No one’s disputing the benefits of regular aerobic exercise for diabetes management. Running, walking, swimming, and biking can all help you keep your blood sugar level in check while boosting your overall health.
But now scientists are finding that people with diabetes can benefit from regular weight lifting, or strength training, as well. In a study from 2023, participants with type 2 diabetes who did strength training alone showed more improvements in blood sugar levels than those who did cardio alone. That said, other research has found that the best results for blood sugar control are associated with a combined routine of strength training and aerobic exercise.
That’s why the American Diabetes Association (ADA) recommended in a position statement that, in addition to performing at least 150 minutes of moderate-intensity physical activity per week (or 75 minutes of high-intensity exercise), adults with type 2 diabetes do strength training at least two or three times per week.
Burns Up Blood Sugar: Strength training relies primarily on the body’s glycolytic, or glucose-using, metabolic system for energy. “As we go through a strength-training workout, we use stored muscle glycogen for fuel,” explains Nick Occhipinti, CSCS, an exercise physiologist. “Once this stored muscle glycogen runs out, we start to mobilize extra glycogen from the liver and from the blood. This helps to directly decrease blood glucose as well as deplete stored muscle and liver glycogen stores, giving blood glucose a place to go next time we eat.”
Improves Glucose Storage: Your muscles serve as storage facilities for consumed sugar and carbohydrates. “Trained muscle has a higher capacity to store blood glucose in the form of glycogen, aiding in lowering blood glucose,” Occhipinti says. That means lowered blood sugar levels and easier glucose management.
Spurs Weight Loss: In people carrying extra weight, losing 5 to 10 percent of your body weight can improve A1C scores, the two- to three-month average of blood sugar levels, according to Johns Hopkins Medicine. Apart from burning calories during your workouts, strength training promotes fat loss by increasing levels of lean muscle mass. “Muscle is one of the few metabolically active tissues in the body at total rest,” explains Occhipinti. “This means that even as we sit around and watch football or sit at a desk and work, the muscle we have on our body is serving to burn calories.”
Targets Harmful Belly Fat Abdominal fat, also called visceral fat because it resides in and around the body’s visceral organs, exacerbates insulin resistance and complicates blood sugar management, he says. He explains that, in addition to storing energy, visceral fat cells produce chemicals and hormones that inhibit the body’s effective use of insulin. Fortunately, research has shown that high-intensity resistance training, when combined with moderate endurance training and a restrictive diet, is effective at reducing visceral fat levels in people with metabolic syndrome (also known as insulin resistance syndrome).
Strength Training Helps Protect Against Diabetes Complications
Improves Heart Health: Type 2 diabetes is a leading risk factor in the development of heart disease, according to the Centers for Disease Control and Prevention. Fortunately, strength training increases levels of HDL (“good”) cholesterol in the body while reducing LDL (“bad”) levels, according to Occhipinti. Research has shown it also helps lower high blood pressure (hypertension).
Boosts Bone Density: While people with type 2 diabetes often have normal bone mineral density scores, they are at a heightened risk of bone fracture, according to one study. Weight-bearing strength training, especially performed from a standing position, builds strength in the bones of the legs, spine, and hips to reduce the risk of bone breaks, says Audra Wilson, RD, CSCS, a bariatric dietitian and strength and conditioning specialist at the Northwestern Medicine
Metabolic Health and Surgical Weight Loss Center at Delnor Hospital in Geneva, Illinois.
Preventing Age Related Muscle Loss Building muscle through strength training directly combats the muscle loss that can occur through the decades. According to the ADA position statement, type 2 diabetes is an independent risk factor for accelerated declines in muscle strength. Research has linked severe age-related muscle degradation, called sarcopenia, to loss of physical function and increased risk of falls, hospitalization, and early death.
Reduces the Risk of Peripheral Neuropathy and Vision Loss: “When we have chronically high blood sugar, glucose molecules start attaching themselves to everything, including our red blood cells. This can prevent healthy blood flow in many places in the body where we have very small blood vessels,” Occhipinti says. It just so happens that the eyes and nerves of the hands and feet have these small vessels. When these areas don’t get the blood flow they need, peripheral neuropathy and diabetic retinopathy can result. Strength training improves blood flow to reduce the risk of these complications, Occhipinti explains.
Until Next time: Stay Safe, Stay Healthy and be Careful out in the World.
James A Vito, D.M.D.