Recently you were diagnosed with type 2 diabetes and you are overweight with fat around the middle of your body. You are probably unhappy with your appearance anyway and now you have high blood sugar levels to be concerned with also. What did you have for a snack just now A bowl of white rice with sweet and sour pork. If you had just exercised maybe this type of meal would have replaced the blood sugars used, if not, you have just added to your high insulin and weight loss problems.

Perhaps you have not heard of the low-glycemic index (low-GI) carbohydrate diet that keeps you energized and manages your blood sugar levels. That bowl of white rice is packed with high-GI carbohydrates and there is fat and sugar in the sweet and sour pork topping. This innocent looking meal has something to hide … it is not good for those carefully watching their blood sugar levels, or those struggling to shed extra pounds or kilograms.

There is more to a low-GI food plan than helping to form a great body shape. This food plan lowers the risk of heart disease and type 2 diabetes as it lowers your insulin levels.

By following this type of food plan you will find only small fluctuations in your insulin and blood sugar levels. This is the secret to long term health: it reduces your risk of heart disease, your type 2 diabetes, lowers your blood pressure and is also the key to sustainable weight loss.

There are two varieties of carbohydrates and the glycemic index of a food reflects how fast it hits your bloodstream:

• complex, and
• simple

Glucose is our body’s preferred energy source and is present in many foods … there are just different types of sugars broken down and absorbed at different rates.

Complex carbohydrates are sugars bonded together. It also contains fiber which helps to slow down it’s digestion and absorption providing you with a steady supply of energy.

Simple carbohydrates are absorbed almost immediately thus increasing the chance of being converted to fat due to the excess amount released into your bloodstream. Carbohydrates that breakdown quickly include white bread, rice crackers, white potatoes and wheat based breakfast foods … they have a high-GI value. The response is really fast.

Low glycemic index carbohydrate food plans have numerous benefits aside from helping your weight loss and keeping your energy levels balanced. Switching to a low-GI diet will help:

• increase your body’s insulin-sensitivity
• reduce your risk of heart disease
• enhance your type 2 diabetes control
• reduce your cholesterol levels
• reduce hunger pangs by keeping you feeling full for longer

For a low GI carbohydrate diet, you eat more:

• oats, bran, and barley for breakfast cereals,
• whole grain bread,
• sweet potato
• multi-grain bread
• pasta
• most fruit
• legumes and many above ground dark green leafy vegetables

Aim to make changes gradually but don’t fall into the trap and eat excessive amounts of low-GI foods. Over consumption will lead to weight gain not weight loss, and will not help you conquer your type 2 diabetes and your blood sugar levels.

Pathophysiology is the study of the changes seen in normal mechanical, physical, and biochemical functions that are either caused by a disease or the result of an abnormal syndrome. The pathophysiology of a given disease or syndrome describes its causes, symptoms and effects.

The pathophysiology of diabetes mellitus is a bit complicated. Diabetes mellitus, most commonly known only as diabetes, is a syndrome of disordered metabolism, usually due to a combination of hereditary and environmental causes, resulting in abnormally high blood sugar levels called hyperglycemia. There are three primary types of diabetes mellitus: Type 1, Type 2, and gestational diabetes. Each is with different behaviors and triggers but all are related and characterized by shared symptoms such as hyperglycemia.

Gestational diabetes is one of the three main types. This occurs during pregnancy and usually goes away after the baby is born. Women suffering from gestational diabetes while pregnant have an increased risk of developing Type 2 diabetes later in life. There are also other risks associated with gestational diabetes for both the infant and mother such as unstable blood sugar at birth, obesity later in life and macromasia or the condition known as "fat baby".

Type 2 diabetes is the most common form of the disease. In Type 2 diabetes, the pancreas produces insulin but the body cannot react, respond or process it properly.

Type 1 diabetes is the last type which results when the pancreas loses its ability to produce insulin. It is considered an autoimmune disorder because the body’s own immune system attacks and destroys the cells in the pancreas that produce insulin.

Symptoms of diabetes include excess thirst and hunger, frequent urination, fatigue, irritability, and unexplained weight loss. Diabetes can cause serious long term physical effects if not treated properly. Early detection is important. Treatment for diabetes can include changes to diet and lifestyle paired with medications, may it be insulin injections or oral insulin medications, depending on the type diagnosed.

Combined aerobic and resistance training may offer significant synergistic and incremental improvement in glycemic control compared with either aerobic training or resistance training alone, a review suggests.

Previous trials and studies have documented benefits of aerobic exercise for glycemic control in people with Type 2 diabetes.

To determine how intensity of aerobic exercise, resistance training, and combined aerobic and resistance training affect glycemic control, a team led by Silvano Zanuso, from the University of Padua in Italy, conducted a literature review.

Interventions with more vigorous aerobic exercise programs resulted in greater reductions in glycated hemoglobin (HbA1c), greater increase in maximal oxygen uptake (VO₂max), and greater increase in insulin sensitivity.

Regarding the effects of resistance training, the researchers write: “Considering the available evidence, it appears that resistance training could be an effective intervention to assist glycemic control, especially considering that the effects of this form of intervention as reported in the three major randomized controlled trials is comparable with that reported with aerobic exercise.”

They further comment: “There exists some controversy over whether the exercise-induced benefits of glucose and insulin control are a result of multiple single bouts of exercise or whether there is a chronic training benefit.”

Regarding combined exercise training, the researchers say that results indicate: “a combined program of strength and aerobic training could induce positive adaptations on glucose control, insulin action, muscular strength, and exercise tolerance.”

They add: “Combined exercise training resulted in an additional change in HbA1c that achieved statistical significance if compared with aerobic training alone and with resistance training alone.”

Writing in the journal Acta diabetologica, the researchers warn: “From this review, it is clear that no known studies have been conducted to address the efficacy of combined resistance and aerobic training program over the long term on a large group of patients with Type 2 diabetes.”

They also point out: “No studies have evaluated the effect of different exercise intensities on HbA1c, some selected physiological parameters (VO₂max, maximal strength, flexibility) as well as on cardiovascular risk factors.”

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a part of Springer Science+Business Media. © Current Medicine Group Ltd; 2009

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