Weight Training and Diabetes

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By: Rick Philbin

Have you ever wondered if weight training is right for you? Maybe you think it’s only for the “muscle heads” at the gym or the women on ESPN who flex for the cameras.

A weight-training program for many people may mean going to the gym, but working out at home with dumbbells or resistance bands can help you getstarted.

Two Times a Week Is a Good Start

The American College of Sports Medicine and theAmerican Diabetes Association recommend that youtrain a minimum of two times per week, doing eight to 12repetitions per set of eight to 10 exercises targeting majormuscle groups.

Some Benefits of Weight Training

Weight (or resistance) training can help you maintainlean body mass, which helps with weight management,decreases the chances of osteoporosis, prevents injuries andincreases sports performance.

For people with diabetes, weight training helps increaseglucose uptake by the muscles and helps the body storeglucose. The stored form of glucose is called glycogen.Glycogen must be replenished after exercise, so anythingthat helps your body to store glucose is a plus for peoplewith diabetes.

Weight training also increases your metabolism—evenafter you have finished with your workout. A fastermetabolism not only helps you burn more calories, it helpsinsulin work better, too.

The Overload Principle

It’s important to understand the basics of weight training.

The Overload Principle is a concept based on “overloading”the muscles by lifting more than it is used to lifting. This isrelative; a sedentary older person may overload the muscleswith only 3 to 5 pounds, whereas a younger athlete mayhave to lift 250 pounds to get the desired results.

As the muscles grow stronger, you need to increase theoverload, but once the desired strength is achieved, there isno need to continuing overloading.

A less-challenging or maintenance approach may suffice.Overloading doesn’t necessarily mean adding more weightor resistance; it can be accomplished by increasing thenumber of repetitions, decreasing the rest time betweensets, or increasing the number of exercises in your workout. Ifyou use too heavy a weight, your form may suffer and injury ismore likely to occur. If you use too light a weight, your bodydoesn’t have to adapt to an overload, and gains become harderto achieve.

Progressive Resistance Training

Progressive resistance training must be done to overloadthe muscle. This is a strength-training method in which youconstantly increase the overload to facilitate adaptation.

The Greeks first witnessed progressive resistive exercises when ayoung man lifted a calf each day until it reached its full growth.

It is well documented that the size of skeletal muscle is affectedby the amount of muscular activity performed. In order toincrease the size or strength of a muscle, you have to use aprogressive resistive approach. Everyone has a genetic ceilingwhen it comes to how much one can lift. For most people, therisks of heavy lifting outweigh the benefits, so lifting a weight toone’s maximum potential is not recommended unless it is partof a competition or possibly for sports performance.

People with diabetes need to be more conservative when liftingheavy weights, especially if they have diabetic retinopathy. Besure to consult with your diabetes care team for clearance.

Safety first, always!

Setting Your Goals for Weight Training

Before starting a weight-training program, you need to identifyyour goals.

For example, an athlete who competes in speed-strengthsports may perform low-repetition, high-intensity exercises during orimmediately prior to the competitive season. A person interested inbodybuilding may perform more sets and repetitions of exercises andmore exercises per body part than weight lifters or strength athletes.Their goal is to build large, defined, symmetrical muscles. Anotherperson might want to simply “tone up,” which could mean doing oneto three sets of eight to 10 reps, two or three times per week.

People vary in the rate at which they gain strength. This is partlydue to the different kinds of muscle fibers. Endurance athletes tendto have more slow-twitch fibers, whereas strength athletes will havemore fast-twitch fibers. People with more fast-twitch fibers tend togain strength faster. The bottom line is that genetics plays a role, buttraining can influence strength gains, too.


Getting Started

Before starting a weight-trainingsession, it is best to raise your corebody temperature by a couple ofdegrees. This can be accomplishedby walking briskly on a treadmill orriding a stationary bike for five to sevenminutes. A good indicator is to have alight sweat across your forehead. Nextyou should stretch the muscles you willbe working (arms or legs). Holding astretch for 30 seconds and doing twoor three reps should be enough. It’salso a good idea to stretch between setsso you can make the most of your restperiods.

Spending 30 to 45 minutes doingfive to seven weight-trainingexercises is plenty when you are first getting started.Remember that your muscles need time to recuperatefrom a workout, so never work the same muscle grouptwo days in a row. If you train three days a week, aMonday, Wednesday, Friday or Tuesday,Thursday, Saturday schedule is ideal.A good rule of thumb for the orderof exercises is to start with the largemuscle groups (chest) then move on tothe small muscle groups (biceps).

To determine the correct weightfor an exercise, it should be heavyenough to cause fatigue by the lastfew repetitions in each set. If you arelifting three sets of 10 reps, the ninthand 10th rep should be difficult for youto perform while maintaining properform. Good lifting technique meansthat you maintain proper posturewhile moving through the lift in a slow,controlled fashion. A count of two tofour for the push or pull and a count of four to six onthe recovery phase or the return to starting position arerecommended.


Weight-Training Facts

  • Although lifting weights should not produce pain during a workout, you may experience muscle soreness a day or two after a new exercise routine, which can last for 24 hours. This pain, called delayed-onset muscle soreness, is caused by changes in the muscle fibers necessary for muscle growth and repair.
  • Most gyms have various weight-training equipment from which to choose. People are usually started on machines since they are safer. They help stabilize your body and guide the body through the specific muscle patterns. Machines need to be adjusted to fit your body; many of the newer machines available at gyms are computerized to streamline this process.
  • With free weights, you can fit the exercise for your body. Free weights provide an opportunity to the body to learn additional motor skills for stabilization and balance, although proper form is essential to prevent injury. A trainer is highly recommended when starting to use free weights. Many gyms also have bands with various resistance that provide weight-training benefits.

—Gerri French, MS, RD, CDE


Below are sample weight-training programs for three people with different goals. All three discussed their exercise programs with their healthcare providers before starting.

1. A weight-training program for a middle-aged womanwith type 1 diabetes who wants to start a strength-trainingprogram because she is concerned about osteoporosis and also wantsto tone up.

Monday, Wednesday and Friday

One to three sets of 10 reps, resting one minute between sets

Chest press, row, elbow curls, elbow extension, leg press, kneeflexion

2. A weight-training program for a competitive athletewith diabetes who wants to increase speed and strength aswell as prevent injuries prior to the season.

Tuesday and Friday

Three to six sets of two to four reps (80 to 90 percent of maximumlift), resting three to four minutes between sets

Dead lifts, squats, power cleans, free-weight bench press, bent-overrow

3. A weight-training program for an older man with type 2diabetes who was told by his doctor to start an exercise programthat includes strength training.

Tuesday, Thursday and Saturday

Three sets of 10 to 15 reps, resting three minutes between sets

Chest press, row, seated military press, lat pull down, kneeextension, knee flexion


Safety Precautions

Here are some basic guidelines and safety precautions for a person with diabetes whowants to start a weight-training program:

  • Talk with your healthcare professional before starting a weight-training program and consult with him or her if any problems arise with your diabetes control.
  • Start out using low weights and higher reps, while concentrating on your form. It’s a good idea to work with a personal trainer for a few sessions to help tailor your program to your needs and to make sure you are using proper form.
  • DO NOT hold your breath when you lift weights; this technique (known as the Valsalva maneuver) raises blood pressure and increases the pressure within your eyes.
  • If you are using free weights (as for a free-weight bench press), always have a spotter.
  • Avoid doing an exercise that causes pain. A burning sensation in the muscle is okay, but any exercise that causes pain in a joint or a sharp or shooting pain should be avoided.

Weight-Training Terminology

There are many terms used in the fitness industry when describingweight training. “Weight training,” “weight lifting,” “strength training” and “resistance training” are often used interchangeably.

Here are some of the basic terms and phrases used in weighttraining with a brief definition of each.

Bar: The metal shaft that forms the handle of abarbell or dumbbell.

Barbell: A bar used with weighted plates on eachend to create resistance.

Breathing (proper): Inhale through the nosejust before performing the exercise and exhalethrough the mouth with the exertion. Inhale on theway back and exhale when lifting the weight again.

Burn: A sensation felt in a muscle when it hasbeen worked intensely. It is caused by exhaustingthe muscle, which creates microscopic muscle tears.

Circuit weight training: A program that mixes light- to moderate-intensityweight training with aerobic training. Acircuit program might involve 10 to 15 stationsset up at close intervals. The goal is to movefrom station to station with little rest betweenexercises until the entire circuit has beencompleted.

Dumbbell: A one-handed barbell. Dumbbells areshorter and usually lighter in weight.

Failure: Working the muscles to the point whereone cannot continue to perform the exercise.

Form (proper): Moving a weight in a controlled andsmooth manner through a range of motion stayingin correct alignment and without locking out yourjoints.

Free weights: Versatile dumbbells and barbellsfree of any machine support or pulley assistance. Many athletesuse this form of weight training.

Hypertrophy: An increase in muscle size as a resultof high-intensity weight training.

Isolation: Focusing an exercise so that it emphasizes one particularmuscle.

Overload: The amount of force against which a muscle is required towork that surpasses the weight which it ordinarily handles.

Power lifting: A sport that involves lifting the heaviest weight possible for one repetition (as in a squat or dead lift). Athletes “power lift” by using heavy weights with few reps to increase power.

Progression: To methodically increase the stress a muscle cantolerate during an exercise. This can be accomplished by increasing the weight,the number of repetitions or the number of sets or by decreasing the restinterval between sets.

Repetition: Often called a “rep.” This involves movinga body part through a specific range of motion and back to the startingpoint. When the body part has progressed through that range of motion andback to the starting point, one repetition has been completed (as in lifting aweight up and down once).

Resistance: The actual weight against which a muscle is performing.This can be done with free weights, machines, resistance bands or evenone’s own body weight.

Routine: A program with a distinct schedule of exercises (such as anupper-body or lower-body routine).

Set: A succession of repetitions done without rest (10 reps = 1 set).

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