Weight training and diabetes

Strength Training: A Great Tool for Diabetes Management

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If you are staying active by focusing on aerobic exercise, you may not be reaping all the benefits of an effective type 2 diabetes exercise plan. Aerobic exercise is terrific — it can improve heart health and lower your risk for heart attack or stroke. But strengthening your muscles is another important part of staying healthy when you have type 2 diabetes.

When you exercise with weights or other forms of resistance, it can be especially helpful for controlling blood sugar levels. “A lot of the resistance training actually improves insulin sensitivity,” says Dawn Sherr, RD, a certified diabetes educator with the American Association of Diabetes Educators. “Your blood sugar may not be as elevated if you develop more muscles.”

Lift Weights to Control Type 2 Diabetes

When you do strength training exercises that target muscles, your body uses glucose from your bloodstream to power them, which can help clear out excess sugar from your system. “It actually signals the glucose to enter the muscle cells,” says Joey Gochnour, MEd, RD, LD, a nutritionist and certified personal trainer with the Division of Recreational Sports at the University of Texas in Austin. Toned muscles also store glucose more effectively, and that helps regulate blood sugar even when you’re at rest.

Strength training also helps build stronger bones, according to the Centers for Disease Control and Prevention (CDC). And it promotes weight loss — an important goal for many with type 2 diabetes — because the more muscles you have, the more calories you burn.

Keep in mind that strengthening exercises are just one part of a well-rounded fitness program. In addition to strength training twice a week, the U.S. Department of Health and Human Services recommends that adults also get at least 150 minutes of moderate-intensity aerobic exercise, such as jogging or cycling, each week.

“I always recommend that people do both,” Gochnour says. In fact, while both aerobics and strength training are helpful when you have diabetes, a long-term program of both produces the greatest health benefits, according to a 2013 study in the Journal of Clinical Endocrinology and Metabolism.

Three Strength Training Exercises to Get You Started

Motivated to add strength training to your fitness routine, but not sure how? Here’s how to get started.

If you’ve never done strength training, start slow and resist overdoing it. Steady progression is key. For instance, with exercises involving handheld weights, choose a weight that you will be able to lift for one set of 8 to 10 reps, suggests the CDC. Work toward completing one set of 15 reps each and then move on to higher weights and/or two to three sets.

Always rest muscles at least one day between sessions. If you feel sore, ease up until you feel better. “You can still make progress if you only train once a week,” Gochnour says.

You can strength-train with free weights, resistance bands, and exercises that use your own body weight as resistance. At the gym, try weight machines, which are often better for learning proper form. Gochnour suggests working with a personal trainer to find the best exercises for you.

If you want to do strength training exercises at home that require little or no extra equipment, these simple moves can get you started:

Chair dips. Stand with your back to a sturdy chair or low table. Sit on the edge of the chair, with your arms behind you. Place your palms on the edge, fingers pointed toward you. Lift your buttocks off the chair and walk your feet forward, making sure your knees don’t bend past your toes. Slowly bend your elbows, lowering your body down, and then straighten. This works several upper-body muscles, including the triceps (rear upper arm), deltoids (part of the shoulder), and pectoral (chest) muscles.

Wall squats. Stand with your back against a wall, feet about a foot in front of you. Bend your knees as you lower your back along the wall until you are in a position similar to one you’d be in if sitting in a chair. Hold for several seconds, then return to standing. This works the quadriceps and hamstrings (front and back of the thighs).

Curls. Hold a lightweight dumbbell in each hand, arms at your sides with palms facing up. Holding elbows steady, curl up your forearms to bring the weights almost to your shoulders, then return to starting position. If you don’t have dumbbells, try this with two soup cans or water bottles. Curls work the biceps (muscles on the front of upper arms).

For each of these exercises, aim for one or two sets of 8 to 12 repetitions.

Managing Blood Sugar While Strength Training

Check with your doctor before starting a strength training program. As with any exercise, strength training can lower your blood sugar level, so you should check your blood sugar before and after exercising to see what kind of effect the activity has on your body. If your blood sugar dips too low, you may want to have a snack before or during your routine. It may also be a good idea to talk to your doctor about changing your medications to allow for your increased physical activity.

Above all, be smart about your new exercise routine to keep it safe and enjoyable. “The best thing to do is start slow,” Sherr says. “You can gradually increase the intensity and reach your goals.”

Diabetes and Strength Training – What You Should Remember

This article does not constitute medical advice. Please see your licensed medical physician for information about how best to manage diabetes in your individual case. It’s always a good idea to talk to your doctor before starting a new diet or exercise regimen.

There are a lot of misconceptions surrounding diabetes. Perhaps the most persistent, at least in the world of strength sports, is that people with diabetes should avoid lifting heavy and stressing their bodies as much as other athletes.

The truth is that exercise, including intense exercise and strength sports like powerlifting and weightlifting, can be appropriate and even recommended for patients with the disease. (Just ask Matthias Steiner, an Olympic weightlifting gold medalist who was diagnosed with Type 1 diabetes at eighteen.)

“The benefits of exercise for people with diabetes are too numerous to list,” says Dr. Sheri Colberg, an exercise physiologist and founder of Diabetes Motion. “Basically, all of the benefits that anyone gets from exercise are the same for people with diabetes, and they have the added benefits of often being able to manage their blood glucose levels better and reduce anxiety and depression associated with diabetes management.”

When it comes to managing the disease, a lot of recommendations are similar to those made for the general population: eat plenty of vegetables, get plenty of exercise, keep your body fat low, avoid sugary foods.

But exercise also affects blood sugar, which is why there are a few things to keep in mind if you have diabetes and you want to try out powerlifting or weightlifting.

Exercise and Blood Sugar

“Exercise is going to make your cells more sensitive to insulin over the long term, so they’re going to do a better job of taking up glucose and using less insulin,” says Amanda Kirpitch, MA, RD, CSSD, CDE, a dietitian practicing in New York City. “So there’s always going to be benefits from exercise.”

For a period of two to seventy-two hours after exercise the body does a better job of using insulin, which is why insulin needs are generally lower in people who exercise regularly. (Though these benefits can be diminished by overeating.)

But Don’t Cardio and Lifting Put Different Demands On the Body?

Yep. For people with diabetes, the main thing to note is that intense lifting can cause a temporary increase in blood glucose levels, compared to cardio training which usually causes a decrease.

“The biggest difference between powerlifting and cardio is the impact on glucose levels,” says Kirpitch. “There’s often a rise in glucose that people don’t anticipate when they do anaerobic activity, strength training, things of that nature, compared to running. People assume that any exercise is going to result in lower blood sugar, and they then come out of an anaerobic strength workout and they have no understanding to how that manifests. So it’s a very different type of situation.”

So what should you do before, during, and after a workout to maximize benefit and minimize risk? It depends on your potential for low and high blood sugar, which varies by patient.

“If you’re not on insulin, the target blood glucose can be lower before starting exercise,” says Kirpitch. “But if you’re on insulin, you probably want the blood sugar to be at least over 100 for powerlifting and weightlifting, even 120. It doesn’t need to be as as high as it needs to be for cardio, because with lifting the blood sugar is likely to rise.”

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Whether and how much your blood sugar increases from lifting weights depends on how well-trained you are — the newer you are to lifting, the more likely it is to rise during or immediately after a workout due to counter-regulatory hormones. If you are newish to lifting and you’re working out an hour or more, it might be a good idea to consume thirty to sixty grams of carbs after an hour of work. A cardio warm-down can also help to stabilize blood sugar.

“Powerlifting and weightlifting result in benefits that are directly related to the type of activities these are,” adds Dr. Colberg. “In general, having a greater amount of muscle mass is beneficial because it increases the size of the ‘muscle tank,’ or the primary place we have to store carbohydrates in the body as muscle glycogen. Gaining and keeping as much muscle as possible over a lifetime is beneficial to blood glucose management. Keeping the muscle tank partly empty due to recent activity also increases insulin action. So doing intense activities like powerlifting use up a lot of muscle glycogen, and insulin action will be increased during the time it is being replaced post-exercise.”

That said, people with diabetes are also more prone to overuse injuries, so it’s particularly important for them to do accessory exercises and not perform the exact same heavy workouts every week. But as far as training frequency and intensity, people with diabetes don’t usually need to train very differently to people without it unless otherwise indicated by their doctor.

On Meet Day

So what about on the day of a weightlifting or powerlifting meet? When you’re pushing your body to its absolute limits and your max lifts are being spread out over a period of hours, is there anything different about how you should approach things?

Kirpitch says preworkouts like caffeine, BCAAs, and l-arginine are fine and shouldn’t have a big impact on blood sugar, but she advises against the old crush-a-box-of-donuts strategy.

“You’re always going to be better off with a more balanced intake, pre-workout and throughout the day. High carb is good, but you want to balance that with protein if you can and fat if you can tolerate it, because that’s going to give you a slower rise in glucose. You’d be better off getting a rise that lasts longer, because if glucose rises rapidly, there may be a mismatch with insulin in which case you may dampen your performance.”

Matthias Steiner, Olympic weightlifting gold medalist who has Type 1 Diabetes.
Image via Dacoucou, licensed under CC BY-SA 3.0 and @brandalarm34 on Instagram.

On Bulking Cycles

She also notes that while some powerlifters happily gain significant levels of body fat so as to increase their strength and move up weight classes, this isn’t a good idea if you have diabetes as the disease confers a higher risk of cardiovascular disease.

“There’s no doubt that the overweight fit person is in better health than the person who’s overweight and not fit,” she says. “But you don’t want to increase your body fat significantly, especially if there’s a lot of weight cycling. We would argue that nobody should be doing that. Carrying extra weight may increase joint issues and other health problems, even if you’re fit.”

It’s also strongly recommended that in addition to lifting weights, you engage in some sort of cardio to keep the heart healthy. A lot of lifters shun steady state cardio for fear it will “eat their muscle,” but that’s a powerlifting rule you should break — it’ll improve your recovery between sets, help keep up cardiovascular health, decrease soreness, and promote blood flow to repair your muscles.

A younger Matthias Steiner squatting with his insulin pump displayed on his hip. Picture via Matthias Steiner on Facebook.

Do These Rules Change for Type 1 and Type 2 Diabetes?

There are a lot of differences between the two types of diabetes, but when it comes to strength training, much of the advice remains the same in either case.

“Type 1 diabetes just requires more vigilance to keep blood glucose levels balanced with regards to insulin versus food intake,” says Dr. Colberg. “Type 2 is usually easier to manage with exercise, but a lot of those people are older and have other health issues to deal with as well.”

Again, there are plenty of differences, particularly with regard to insulin dosage, but lifting heavy weights is beneficial in either case and training recommendations don’t change.

“People with Type 2 are optimizing their muscles, and building muscle and losing fat, so they’re going to have more insulin sensitivity, which is great,” says Kirpitch. “And there are a lot of arguments and papers starting to come out on strength training being so important for patients with diabetes — Type 1 and Type 2 — because that’s a part people forget and they often end up just walking, but strength training is critical. Changing the muscle composition and changing the body composition through building muscle is huge, it matters a lot.”

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The Takeaway

When it comes to diabetes and lifting weights, nutritionists will give a lot of the same advice whether or not you have diabetes: don’t overtrain, eat balanced meals, keep your body fat low. The main thing to take into account is to avoid overuse injuries, maintain a cardio habit, and avoid the donut plate on meet day.

But as is absolutely always the case, speak to your doctor or a diabetes educator before starting any new diet or exercise regimen.

Thanks to Barbie Cervoni, RD, CDE, for her help putting together this article.

Featured image via Matthias Steiner on Facebook.

A Diabetes Exercise Tip: Add Weight Training to Your Routine

Research has established the benefits of regular aerobic exercise: Running, swimming, and biking all can reduce your risk of heart disease, cancer, and — yes — diabetes, according to the National Institutes of Health. But now scientists believe that people with diabetes can benefit from a regular weight, or strength, training routine as well. In fact, the American Diabetes Association recommends that all people, even those without chronic illness, strength train at least twice a week. Not only can lifting weights help improve type 2 diabetes symptoms, but when part of a workout plan that includes aerobics, it can put you on the path to long-term good health.

Reaping the Benefits of Weight Training

Diabetes is marked by the body’s inability to process glucose and use insulin efficiently, but strength training can help with those issues. Here’s how:

  • You can experience an increase in lean muscle mass, which boosts your base metabolic rate and causes you to burn calories at a faster rate. “Burning these calories helps keep your blood glucose levels in check,” notes Sherin Joseph, MPH, health education manager at Montefiore Health System’s Williamsbridge Family Practice Center in the Bronx, New York.
  • The ability of your muscles to store glucose increases with your strength, making your body better able to regulate its blood sugar levels.
  • Your body’s fat-to-muscle ratio decreases, reducing the amount of insulin you need in your body to help store energy in fat cells.

Even better results have been observed when people with type 2 diabetes combine a weight-training routine with regular aerobic exercise, adds Joseph. The two forms of exercise work together to create better health benefits than either does on its own.

Protecting Against Complications

Strength training also can help guard against some complications of diabetes by:

  • Reducing your risk of heart disease
  • Helping control blood pressure
  • Increasing your levels of good cholesterol while reducing bad cholesterol levels
  • Improving bone density
  • Preventing atrophy and age-related loss of muscle mass

Starting a Weight-Training Routine

A weight-training routine involves performing movements that work specific muscle groups in the body. Each workout is broken down into exercises, reps, and sets in the following ways:

  • The exercise is the specific movement that works a muscle group. For example, a bicep curl or a chest press.
  • A rep, or repetition, is one completed motion. For example, one rep of a bicep curl involves lowering the dumbbell and raising it to the starting position.
  • A set is the number of reps performed together, and sets are separated by a short rest period.

The American Diabetes Association suggests the following guidelines for a weight-training routine:

  • Strength training should be practiced two or three days every week, with at least one day off between sessions, to allow muscles to rest and rebuild.
  • Strength training can include hand weights, elastic bands, or weight machines, reminds Joseph.
  • Perform at least 8 to 10 weight exercises per session, to work all the major muscle groups of the upper and lower body.
  • Exercises can be of low or moderate intensity. Low intensity involves two or three sets of 15 reps with lighter weights, and moderate intensity involves two or three sets of 8 to 12 reps with heavier weights. There should be two to three minutes of rest between sets.
  • The workout should last 20 to 60 minutes per weight-training session.

Practicing Common Sense

To help ensure good results and prevent injuries, follow these common sense rules:

Get your doctor’s clearance. As with any exercise program, you should check with your doctor before starting a weight-training regimen.

Focus on your form. Try to maintain proper posture, and perform each exercise exactly as required, even if it means you need to use less weight.

Breathe. Exhale while lifting the weight and inhale while lowering it.

Allow for variety. Every now and then, change the exercises in your workout, or alter the number of sets or reps you are doing. Your body adapts to exercise, and your progress can plateau if you don’t keep your body guessing.

Ask for help. If you need some guidance, consider working with a trainer or joining a weight-training class at your local gym or YMCA.

Always give yourself time to recuperate. Don’t work out using a muscle or joint that feels painful. In other words, don’t overdo it.

Strength Training Exercise and Diabetes

There are a variety of tools for managing diabetes. As you do, physical activity is an important consideration because, the more weight you carry, the more insulin you may need. Among your exercise options, strength training can build muscle and lower the risk of low blood sugar during exercise in people with type 1 diabetes.

Working out with weights also touts other health benefits: It strengthens bone, lowers blood pressure and cholesterol, helps with weight loss and reduces the risk of heart disease and stroke, explains the American Diabetes Association.

Following ADA recommendations, adults with type 2 diabetes should ideally perform both aerobic and resistance exercise training for optimal glycemic and health outcomes. That includes strength training. Moreover, 150 minutes of aerobic exercise weekly clearly improves glycemic control in type 2 diabetes.

Before You Begin

Before starting any new fitness activity, you should check with your doctor to be sure it’s safe for you. With their approval, you can do these exercises at home with your own body weight or small dumbbells. If you decide to include weights in your workouts, choose light ones to begin as you build your strength. Do two sets of 8–12 repetitions of these basic strength training exercises.

Wall Push-Ups

  • Stand facing a wall. Experiment with the distance to determine the right difficulty for you. For intensity, closer is less so, farther is more so.
  • Place your palms flat against the wall. Bend your elbows to lower your chest toward the wall, keeping your body straight in a strong plank position.
  • Slowly straighten your arms to return to the starting position.

Side Raises

  • Sit or stand with your hands at your sides and a weight in each hand.
  • Raise both arms to the side, elbows bent slightly, until they reach shoulder height in a “T” shape.
  • Lower arms back down.

Bicep Curls

  • Hold a weight in each hand, arms at your sides and palms facing in.
  • Bend one arm to bring the weight to your shoulder, palm facing you.
  • Return down and repeat on the other arm.

Triceps Extensions

  • With a weight in one hand, bring your arm above your head so your elbow is pointing to the ceiling, with the weight in your hand pointed down at the floor behind your back.
  • Use your other hand to hold your arm in place to protect your elbow through the movement.
  • Straighten your arm, raising the weight over your head. Return back down.
  • Repeat with the other arm.

Chair Raises

  • Sit near the front of a secure chair. If it’s on casters, be sure they’re locked.
  • Cross your arms over your chest and lean back.
  • Move your upper body forward to sit up straight, straighten your arms in front of you, and stand up.
  • Return to sitting.

Things to Consider

You should check your blood sugar regularly during exercise if you have type 1 diabetes. You may have to adjust your intake of carbohydrates or insulin before and after a workout.

These simple moves can help increase your overall strength and help you better manage your diabetes. But before you start, remember to talk to your doctor about exercise and diabetes. Ask if they have any special instructions or restrictions to recommend. Your doctor can guide you on the best weight-bearing exercises for you.

Having diabetes won’t stop you from building muscle. However, it’s wise to follow a few precautions when it comes to gaining muscle.

There are many different types of exercise and one of the most popular is strength or power training, which is very effective for building strong bones and muscles.

Strong muscles collect oxygen and nutrients from the blood much more efficiently than weak ones, meaning that any physical activity you do will require less cardiac work and put less strain on your heart

As well as being good for the heart, they also improve weight control and help the body remain sensitive to the hormone insulin, which is vital for keeping blood sugar levels in check and preventing or controlling type 2 diabetes.

Here are some tips on how you can build strong, lean muscle, without affecting your diabetes:

Load up on protein

Protein intake is vital for building muscle.

However, your body constantly drains its protein reserves for other uses such as producing hormones, resulting in less protein available for muscle building.

To counteract this, you need to build and store new proteins faster than your body breaks down old proteins.

You should look to consume about 1 gram of protein per pound of body weight , which is roughly the maximum amount your body can use in a day.

Good sources of protein include:

  • Chicken
  • Tuna
  • Eggs, milk and cottage cheese
  • Protein shakes (see below for more about shakes)

Remember, the more protein your body stores (protein synthesis), the larger your muscles grow.

Have a protein shake before your workout

Protein shakes are very effective for improving strength.

While many trainers have a post-workout shake, research has shown that drinking a shake containing at least 6 grams of amino acids – the muscle-building blocks of protein – and 35 grams of carbohydrates 30-60 minutes before exercising increases your protein synthesis more than drinking the same shake after training.

“Since exercise increases bloodflow to your working tissues, drinking a carbohydrate-protein mixture before your workout may lead to greater uptake of the amino acids in your muscles,” says Kevin Tipto, PhD, an exercise and nutrition researcher at the University of Texas.

Good quality whey-protein powders usually contain at least 30 grams of protein per serving, as well as a healthy supply of vitamins and minerals.

Other liquid supplements such as weight-gain powders can also provide a lot of high quality protein and nutrients in each serving, but they also tend to be extremely high in calories, carbohydrates and sugar.

While this is sufficient for most weight lifters, it is not ideal for those with conditions such as type 2 diabetes, for whom weight loss may be a key goal.

Work your biggest muscles

If you’re new to weight lifting or strength training, just about any workout will be intense enough to increase protein synthesis and build muscle.

However, if you’re experienced with weights, you’ll see the biggest and fastest results by focusing on the large muscle groups, like the back, legs and chest.

The best exercises for these body parts are squats, dead-lifts, bench press, leg press, pull-ups, bent-over rows, shoulder press and dips. Add two or three sets of 8 or 12 repetitions to your workout, with about 60 seconds’ rest between sets.

Eat a high-quality meal after training

Post-workout meals or snacks should be high in carbohydrates and protein. Carbohydrates are needed to fuel exercise. As well as being a vital energy source they also play a role in the release of insulin, which regulates levels of blood sugar and is also the body’s most potent anabolic hormone.

However, people with diabetes are generally advised to limit their carb intake to keep their blood sugar levels under control as their bodies struggle to produce insulin or don’t use the insulin produced effectively.

The problem with this though is that a lack of stored carbs can result in the body using protein for energy production, thus leaving less protein for building muscle.

The key is to cut out bad carbs such as. refined, processed carbohydrates found in white bread, potatoes, pasta and rice from your diet and replace them with good , unprocessed carbs from fruit and vegetables, beans, nuts, seeds and whole-grain versions of bread, pasta and rice.

Foods with good carbs generally have a lower glycemic index (GI), which means they tend to break down slowly to form glucose. Low GI foods also have a high nutritional value and provide prolonged release of energy.

Drink plenty of water

Adequate water consumption is one of the most overlooked factors in exercise. Water comprises up to 70% of the human body and if you’re dehydrated, your muscle size suffers as well. The other way of looking at it is that one pound of muscle can hold up to three pounds of water.

Rest

Rest is another hugely overlooked factor in building strong, lean muscle.

The simple fact is that after an intense workout, the body needs the proper nutrients and recovery time to grow bigger and stronger.

In fact, your muscles grow when you’re resting, not when you’re working out.

If you’re a beginner, do a full-body workout followed by a day of rest. Alternatively look at setting aside at least 3 days of rest each week.

Consume good fats

A common misconception among the general public is that all types of fat are bad for you. While saturated fats and trans fats (i.e. bad fats) increase cholesterol and your risk of certain diseases, monounsaturated fats and polyunsaturated fats can have the opposite effect and benefit your overall physical and mental health

They are also important for muscle growth.

Good sources of healthy fats such as omega-3 fatty acids include:

  • Fish – salmon, tuna, mackerel, herring, trout and sardines
  • Avocados
  • Olives and olive oil
  • Nuts – almonds, hazelnuts, pecans, walnuts, cashews and macadamia nuts
  • Peanut butter
  • Tofu
  • Sunflower, sesamen, and pumpkin seeds, and flaxseed

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