Diabetes Pathophysiology and Pharmacology 09:24

Diabetes can present with a number of unique pathologies that each require specific attention when designing exercise sessions and exercise training programs:

Type I Diabetes Mellitus is an auto-immune or idiopathic disease with impairment of the functioning of pancreatic beta cells resulting in their inability to produce insulin. This requires the regular administration of insulin to stimulate the uptake of glucose at the skeletal muscle.

Type II Diabetes Mellitus (formerly adult-onset or non-insulin-dependent) is a progressive loss of insulin secretion from pancreatic beta cells as a result of skeletal muscle becoming resistant to its effects. This is typically a result of chronically elevated blood glucose and over-secretion of insulin during early disease progression.

Risk factors for type II diabetes mellitus include:

  • 45 yrs or older
  • Hypertension
  • Hypercholesteremia, hyperlipidemia, low HDL
  • BMI ≥ 25kg/m2 or abdominal/central adiposity
  • Female having delivered > 9lb baby or past-diagnosis of gestational diabetes
  • Impaired glucose tolerance or impaired fasting glucose

Complications from type II diabetes mellitus include:

  • Hyperglycemia
  • Ketoacidosis
  • Hypoglycemia (as a result of treatment)

And can result in:

  • Macro and microvascular complications (coronary artery disease, diabetic retinopathy)
  • Peripheral neuropathy (loss of sensation)
  • Autonomic neuropathy (elevated resting HR)

Gestational Diabetes Mellitus is typically diagnosed in the 2nd or 3rd trimester of pregnancy and may be resolved following birth. It is also associated with elevated blood glucose and the reduction in the effect of insulin.