I will start with the basics. If you have T2DM and you run make sure you check your blood pressure. T2DM and hypertension go hand in hand many times. Also research has shown that resistance training helps lowering glucose levels.
Do not forget that muscles are using most of the glucose due to their size.
Best exercise for people with T2DM: Combination of endurance and strength training.
Sigal RJ, Kenny GP: New evidence for the value of supervised exercise training in type 2 diabetes mellitus. Archives of inernal medicine 2010;170:1790-1791.
Maiorana A, O'Driscoll G, Goodman C: Combined aerobic and resistance exercise improves glycemic control and fitness in type 2 diabetes. Diabetes research and clinical practice 2002;56:115-123.
Thit is very interesting. If you know someone like this tell him to find the best endocrinologist he can to see him. It could be something different than T2DM.
A sub 2:20 marathoner with T2DM would be something extaordinary. Why?
Patients with T2DM have a low VO2max, a low maximal peripheral O2 extraction and a reduced fraction of oxidative, highly responsive muscle fibers compared with healthy subjects even when matched for leveld of ambient activity.
In agreement with this, their nonobese, nondiabetic first degree relatives also have a low level of fitness and a high content of nonoxidative fibers in skeletal muscle.
The diminished VO2max in T2DM maybe explained by myocardial dysfunction, mitochondrial dysfunction and impaired increase in capillary surface area in working muscle.
Wow, I'm sure this is basic stuff to those in the know but it's all new to me. Are the type II fibers still there in T2DM patients or is it the oxidative intermediate ones that are missing. oh, and if this isn't too stupid a question, where did they go?
Found the article. It was undiagnosed Type 1.
He was actually sub-2:15:
Performance Wind Place Date
1500 Metres 3:48.0 Melbourne 19 MAR 2002
3000 Metres 8:18.02 Canberra 31 JAN 2004
5000 Metres 13:28.31 Heusden-Zolder 18 JUL 2009
10,000 Metres 27:52.10 Palo Alto, CA 02 MAY 2009
10 Kilometres 28:17 Cape Elizabeth, ME 07 AUG 2010
Half Marathon 1:01:34 Philadelphia, PA 18 SEP 2011
Marathon 2:14:37 Houston, TX 15 JAN 2012
So, is there any life threatening risk for runners T2DM?
I would not be so extreme.
Exercise is the best thing for improving your health and your quality of life.
Unfortunately, someone with T2DM has higher cardiovascular risk.
I would advise someone with diabetes type 2 to have a full consultation with a doctor whose specialty is diabetes. Especially for blood pressure measurements since hypertension is very common in people with T2 diabetes.
The other problem is that more often than not, people with type 2 diabetes are not very fit.
So it is wise to start slow, do many different kinds of exercise, increase the muscle mass, the efficiency of the cardiovascular system, the strength of the musculoskeletal system, reduce your BP, reduce your heart rate and then start thinking about running faster, training harder or participating in competitive sports.
Get healthier first. Then everything is going to get easier. Train and eat smart. Get enough sleep.