Resistance Training for Diabetes Prevention and Management

What you need to know about strength training and diabetes.

If you’re one of the millions of people with diabetes, you may wonder if resistance training is a good option for you. You’ve probably heard that it can help with blood sugar control and weight loss, but what does that mean exactly? And how do you get started?

In this article, we’ll explore what resistance training is, the benefits it offers for diabetes management, and the different types of resistance training available. We’ll also give you tips on getting started safely and effectively.

Always discuss exercise with your doctor BEFORE starting any kind of exercise program. This is especially important if you are on medications. Full disclaimer here.

Benefits of Resistance Training for Diabetes

Insulin sensitivity refers to how sensitive your body’s cells are in response to insulin. A higher insulin sensitivity allows your body to use less insulin to manage blood glucose levels more effectively. Diet, sleep, stress, and exercise majorly affect your body’s insulin sensitivity.

Older woman using a yellow resistance band outside on the grass.According to the National Library of Medicine, “Emerging research suggests that resistance training has the power to combat metabolic dysfunction in patients with T2D (Type 2 Diabetes) and seems to be an effective measure to improve overall metabolic health and reduce metabolic risk factors in diabetic patients”.

Not only does the body’s sensitivity to insulin improve with resistance training, but it also becomes more efficient in managing your blood sugar. This happens because the exercise stimulates your muscles to produce more insulin receptors.

Lower your risk for heart disease by reducing body fat, creating leaner muscle, increasing HDL (good cholesterol), and lower LDL (bad cholesterol).

Losing weight can be difficult for people suffering from diabetes. For people who take insulin, losing weight can be even more difficult. This is because insulin allows glucose (sugar) to enter your cells. Resistance training not only burns calories from the workout, but your body continues to burn calories for up to 38 hours after the workout by building a larger amount of lean muscle mass, which impacts your basal metabolic rate (BMR).

Other benefits of resistance training include pain management, decreased risk of injury, improved posture, reduced risk of osteoporosis, better sleep, reduced cognitive decline, and increased self-esteem.

Research has found that resistance training improves blood sugar and lowers HbA1c more than walking on a treadmill. While walking has many health benefits and should be part of your exercise routine, it should not take the place of resistance training. If you have diabetes, it is crucial to incorporate resistance training to help lower your blood sugar levels.

Two Main Types of Exercise

There are two main types of exercise: aerobic and anaerobic exercise.

Aerobic exercise is associated with endurance and slow-twitch muscle fibers. This is accomplished by performing an exercise for usually 30 minutes or longer. Examples of aerobic exercise include walking, jogging, cycling, swimming, and rowing.

Anaerobic exercise is associated with short bursts and fast-twitch muscle fibers. Maximum strength and power are usually the focus for anaerobic athletes. Examples of anaerobic exercise include weightlifting, HIIT (high-intensity interval training), and any type of sprinting (running, biking, swimming, etc.).

It is healthy to include both types of exercise in your program. However, elite athletes will typically focus on the type of exercise required for their specific sport.

What Is Resistance Training?

Resistance training, also called strength training, uses some form of resistance to contract muscles within the body to build strength through anaerobic exercise and increase muscle mass. In short, resistance training is any exercise where you pull or lift against some outside force.

Types of Resistance Training

Free Weights

African American woman exercising in her home with dumbbells.Free weights include dumbbells and barbells, which most people think of when going to a gym or fitness center. As the name suggests, free weights can be any weights you can pick up and move. The requirement is only that the weight isn’t attached to another piece of equipment. Kettlebells and medicine balls are also popular free weights used in resistance training.

Weight machines are also typically found at a gym or fitness center. Weight machines can be safer for beginners and usually have adjustable seats, handles, cables, and settings that can be adjusted for each individual. This allows you to move a pin to set the weight instead of having to pick up and move plates to perform an exercise.

Resistance Bands

Resistance bands are a great way to incorporate resistance training into your health plan from home. They are safe, effective, and inexpensive, which is one of the main reasons they are often used for rehabilitation. The low impact of the band, along with the functionality of the band, helps reduce injuries and provides deeper stretches for the muscles. Resistance bands can be more of a cable or flat and wide (loop bands). Cloth loop bands are great for leg exercises as they prevent the band from slipping and rolling.

Bodyweight/Calisthenics

Bodyweight, also called calisthenics, uses your body weight to exercise. Although the term bodyweight seems to indicate no need for equipment, some items are usually needed, such as a pullup bar, some resistance bands to assist and resist, or rings. Although some calisthenics may seem difficult, it is important to remember that almost all forms of exercise have modifications that can be made for beginners to avoid impact or to reduce the risk of injury. Calisthenics is no different, and a beginner can use modifications to scale back the movements and make them easier to get started. Likewise, a more advanced athlete can use progressions to provide a more challenging experience. Leg training can be limited with calisthenics.

As with all exercises, there are different areas you can focus on when training, such as strength, power, hypertrophy (size/mass), and endurance. Although the types of exercises performed are important, the amount of weight used and repetitions of an exercise are used to help improve these specific goals (strength, power, size, or endurance).

Which type of resistance training is the best? Unfortunately, there isn’t a clear answer to this question. Each type of resistance training offers many benefits. All forms of exercise have modifications that can be made to make the exercise easier (regression) or more challenging (progression). This allows you to create the right program regardless of the type of resistance training.

Different Environments For Exercise

What are some different environments to exercise, and which type of fitness environment is right for you?

Although there are several different resistance training environments, the three main types are home, gym, and group fitness.

Home Fitness

Home fitness is perfect for someone who is self-motivated and isn’t comfortable working out around other people. This is also an excellent option for someone with health concerns, such as covid or cancer, or someone who wants to save money or save time by not having to go somewhere to work out.

If money is a concern, then a few resistance bands should be all it takes to get started. We recommend a couple of different types of bands to help with resistance training and functional movement.

If money isn’t as much of a concern, then a set of dumbbells with a workout bench that can incline or decline is nice to have. Buying some foam tiles for the floor will help with reducing impact. If you live somewhere where the temperature gets extremely hot or cold, then an exercise bike or treadmill may be a good option. A recumbent bike would be suitable for people looking for a more comfortable biking option.

Gym Fitness

If you want access to a lot of equipment and are motivated by seeing other people work out, a gym would be a great fit. Not only are there people around you working out, but you can hire a personal trainer to help develop a program for your individual needs. They can also ensure you perform your exercises with proper form to help reduce the chance of becoming injured and make sure you are getting the most out of your workout.

The equipment and amenities are a great benefit of belonging to a gym. There are usually several treadmills, elliptical machines, stair steppers, rowing machines, bars, dumbbells, plyometric boxes, and bands. Some amenities might include tennis courts, racquetball courts, basketball courts, a pool (great if impact reduction is a concern), a hot tub, and/or a sauna.

Gyms will also typically offer different types of classes that may fit your interests. These may be classes in dancing, cycling, yoga, pilates, circuit training, HIIT (High-Intensity Interval Training), water aerobics, boot camps, or kickboxing.

Group Fitness

Group fitness classes are great for someone needing others to help hold them accountable for exercising. This environment is often the most motivating environment of these three options. People in your class may cheer you on and provide encouragement or advice.

Some fitness places are designed with a group environment in mind. In fact, many of these places can only be accessed during certain times with a group leader who leads the class. Classes usually take place at different times, so if your schedule changes or you need to move your workout time for the day, you can join another group during that time.

One of the best parts of joining a group fitness class is becoming part of a community. Being part of a “fit family” can provide that extra nudge or inspiration to help make you want to exercise for the day. Many people in your group will be beginning, so having other people to talk to with similar backgrounds can also inspire you to continue working out.

Pros and Cons


Home

Gym

Group

Pros

No travel

Less expensive

Privacy

Convenient

Flexibility

Personal trainer

More equipment

Amenities

Classes

Sense of community

Motivating

Group accountability

Classes

Equipment

Cons

Need to be motivated

Fewer options

No people

Not enough space

Cost

Travel

Need to be motivated

Can get overcrowded

Social media (filming)

Hours of operation

Cost

Travel

Less variety

Hours of operation

All group based

How to Get Started

Please consult your doctor or health care professional before starting any new exercises to determine if they suit your needs. This website offers health, nutritional, and fitness information and is designed for educational purposes only. Do not start any fitness program or exercise if your doctor advises against it. You should stop exercising immediately if you experience faintness, dizziness, pain, or shortness of breath. Full disclaimer here.

No matter which environment you choose, there are certain items that you will need or want to help improve your results.

If you have diabetes, you need a way to check your blood sugar before, during, and after exercising. If you don’t have a continuous glucose monitor (CGM), we recommend you talk to your doctor about getting one, especially if you want to exercise often.

We recommend keeping a small zippered bag with all of your diabetes supplies. Be sure to include your testing materials, glucose tablets/gel, or other methods of raising your blood sugar, and an emergency glucogen pen (if your doctor prescribes one for you). Glycogen pens are more common for type 1 diabetes and LADA and less common for type 2 diabetes.

While working out, you may want a smartwatch to track important vitals, a nice pair of shoes to help reduce injury (especially for walking or running), a water bottle, and earbuds if you want something to listen to while working out.

Once you have everything you need, figure out what type of exercise you are interested in within your preferred environment(s). Do some research and talk to other people in your community. Each establishment takes care of its facilities, equipment, and customers differently. If you are paying money to exercise, you want to make sure that the place you are working out has a safe and respectful workout environment.

If you are exercising at home, consider getting some resistance bands. YouTube is a great place to get started, as you can find several different exercise programs for free. Total Diabetes Wellness has some workout videos to help you get started. Our paid membership includes an individualized exercise program customized to your needs.

Safety First

Exercise can change your blood sugar levels, so wearing a continuous glucose monitor is especially important for type 1 diabetes and LADA. People with type 2 diabetes may also experience blood sugar changes. If there is concern that your blood sugar may get too low or high during exercise and you don’t have a continuous glucose monitor, then it is recommended that you check your blood sugar every 30 minutes.

You should not exercise if your blood sugar exceeds 250 mg/dL. This high range puts you at risk of ketoacidosis, so we recommend you wait to exercise until your blood sugar levels are consistently at a lower level. Diet and sleep can quickly lower your blood sugar levels. For more help lowering your blood sugar levels, check out our free Diabetes Wellness Plan.

If your blood sugar is below 100 mg/dL, then your blood sugar may be too low to exercise safely. We recommend eating a small snack containing 15 to 30 grams of carbohydrates before beginning your workout.

Stop exercising if your blood sugar is 70 mg/dL or if you start experiencing side effects such as weakness, confusion, or feeling shaky. If this happens, eat or drink something to help raise your blood sugar levels back to a safe level that contains approximately 15 grams of fast-acting carbohydrates. Some good options are glucose tablets/gel, a half cup of fruit juice, or hard candy such as jelly beans. After 15 minutes, recheck your blood sugar to see if it is safe to continue the workout. If not, repeat this process until it becomes safe to exercise again.

Due to the effects of exercise on blood sugar, we recommend you check your blood sugar immediately after exercising and every hour for the next 3 hours. This is because exercise uses sugar stored in your liver and muscles for energy while working out. As your body tries to rebuild the stored sugar, it needs to take sugar from your blood, which can cause your blood sugar to lower after working out.

The Bottom Line

You should see your doctor if you have diabetes and you:

  • Have any changes in your vision.
  • Have numbness or tingling in your feet.
  • Fall more often than usual.

Please note that this content is meant to be used as general information and is not intended to replace professional medical advice. If you have diabetes and are experiencing changes in your vision, numbness or tingling in your feet, or falling more often than usual, please see your doctor.