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.