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Getting Started Getting Stronger

Strength training and diabetes

Resistance, or strength, training (also referred to as “lifting weights”) sometimes seems like an afterthought for many. In my experience, when people talk about “exercise,” they are really referring to “cardio” activities such as walking, jogging, or dancing. In fact, it wasn’t until 1990 that the American College of Sports Medicine added strength training to its guidelines; but the evidence is growing that those living with diabetes may benefit from strength training.

According to a recent study in the Archives of Internal Medicine, when Harvard researchers followed more than 32,000 men for nearly 20 years, they found that those who did resistance training at least 150 minutes per week were thirty-four percent less likely to develop type 2 diabetes than non-exercisers. Men who did cardio cut their risk by fifty-two percent. But those with the lowest risk – a fifty-nine percent decrease – were exercisers who did both cardio and resistance workouts for at least 150 minutes per week.

The benefits of combining these two types of exercise may also extend to people already living with type 2 diabetes. Long-term blood sugar control, as measured by HbA1c levels in 262 people with diabetes, improved in those who combined both cardio and resistance training compared to people who did only one of the types of exercise, according to a study published in the Journal of the American Medical Association. All the exercisers, however, lost weight, which may help with blood sugar management.

“This shows how powerful exercise is,” say Jackie Shahar, MEd, RCEP, CDE*, a certified diabetes educator, clinical exercise physiologist, and manager of exercise physiology at Harvard University’s Joslin Diabetes Center. “In my opinion, exercise is medicine for people with type 2 diabetes.”

Resistance training is unique because of its effects on muscle. “Unlike cardio – lifting weights or other types of exercise such as resistance training builds muscle or, at the very least, prevents the decline that occurs as you get older and less active,” explains Shahar. After the age of forty, inactive adults can lose three to five percent of muscle mass and strength per decade. Adds Shahar, “As muscle decreases, we tend to become less active and gain more fat, increasing the chances of developing type 2 diabetes or making it harder to manage if you already have it.”

But resistance training may help combat muscle loss and perhaps even build more. The result of the added muscle mass: “Your body utilizes glucose and insulin more effectively,” says Shahar. “It also may make you stronger, reduce joint pain, and improve posture.

How to Get Started

Erase all those images you may have of old-fashioned high school weight rooms, grunting football players, and muscle-rippling bodybuilders. There are lots of ways to build muscle, and many of them you can do right at home. Before you get started, talk to your doctor. He or she is best able to instruct you on any modifications that you may need to get the best results possible.

Once you have the all-clear to start strength training, Shahar recommends choosing equipment that you’ll be comfortable using. Here are some options:

Dumbbells: A low cost option you may use at home. You may need several sets: heavier ones for exercises using large muscles like your legs, chest, and back, and lighter ones for your arms and shoulders. You can find dumbbells in most sporting goods stores, or online.

Elastic resistance bands or tubes: They’re lightweight, inexpensive, and portable. You can also do a wider range of exercises with them than dumbbells. Bands are generally as widely available as dumbbells.

Body weight exercises: Think squats and push-ups. While they’re free and you can do them anywhere, they can be challenging for beginners because it’s harder to change the amount of resistance (your body weight) that you’re trying to move.

Exercise machines: If you have access to a gym, these can be a great option for beginners. Your movements are more restricted, so you don’t have to worry about form as much as you might with the other devices.

Proper technique and good form can help you to avoid injury so, if it fits in your budget, a few sessions with a certified personal trainer may be a wise way to get started. Small group training, in which a trainer works with three to five clients at a time, is a lower-cost option since the clients share the fee.

You can also look for strength training classes at gyms, health clubs, universities, hospitals, and community centers in your area. If you prefer to work out at home, consider trying these band and body weight routines from Joslin Diabetes Center.

According to Shahar, “You should aim to do strength training two or three times a week on nonconsecutive days. Muscles get stronger by repairing the micro-tears that occur during resistance exercise so your body needs a day between workouts to recuperate. Another option is to do exercises for your lower body one day, and upper body exercises the next. If you want to keep your workouts shorter, do them more frequently, hitting each body part two or three times a week.”

Shahar also recommends that you start with one set of ten repetitions of each exercise. “You want to feel comfortable, not exacerbate any pain. You should feel good about the workout afterward, and be able to continue with your daily routine. When you feel like you can do more, progress to fifteen reps, then increase to two sets of ten to fifteen reps, resting for thirty to sixty seconds between sets. Work up to three sets of fifteen reps per exercise.”

Shahar says, “You should feel fatigued on your last few repetitions, but still able to maintain control and good form. If you feel like you could do more reps, then you need to increase the resistance by choosing heavier weights, getting a stronger band, or trying new exercises.”

Make sure that you track your blood sugar levels and discuss any changes with your doctor or diabetes educator. “Seeing improvements in your numbers can be powerful motivators to keep exercising,” says Shahar.

For more stories in the Getting Started exercise series, visit The DX archive.

Michele Stanten is a certified fitness instructor and freelance writer. Her work has appeared in Prevention, Shape, More, and other magazines. She is also on the Board of Directors for the American Council on Exercise. Michele lives in Coopersburg, PA, with her husband, two children, and two cats. Stanten is a paid contributor for The DX. All opinions contained in this article reflect those of the contributor and interviewee, and not of Sanofi US, its employees, agencies, or affiliates.

*“Certified Diabetes Educator” and “CDE” are certification marks owned and registered by the National Certification Board for Diabetes Educators (NCBDE). NCBDE is not affiliated in any way with Sanofi US. NCBDE does not sponsor or endorse any diabetes-related products or services.

© 2014 The DX: The Diabetes Experience

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