Is diet and exercise management alone really effective for diabetes?
Answer:
Diet and exercise are in fact the most effective treatments of all for most forms of type 2 diabetes, but are not primary measures for management of type 1 diabetes. In type 1 diabetes, profound insulin deficiency necessitates that insulin treatment is the principal form of treatment. Nevertheless, attention to diet and exercise can provide benefits in diabetes control and general health in patients with type 1 diabetes and should be included in the comprehensive treatment plan. In the case of type 2 diabetes, the reason that diet and exercise are so effective is because lack of exercise and weight gain are the most significant causes of the disease and reversal of these issues can essentially reverse the problem of development of diabetes. However, if one loses weight, one is able to travel back down the slope of diabetes to a large extent. Reduction in weight can reduce or even eliminate the need for medications in many patients, even those who have been on insulin injections for several years. The most striking example of this is bariatric surgery, which has been shown to reverse diabetes and to do so for several years, being effective as long as weight reduction is maintained. Exercise works by making the body more sensitive to the actions of insulin and also by using up stored energy in the exercising muscles. The muscles then replace this energy by pulling in glucose and other sources of energy from the bloodstream. While this process can occur to some extent without insulin and in the absence of exercise, it occurs much more efficiently when the muscles are conditioned through regular exercise and normal levels of insulin are present. In addition, exercise helps to prevent recurrence of weight gain after successful attempts at reduction through diet. However, the longer diabetes has been present, the less effective diet and exercise are likely to be as treatment, although they are virtually always beneficial to some extent. Unfortunately, however, as we all know, there are many factors working against our ability to succeed in managing diabetes with diet and exercise in modern society. Longstanding success with diet and exercise alone is therefore the exception rather than the rule.
