The treatment of Type 2 diabetes is never one-size-fits-all – it’s always individualised and depends on the patient's unique medical history, lifestyle and preferences.

“There are many facets to prevention and treatment, including diet, exercise, medication and lifestyle modification,” says Dr Micky Sunnyraj, a physician and expert in diabetes at Mediclinic Newcastle. “It’s important to work with various healthcare providers to develop a personalised treatment plan that meets the individual's needs.”

Understanding diabetes

At the heart of the problem of Type 2 diabetes is mitochondrial inefficiency, Dr Sunnyraj says.

“Mitochondria are the powerhouses of our cells, and they’re responsible for converting food into energy. When mitochondria are inefficient, they produce less energy, which can lead to a variety of health problems, including fatigue, weight gain and insulin resistance.”

Exercise is one of the main pillars to prevent and treat Type 2 diabetes.

“Exercise helps to improve mitochondrial efficiency by increasing the number and size of mitochondria in our cells.”

Top tips

“I always recommend patients get guidance from a healthcare professional when starting an exercise programme,” Dr Sunnyraj says.

“Exercising incorrectly can lead to injury. A physiotherapist or biokineticist can help you to create an exercise programme (focusing on balance, stability and flexibility) that’s safe and effective for your individual needs.

He does, however, have the following recommendations:

  • Strength training is essential for improving mitochondrial efficiency. It helps to build muscle mass and stave off muscle loss in ageing, which increases the number of mitochondria in our cells. Strength training should be done by people of all ages, with a focus on the hip abductors, hip flexors, hamstrings, quadriceps, core muscles, chest, shoulders, and back muscles. Examples of strength training include lifting weights, working with resistance bands, heavy gardening such as digging and shovelling, climbing, hiking and doing push-ups, sit-ups and squats.
  • Aerobic exercise is also important for improving mitochondrial efficiency. “It helps to increase the size of mitochondria in our cells. Aerobic exercise can be divided into moderate-intensity and high-intensity exercise. Examples of moderate-intensity exercise include brisk walking, water aerobics, riding a bike, playing doubles tennis, pushing a lawnmower and hiking. Moderate-intensity aerobic exercise should be done daily, aiming for   60% of your maximal heart rate, Dr Sunnyraj says. You can gauge this using the talk test: you should be able to talk in complete sentences without becoming too short of breath. “Once you’re comfortable with moderate-intensity aerobic exercise – I generally recommend a period of six months – you can start high-intensity aerobic exercise, such as VO2 max training.”
  • VO2 max, also known as maximal oxygen consumption, is the maximum amount of oxygen your body can use during intense exercise. “It’s a measure of your aerobic fitness and is often used to assess athletic performance,” Dr Sunnyraj says. “The higher your VO2 max for your age, the more efficient your mitochondria are.” A good example of VO2 max exercising is running hard for two minutes, then recovering for two minutes, or running for 400m then walking for 400 m. To improve your VO2 max, keep adding a minute until you’re working hard for six to eight minutes before you slow down.

“By following an exercise programme and eating a healthy diet, you can improve mitochondrial efficiency and reduce your risk of metabolic dysfunction and type 2 diabetes,” he adds.

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