Resistance Exercise for Diabetes

Weight Training Helps Your Diabetes

Bench Press
Bench Press. (c) Paul Rogers

There are two main types of diabetes -- type 1 and type 2. Type 1 diabetes is "insulin dependent diabetes." Natural supplies of insulin, produced in the pancreas, have failed or diminished greatly and it needs to be replaced by regular injection of insulin. The reasons for this failure are uncertain, although an autoimmune response in combination with genetic and environmental factors are suggested.

The disease can run in families.

Type 1 diabetes usually occurs in childhood or early teens, which suggests the former name of "juvenile diabetes." However, it can occur in older people and it might then be called "latent autoimmune diabetes in adults" or LADA.

Both diseases result in too much glucose in the blood, the health consequences of which can be serious if the amount of glucose (blood sugar) is too high. In type 2 diabetes (T2DM), glucose may be high because even though insulin is present because it cannot store the glucose efficiently in muscle and liver. This is called "insulin resistance." Type 1 is always a result of having insufficient natural insulin.

Type 2 diabetes is a disease of lifestyle, although genetics probably also plays a part. Being overweight with poor diet will make you more likely to get type 2 diabetes, which is mostly not reversible in advanced stages. Over time, type 2 diabetics can lose some natural insulin supply until eventually they may require insulin injections just like type 1s.

Physical Activity and Type 2 Diabetes

Physical activity helps to prevent type 2 diabetes and manage the condition of those with diabetes, along with a healthy diet and weight maintenance, as confirmed by the American Diabetes Association. Weight training and strength training is an important part of the exercise program in this prevention strategy.

Exercise helps reduce abnormal blood glucose by making insulin more sensitive and efficient at storing glucose in a form called glycogen in muscle and liver.

Strength training has a particular role to play because when you lift or push weights the main fuel used is that stored as muscle glucose (glycogen). Building extra muscle also improves the body's glucose storage and processing ability, factors crucial in preventing and managing type 2 diabetes.

Aerobic and high-intensity exercise helps by burning glucose and fats and assisting with fat loss, while strength training also assists with weight management by expending energy and building muscle.

Exercise for Prevention and Management of Diabetes (Type 2)

In their consensus guideline of 2010, the American Diabetes Association and the American College of Sports Medicine recommend a combination of aerobic and resistance exercise. They suggest that the combination may be more effective than either type alone.

  • Persons with T2DM should undertake at least 150 min·wk of moderate to vigorous aerobic exercise spread out during at least 3 d during the week, with no more than two consecutive days between bouts of aerobic activity. 
  • In addition to aerobic training, persons with T2DM should undertake moderate to vigorous resistance training at least 2–3 d.wk.
  • Before undertaking exercise more intense than brisk walking, sedentary persons with T2DM will likely benefit from an evaluation by a physician. Electrocardiogram (ECG) exercise stress testing for asymptomatic individuals at low risk of coronary artery disease (CAD) is not recommended but may be indicated for higher risk.
  • Individuals with T2DM engaged in supervised training exhibit greater compliance and blood glucose control than those undertaking exercise training without supervision. 

If you are considering a weight training program for this purpose, a trainer with some experience of training in diabetes management is preferable. Liaison with your doctor and / or dietitian is always a good idea.

Exercise and Weight Training for Type 1 Diabetics

Having no natural insulin creates a special problem for type 1 diabetics (T1) because when you replace it with injected insulin you don’t have the body’s natural adjustment mechanisms (homeostasis) to regulate supply; you have to work it out and adjust it for various circumstances.

One of those variables is how much and how intense the exercise you do. Most type 1 diabetics already know this because they will have been trained in the dynamics of insulin use from an early age, especially with regard to physical activity. Yet this information is also useful for fitness trainers who may have to train T1s.

Getting the insulin dose wrong, especially taking too much, can cause blood sugar (glucose) to get too low, which is known as hypoglycemia. An occurrence of this is usually known as a “hypo” and is signaled by feeling faint or week, or even worse, unconsciousness and coma. T1s guard against this by always carrying some sweet food or drink that can correct a hypo by raising blood sugar. Failure to correct plummeting blood sugar can be very dangerous and even fatal.

Exercise can lower blood sugar independently of insulin action. In such cases, insulin dose, and perhaps food intake, need to be adjusted around exercise time. Further, the idea that exercise, especially high-intensity exercise, is not to be recommended for type 1 diabetics because of this danger, is almost universally rejected now. Many elite and world class athletes are T1s..

Example Training Program

A weekly program, adjusted for existing fitness, age, goals and convenience could look like the following.

Day 1. Aerobic training - 45 to 60 minutes.

Day 2. Weight training – 45 to 60 minutes

Day 3. Rest

Day 4. Aerobic training as for day 1.

Day 5. Weight training as for day 2.

Day 6. Rest.

Day 7. Aerobic training as for day 1.


American College of Sports Medicine, American Diabetes Association. Exercise and type 2 diabetes: American College of Sports Medicine and the American Diabetes Association: joint position statement. Med Sci Sports Exerc. 2010 Dec;42(12):2282-303. [295 references]

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