Exercise for Diabetes: Resistance Training

Aerobic exercise, also known as “cardiovascular” or “endurance” exercise, is the type of workout most people think of when they’re trying to keep fit. And with good reason, as the health benefits it provides are numerous.

But it’s also vital to tend to your muscles—especially if you have type 2 diabetes. Adding resistance exercises to your workout routine can lower blood glucose and decrease insulin resistance— which may ultimately lower your risk of heart disease. And recent evidence suggests it may even improve your quality of life.

What is resistance training?

Resistance training (also called weight training or strength training) is any movement that requires the body to exert or resist force. Lifting weights (using a weight machine or free weights such as barbells, dumbbells or ankle weights), is the most common type of resistance exercise. Exercises where force is exerted against one’s own body, such as push-ups and sit-ups, are also forms of resistance exercise, as are exercises done against a resistance band. In resistance exercises, the muscles lift or move more weight than they are accustomed to, which strengthens them.

Compelling evidence of the benefits of adding a resistance component to your aerobic exercise plan comes from the HART-D (Health Benefits of Aerobic and Resistance Training in Individuals with type 2 Diabetes) study. The investigators recruited 262 sedentary adults with type 2 diabetes, ages 30 to 75, and randomly assigned them to either:

• an aerobic-training-only group,

• a resistance-training group,

• a combination group that performed aerobic and resistance training, or

• a self-directed control group.

All exercise groups were supervised, and each group had HbA1c blood tests at the start and end of the nine-month study to assess long-term changes in blood glucose control.

The findings, which were reported in 2010 in The Journal of the American Medical Association, showed that 140 minutes a week of a combination of aerobic and resistance training had greater benefits on blood sugar levels, fitness, and weight control than either aerobic or resistance training alone.

A more recent analysis of the HART-D data was published in 2014 in Medicine & Science in Sports & Exercise. In that study, investigators looked at data from participants who had both type 2 diabetes and metabolic syndrome—a cluster of risk factors including elevated triglycerides, HDL cholesterol levels, and high blood pressure that when present increase the risk of heart disease. They found that the combination aerobic and strength-training program reduced metabolic syndrome scores and the prevalence of metabolic syndrome.

Another benefit reported by the HART-D investigators in 2013 in Diabetes Care: Participants in the combined exercise group had greater improvements in assessments of their mental health and vitality than their counterparts in the other groups.

Starting resistance training

Don’t let age be a deterrent for starting a resistance exercise program. Studies have shown that older people can benefit just as much as younger ones. Resistance training may be even more important for older people, as it can also help reduce bone loss and prevent fractures. Before starting resistance training, be sure to get your doctor’s OK.

The American Diabetes Association and American College of Sports Medicine recommend that people with type 2 diabetes perform moderate to vigorous resistance training at least two to three days each week. You can use weights, resistance bands, or common objects from your home; for example, an 8-ounce can of food. Or, you can use the strength-training equipment at a fitness center or gym. Start out with light weights. Try to exercise all five of the major muscle groups (chest, back, arms and shoulders, abdominals, legs) for 30-minute sessions each, but don’t exercise the same muscle group on any 2 days in a row. Your muscles need time to recover.

If you have never used weights before, schedule some time with a personal trainer or fitness instructor at a gym or community center. She or he can show you how to use the equipment properly, as well as determine the appropriate weight and number of repetitions that are right for you.

For more on exercise with diabetes, see Two Resistance Exercises to Try.