Is diet and exercise management alone really effective for diabetes?

Diet and exercise are in fact the most effective treat- ments of all for most forms of type 2 diabetes, but are not primary measures for management of type 1 diabetes. In type 1 diabetes, profound insulin deficiency necessi- tates that  insulin treatment  is the  principal form of treatment. Nevertheless, attention to diet and exercise can provide benefits in diabetes control and  general health in patients with type 1 diabetes and should be included in the comprehensive treatment plan. In the case of type 2 diabetes, the reason that diet and exercise are so effective is because lack of exercise and weight gain are the most significant causes of the disease and reversal of these issues can essentially reverse the  problem  of  development  of  diabetes. 

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.