Lisa Grenfell, a biokineticist, expands on the benefits of resistance exercises for people living with diabetes.
You may be asking which type of exercise works better to control your blood glucose levels? We all know that aerobic or cardiovascular exercise like walking, swimming, cycling, or doing vigorous household chores raises your heart rate, improves your general conditioning, and increases weight loss. These exercises accomplish this by burning calories which is always encouraged for people living with Type 2 diabetes as they may have higher fat levels.
When doing physical exercise, energy is used from various sources depending on its intensity and duration. Therefore, your effort will determine the type of energy used.
Resistance training
Resistance training uses muscle strength to move weights or body weight, or it entails moving against elastic bands, free or machine weights.
When muscles contract it changes how the cell membranes respond to insulin, making it more usable. Resistance training increases muscle mass which uses the excess blood glucose as an energy source and therefore controls blood glucose levels better. Blood glucose levels are more stable than if you were doing aerobic exercise alone.
Resistance type exercises are less likely to drop glucose sugar levels with the risk of hypoglycaemia (low blood glucose) than it does during aerobic types of exercise. This type of exercise has been proven to increase insulin sensitivity, muscle strength, quality of life, bone density and reduce blood pressure and lipid (cholesterol) levels and finally it reduces haemoglobin HbA1c (blood test that measures your glucose levels over a three-month period).
In addition, the muscles release a protein which has anti-inflammatory properties and is more effective in reducing blood sugar when used in a combination of aerobic and resistance exercises.
How hard, often and long should I do resistance exercise to gain benefit?
HOW OFTEN: Train three times a week.
HOW LONG: 45 min at a time.
HOW HARD: How much resistance depends on your initial strength and conditioning. A general rule of thumb is the two for two progression rule. For example: if you can do 12 repetitions of the exercise for two consecutive work outs then add two more reps for your third work out and for each subsequent session.
Precautions
If you have joint issues be careful of how you manage this load. A biokineticist can monitor and guide your programme with regards to technique and supervision of the exercises.
8 – 15 reps (moderate intensity)
5 – 8 reps/set (vigorous – this intensity showed the greatest reduction in HbA1c)
1 – 5 reps/set (intensive)
Remember that if your weight goes up, so does the resistance your body is working against. Carrying extra fat mass (adipose tissue) is non contractile or non-working weight and doesn’t contribute to moving you. The muscles have to work harder against this load to achieve the movements it needs. This is why walking upstairs is so much harder than down. Your joints are also more vulnerable as exercise has greater impact on them therefore you need to have a balance between increasing resistance and increasing load on the joints.
Balance issues
If you are older, diabetes alone reduces your muscle strength, especially in the legs and increases the risk of disability by as much as two to three times (commonly due to falls). It would be highly recommended to add balance and proprioception (awareness of your body parts in space) exercises to your regime. Examples of this may be single leg standing or tandem leg standing, or using an uneven surface, such as a high-density foam pad, to stand on to challenge your balance. The smaller stabiliser muscles have to work really hard to maintain your positioning and not lose balance; this increases your spatial awareness, balance, and muscles responsible for posture correcting reflexes. A biokineticist can prescribe a full programme to address these specific areas and ensure you progress at the correct pace while still stimulating positive change.
Strength issues
From as early as 25 years of age your muscle strength declines and this speeds up from 50 years. So, by age 80 you may have lost as much as 40% of your muscle strength. With loss of strength also comes loss of power, mobility, and the ability to perform activities of daily living, such as walking, climbing stairs, and carrying capacity.
Losing muscle mass reduces where glucose can be used in the body, leaving more available in the bloodstream. This then raises the blood glucose levels.
Combination
A combination of different types of exercise (aerobic, resistance and flexibility) as well as dietary and medication control is more beneficial for people living with diabetes to control blood glucose levels than any one thing alone.
Consult a biokineticist
Now that you know the benefits of resistance exercises, you many ask who can guide me and ensure I do this safely and effectively?
A biokineticist can assist in advising which form of exercise might be most appropriate for your specific condition. Firstly, they will collect a full medical history and evaluation of all your health components (body fat, heart and lungs, muscle strength, endurance, and flexibility as well as screening of cholesterol, glucose, and blood pressure).
They are trained to make sure that if you have any existing conditions, such as high blood pressure (hypertension) or heart problems (angina – chest pain with or without exercise) associated with your diabetes that these are well-controlled and that it’s safe to exercise.
A biokineticist can adapt your training programme (either at home or in a controlled environment like their practice or a gym) to make sure you are training at the correct intensity and that the exercises are appropriate for your level of fitness, or any symptoms you might be experiencing. They also monitor your blood pressure, heart rate and general responses to exercise to track how your body is coping with the stress of exercise.
Contact your a biokineticist to advise you on an appropriate assessment and intervention programme. Find a biokineticist on www.biokineticssa.org.za
References
- Wróbel M, Rokicka D, Czuba M, Gołaś A, Pyka Ł, Greif M, et al. Aerobic as well as resistance exercises are good for patients with type 1 diabetes. Diabetes Res Clin Pract. 2018;144:93–101.
- McGinley SK, Armstrong MJ, Boulé NG, Sigal RJ. Effects of exercise training using resistance bands on glycaemic control and strength in type 2 diabetes mellitus: a meta-analysis of randomised controlled trials. Acta Diabetol. 2014;52(2):221–30.
- Lima V de A de, Menezes FJ de, Celli L da R, França SN, Cordeiro GR, Mascarenhas LPG, et al. Effects of resistance training on the glycemic control of people with type 1 diabetes: a systematic review and meta-analysis. Arch Endocrinol Metab. 2022;(7):1–8.
- Röhling M, Herder C, Roden M, Stemper T, Müssig K. Effects of Long-Term Exercise Interventions on Glycaemic Control in Type 1 and Type 2 Diabetes: a Systematic Review. Exp Clin Endocrinol Diabetes. 2016;124(8):487–94.
- Consitt LA, Dudley C, Saxena G. Impact of endurance and resistance training on skeletal muscle glucose metabolism in older adults. Nutrients. 2019;11(11):1–17.
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