Statistics regarding diabetes in the United States
The statistics regarding diabetes in the United States are worrying, and there is a need to look at the risk factors, invent wide-ranging pandemic control strategies, and effectively implement them. The data shows how diabetes is consuming the lives of many Americans and leading to numerous non-traumatic amputations, disabilities, and other comorbidities. Centers for Disease Control and Prevention show that about thirty-four million Americans have diabetes. Out of this number, one in five is undiagnosed. Besides, it shows that nearly eighty million United States adults are prediabetics, and about eighty percent do not know that they have prediabetes. According to the American Diabetes Association, about 1.6 million people in the United States are currently living with type 1 diabetes. This number includes over two hundred thousand adolescents and children and nearly one million adults who above twenty years old. Additionally, about sixty-four thousand Americans are diagnosed with diabetes type 1 every year. United States’ annual incidence of diagnosed type 1 diabetes was about eighteen thousand two hundred and five thousand eight hundred for type 2 diabetes.
One of the best and cost-effective interventions that have been approved to promote health among people with diabetes, prevent the progression of diabetes, and prevent healthy people from having diabetes is physical activity. Often when people hear of physical activity and diabetes, they think of maintaining healthy body weight and keeping fit. However, physical activity has a tremendous effect on pancreatic beta cells, which plays a crucial role in producing hormones essential for ensuring glucose is within the normal range, thus preventing diabetes and controlling it. Pancreatic islets beta cells are the only cells in the body that produces insulin and controls blood glucose, meaning that when they are destroyed, the body must be supported to regulate glucose levels in the body. Therefore, their development, survival, and effective functioning are crucial for the body to prevent diabetes pathophysiology and progression, thus controlling the diabetes pandemic.
Studies show that physical activity improves the functions of pancreatic islet beta cells, thus lower risks of diabetes. Zhao et al. (2018) carried a study to determine whether exercise preserves the pancreatic beta cells mass and function. The study used OLETF rats and found that exercise significantly enhances the pancreatic islets beta cells competencies, which improved glucose tolerance since the circulating pancreatic and circulating plasma levels were increased in the obese rats. Moreover, Zhao et al. (2018) revealed that exercise reduced pancreatic islets beta cells apoptosis and increased beta-cells mass. According to Tomita (2016), beta cells’ apoptosis plays a pivotal role in diabetes type 2 pathophysiology. While the etiology of T2DM is multifactorial, the loss of beta-cell mass via beta-cell apoptosis is a crucial element that speeds up diabetes type 2 and type 1 diabetes. Zhao et al. (2018) attribute loss of beta cells that result in T1DM and T2DM to apoptosis. Glucose-induced insulin secretion is the primary pathophysiology of diabetes, and studies show that inadequate secretion of insulin leads to chronic hyperglycemia, which will ultimately cause diabetes.
Besides, Zhao et al. (2018) revealed that exercise decreases the total triglycerides and cholesterol levels, which suggested a decrease in glucolipotoxicity. It attributes this decline in glucolipotoxicity to improve beta-cell mass through a reduction of the rate at which beta-cell are automatically killed via apoptosis. Glucolipotoxicity is linked to decreased beta-cell through apoptosis. Bagnati et al. (2016) show that hyperglycemia and hyperlipidemia plays a role in the decline of insulin-secreting beta cells. The study revealed that these two conditions activate transcription factors, often known as NF-κB or the nuclear factor kappa-light-chain-enhancer of activated B cells and signal transducer and STAT-1, which is the activator of transcription. Therefore by reducing hyperlipidemia, exercise decreases the death of beta cells by apoptosis, thus improving insulin secretion, which leads to a reduction in the case of diabetes.
Often Akt pathway acts as a signal transduction pathway which warrants survival and growth as cell respond to extracellular signals and often present in all cells. The pathway usually involves phosphatidylinositol 3-kinase (P13K) and Protein Kinase B, which is also known as Akt. Manning & Toker (2017) provides that the Akt network is found in almost all organ systems playing the role of warranting survival and growth of cells. The two authors note that dysfunction in the Akt pathway can lead to insulin resistance and consequential increased beta-cell death by apoptosis. The study further shows that Akt network activation happens towards phosphoinositide 3-kinase, also known as PI3K, which is a lipid kinase associated with cellular transformation as well as insulin response. This shows the impact that the Akt pathway can have on beta-cell survival and mass, which directly impacts their functioning, and Zhao et al. (2018) confirm this when they realized an improvement in beta-cell mass following an increase in Akt activation during the exercise.
Heiskanen et al. (2018), a study that aimed to show that exercise decreases pancreatic fat content and enhances beta cell functioning, revealed a higher total insulin secretion rate in prediabetic and type 2 diabetics compared to the healthy men which showed that a higher glucose level and a corresponding association between insulin sensitivity and secretion. The study showed that increased insulin secretion rate compensated for insulin sensitivity up to levels that beta cells could not compensate anymore. Besides, after the exercises, basal insulin secretion rate reduced in prediabetic and in men having type two diabetes while the early insulin secretion rate rose in healthy men. These portray an increase in pancreas islet beta cells. Pancreatic beta cells often secrete insulin when the glucose levels rise above the normal range. The islet beta cells, as stated earlier, are the only insulin-secreting cells in the body; therefore, an increase in insulin secretion rate implies an improvement in beta cells function. Heiskanen et al. (2018) concluded that two-week exercises increase beta cell functioning in both prediabetic and diabetes type 2 individuals, no matter their baseline glucose tolerance. Further, it stated that exercise lessens the ectopic fat around and within the pancreas; therefore, it can be used to decrease the risk for type two diabetes effectively. As seen earlier, a decrease in fats in the body improves beta-cell function as hyperlipidemia contributes to the decline of beta cells but promoting their death via apoptosis.
The outcomes from Heiskanen et al. (2018) study were confirmed by Shih & Kwok’s (2018) work, which revealed that that the disposition index increased in the first twelve weeks of the exercise, which showed a probable increase in beta cell functioning. The study, which was done to determine whether exercise reduced the body fat, improved insulin sensitivity, and increased beta-cell function, showed that the early impairment in beta cells could be reversible at least in later part of the exercise. It also revealed that there is a possibility that beta-cell impairment can improve with physical activity or even reversed with well manage exercise and concluded that exercise improved beta cell functioning in adolescents.
It is apparent the impact that physical activity has on pancreatic islets beta cells and how this can contribute to diabetes management. When the body has defective beta cells, glucose will not be well controlled in the body. For instance, when the body cannot produce enough insulin, glucose will accumulate in the bloodstream because there will be no insulin to facilitate its movement into the cells for metabolization. Excessive glucose in the bloodstream can cause devastating effects and numerous comorbidities. Increased physical activity leads to improved beta-cell functioning and prevents this fatal condition.