esistance training, or strength training, is included in the exercise guidelines for a person with type 2 diabetes, and can improve insulin action at the muscles as well as help lower blood glucose and A1c.
However, there are many other benefits of strength training for all people including:
- an increase in muscle mass (size) and strength
- a decrease in the risk of heart disease by decreasing body fat, improving cholesterol, and decreasing blood pressure
- slowing or reversal of muscle loss that comes with disuse or aging
- improvement in balance to prevent falls; improvement or maintenance of bone density to prevent osteoporosis and fractures
- the improved ability to do normal activities including standing from a chair or toilet, climbing stairs, and carrying groceries.
Some perceived barriers to strength training, like not having strength training equipment and not wanting to exercise away from home, can be overcome by doing exercises in the home, no equipment required.
First, what is resistance training?
It is a type of physical activity where you exercise a muscle or muscle group against outside resistance. It can be performed using body weight, free weights (dumbbells and barbells), weight machines, medicine balls, or exercise bands.
How often should a person (with or without diabetes) do strength training?
Twice, but preferably, three times per week with at least one day of rest between sessions.
How hard should strength training be?
It should be moderate to vigorous; a person should be able to complete 10-15 repetitions to momentary fatigue of the muscle group (when you start to get tired). When more than 15 repetitions can be done, the resistance should be increased. Resistance should not be so hard that a person bears down without natural breathing.
How much should a person do?
At least one set of the repetitions should be performed, increasing over time to 3-4 sets of the exercise. During each session, 5-10 exercises should be performed involving the major muscle groups in the arms, legs and trunk.
To avoid injury, a person should progress slowly with the ultimate goal of training 3 times per week, completing 3 sets of 8-10 repetitions of each exercise to muscle fatigue (10 to 15 repetitions to fatigue for a person who is more frail or has other problems that would make the higher intensity unsafe).
A person should consult with a healthcare provider for an individualized program prior to starting exercise more vigorous than normal daily activities if any of the following are true:
- An individual has not been active
- Has heart, blood pressure, or other medical problems
- Has complications from diabetes
- Has painful conditions
Here are five strength exercises that can be done at home, without equipment:
Incline push-ups: stand with a straight body with arms extended and hands on a surface. Lean into the surface, keeping the body straight, and then slowly push back away. Initially, this may be done with hands on a wall at shoulder level, increasing the challenge by moving to lower surfaces (for example, to the edge of the kitchen counter, then the bathroom counter, then the 4th step/3rd step/2nd step, and possibly hands to the floor). Advance the challenge when more than 10 or 15 repetitions can be done without fatigue.
Biceps/triceps isometrics: Stand (or sit) with arms relaxed at the sides, bend elbows to raise hands to waist-level, put the palms of hands together with one hand on top of the other, push the palms together to work the muscle, hold 2-4 seconds, relax and repeat 10-15 times to fatigue. If there wasn’t fatigue, push harder. Switch the top and bottom hands and repeat for the other side.
Abdominal isometrics: Lie on the floor (or bed), bend knees to put feet flat on the surface, support the head as needed (pillow), raise one knee toward the ceiling, put the palm of the hand on the end of the thigh near the knee, pull the abdominals in gently and then press the hand into the thigh to work the muscles while keeping the abdominals pulled in, hold 2-4 seconds, relax (but leave the hand on the thigh) and repeat 5-10 times to fatigue and then change position: push with right hand to right knee, left hand to left knee, right hand to left knee, and left hand to right knee. If there wasn’t fatigue, push harder.
Chair rises: Place a chair with the chairback against a wall, sit on the front half of the chair, cross arms on the chest, slowly stand up and sit down. If it is too hard, place a pillow or two on the chair to allow for 10-15 repetitions to fatigue. To increase the challenge over time, remove a pillow when 10-15 repetitions can be done without fatigue. If a person is at risk of falls, this may be done with the chair in front of a sturdy table or counter.
Heel rises: Stand facing a wall or counter, hands on the surface for balance. Slowly go up onto the toes then slowly lower down. Repeat 10-15 times. When more than 10-15 repetitions is possible without fatigue, advance to performing on one leg with the other foot lifted from the floor.
About the Author
Karen Kemmis is a physical therapist, exercise physiologist, certified diabetes educator, and also holds certifications in Pilates for rehabilitation and exercise for aging adults. She is based out of SUNY Upstate Medical University in Syracuse, NY and splits her time between a Joslin Diabetes Center affiliate, an outpatient rehabilitation department, and a PT program where she is an adjunct professor.