# Exercise as it relates to Disease/Reversing the Effects of Insulin Resistance with Aerobic Exercise Fact Sheet
## What is Insulin Resistance?

Insulin Resistance (IR) is a condition in which the cells of the body become resistant to the effects of insulin. Thus, a person is said to have impaired glucose tolerance / pre-diabetes. IR results in higher levels of insulin being required to maintain normal blood glucose levels. Eventually, the pancreas may be unable to keep up with insulin demand leading to long term health issues.
* 1 in 4 adults in Australia may at some time in their life have impaired glucose tolerance
* Being diagnosed with impaired glucose tolerance does not necessarily mean you will develop diabetes, but it makes you 10-20 times more likely than a normal person
* It is estimated that up to 1.8 million Australians are living with diabetes / impaired glucose tolerance

## Who is at Risk of Developing Insulin Resistance? Patients who -

| Are overweight / obese Are Aboriginal or Torres Strait Islanders Are pregnant | Have a high fat diet Have a family history of type 2 diabetes, hypertension or heart disease Have a sedentary lifestyle |

## Classic Side Effects

A patient with IR may remain asymptomatic (no signs of symptoms) for an extended period of time, classic symptoms are often linked to:
Acute Side Effects :
| Hyperglycaemia Symptoms | Hyperinsulinemia Symptoms |
| Slow Healing | Brain Fogginess (inability to concentrate) |
| Frequent Thirst | Blurred Vision |
| Frequent Urination | Fatigue |
Chronic Side Effects :
| Macro Vascular Issues | Micro Vascular Issues | Hyperinsulinemia Issues |
| Stroke | Retinopathy (Blindness) | Type 2 Diabetes |
| Heart Disease | Nephropathy (Kidney Disease) | Hypertension |
| | Neuropathy (Nervous Tissue Damage) | Bad Cholesterol |
| | | Weight Gain / Central Obesity |
| | | Polycystic Ovary Disease |

## Recommendations for Insulin Resistance Management

Always seek professional health guidance before commencing a training regime
Remember adherance to any form of physical activity is the most crucial step in reversing Insulin Resistance
Aerobic Exercise Recommendations :
| Guidelines | Benefits |
| At least 30 minutes / moderate intensity on most days of the week | Improves insulin sensitivity (Reverses IR) |
| Or at least 20 minutes / vigorous intensity three times per week | Improves quality of life |
| Influencing lifestyle choices can also contribute to daily aerobic activity | Controls blood glucose, insulin and blood pressure levels |
| • Transport - substitute driving with walking or cycling to work | Reduces the risk of obesity, death and illness |
| • Recreation - substitute indoor activities for outdoor activities | Reduces the risk of chronic IR issues |
| • Occupation - substitute the elevator for the stairs to the office | • Macro Vascular issues |
| • Home - subtitute take away for a home cooked meal | • Micro Vascular issues |
| | • Hyperinsulinemia issues |
Examples of Aerobic Activity that Meets the Guidelines :
| Low Intensity | Moderate Intensity | High / Vigorous Intensity |
| Does not cause a noticeable change in breathing rate | Able to maintain a conversation uninterrupted | Unable to maintain a conversation uniterrupted |
| • Washing | • Walking | • Jogging |
| • Cooking | • Swimming | • Aerobics |
| • Cleaning in the Home | • Social Sports | • Competitive Sports |

## Further Reading / Informational Sources

* Diabetes Australia - National Diabetes Services Scheme - http://www.diabetesaustralia.com.au/ndss/
* Department of Health and Ageing – http://www.health.gov.au/
* Exercise & Sports Science Australia - http://www.essa.org.au/
* 1 2 Appel, SJ. Sizing up patients for metabolic syndrome. Nursing 35: 20-21, 2005.
* 1 2 3 Diabetes Australia. National Diabetes Services Scheme. 2011, 2011.
* 1 2 Gallagher, EJ, LeRoith, D, and Karnieli, E. Insulin Resistance in Obesity as the Underlying Cause for the Metabolic Syndrome. Mount Sinai Journal of Medicine 77: 511-523, 2010.
* 1 2 Valensi, P, Chanu, B, and Cosson, E. Obesity, Metabolic Syndrome, Diabetes and Arterial Hypertension. Immunology, Endocrine & Metabolic Agents - Medicinal Chemistry 6: 407-423, 2006.
* ↑ Akram, T, Hasan, S, Imran, M, Karim, A, and Arslan, M. Association of polycystic ovary syndrome with cardiovascular risk factors. Gynecological Endocrinology 26: 47-53, 2010.
* ↑ Viljoen, A, and Wierzbicki, AS. Potential Options to Treat Hypertriglyceridaemia. Curr. Drug Targets 10: 356-362, 2009.
* ↑ Reinehr, T. Clinical presentation of type 2 diabetes mellitus in children and adolescents. Int. J. Obes. 29: S105-S110, 2005.
* ↑ Department of Health and Ageing. Physical Activity Guidelines. 2011, 2011.
* ↑ Exercise & Sports Science Australia. Adult Pre-Exercise Screening System. 2011, 2011.
* ↑ Nocon, M, Hiemann, T, Müller-Riemenschneider, F, Thalau, F, Roll, S, and Willich, SN. Association of physical activity with all-cause and cardiovascular mortality: a systematic review and meta-analysis. Eur J Cardiovasc Prev Rehabil 15: 239-246, 2008.
* ↑ Sassen, B, Cornelissen, V, Kiers, H, Wittink, H, Kok, G, and Vanhees, L. Physical fitness matters more than physical activity in controlling cardiovascular disease risk factors. Eur J Cardiovasc Prev Rehabil 16: 677-683, 2009.