormalities in the translocation of muscle glucose transporters kn
own as GLUT 4’s. This
can occur even if GLUT 4 is in correct working order (Dela
et al.
1994). The abnormalities inthe translocation of GLUT 4 stimulate insulin to be secreted from the beta cells within theislets of Langerhanns of the pancreas. This secretion of insulin is an attempt to overcomethe increased demand to maintain appropriate glycemic state (Porth. 1998, p. 812). Thisbeta cell secretion initially compensates for insulin resistance, however beta cell functionreduces as glucose tolerance deteriorates. Due to this, major abnormalities with beta cellfunction are observable by the time type 2 diabetes has developed (Cavaghan
et al.

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