Weight Training & Diabetes
- October 2007
Have you ever wondered if weight training is for you? Maybe your perception is that it’s for the “muscle heads” at the gym or the women on sports shows who flex for the cameras. Those are extreme cases maybe even involving the use of illegal substances to look so pumped up. In reality everyone can benefit from a resistance program of some type.
A resistance program may mean going to the gym for some, but working out at home with bands or dumbbells is a good way to get started.
A basic recommendation from the American College of Sports Medicine and promoted by the American Diabetes Association is to train a minimum of two times per week, doing 8-12 repetitions per set of 8-10 exercises targeting major muscle groups. As with diabetes this can be individualized but as long as you are in good control there is no reason why you should not participate in a strength training program. Discussed will be the benefits of weight training, common terminology, principles, individual goals, and safety precautions around diabetes.
Benefits of Weight Training
Resistance training (weight training) can help maintain lean body mass which will help in weight management, decrease the chances of osteoporosis, prevent injuries, and even increase sports performance.
In diabetes, weight training will help increase glucose uptake by the muscles and help the body store glucose. The stored form of glucose is called glycogen which must be replenished after exercise, so any help storing glucose is a plus for people with diabetes. Weight training will increase your metabolism even after you are done working out.
This will help burn more calories and help insulin work better. Of course, anytime you start an exercise program or add in weight training, make sure you check with your healthcare team so adjustments in insulin or oral medications can be made if needed.
Common Terminology
There are many terms used in the fitness industry when describing weight training. In fact weight training, weight lifting, and resistance training are often used interchangeably. To get a basic understanding of the terminology Table 1 outlines basic words or phrases used in weight training with a brief definition.
Principles of Weight Training
It is important to understand the basic concepts of weight training. The Overload Principle is a concept based on “overloading” the muscles by lifting more than they are used to doing. This is all relative. A sedentary older person may overload the muscles with 2-4kg whereas a young athlete may need to lift 120kg to get the desired results. As the muscles become stronger there is a need to increase the overload, but once the desired strength is achieved there is not a need to continue overloading. A less challenging or maintenance approach may suffice.
The overloading does not necessarily mean more weight or resistance but can be accomplished by increasing the number of repetitions, decreasing the rest time between sets, or increasing the number of exercises in a workout. If an inappropriate amount of weight is used (too much), the form of the exercise may suffer and injury is more likely to occur.
If too little weight is used, the body does not have to adapt to an overload and gains become harder to achieve. Progressive resistive training must be done to overload the muscle. This is a strength training modality in which the overload is constantly increased to facilitate adaptation. Progressive resistive exercises were first witnessed by the Greeks when a young man lifted a calf each day until it reached its full growth.
It was well documented that the size of skeletal muscle is affected by amount of muscular activity performed. In order to increase the size or strength of a muscle, a progressive resistive approach must be taken. Everyone has a genetic ceiling when it comes to how much they can lift. For most people the risks outweigh the benefits, therefore lifting a weight to one’s maximal potential is not recommended unless it is part of a competition or possibly for sports performance. People with diabetes will need to be more conservative when lifting heavy weights especially if retinopathy is present.
Individual Goals for Weight Training
Before starting a weight training program it is important to know your goals. For example an athlete who competes in speed-strength sports may perform low repetition, high intensity exercises during or immediately prior the competitive season. A person interested in body building may perform more sets and repetitions of exercises and more exercises per body part than weight lifters or strength athletes.
Table 1
Bar - The metal shaft that forms the handle of a barbell or dumbbell. |
Barbell – A bar used with weighted plates on each end to create a resistance |
Bodybuilding - A sport that involves lifting weights to develop your muscles to their greatest capability. |
Breathing (Proper) – Inhale through your nose just before performing the exercise and exhale through your mouth when you exert. Inhale on the way back and exhale when you lift the weight again. |
Dumbbell - A one-handed barbell. Dumbbells are shorter and usually of a lighter weight. |
Failure - Working the muscles to a point where you are unable to continue to perform the exercise. |
Free Weights - Versatile dumbbells and barbells free from machine support or pulley assistance. Many athletes like using this form of weight training.
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| Form (Proper) – Moving a weight in a controlled and smooth manner through a complete range of motion. |
Hypertrophy - An increase in size of a muscle. |
Isolation - Focusing an exercise to one muscle. |
Overload - The amount of force against which a muscle is required to work that surpasses the weight which it ordinarily handles. |
Pin-loaded Weight Machines - A weight stack with pulleys and cable systems which enables you to push or pull through a predetermine range of motion. A pin is placed at the desired weight before performing the exercise. Often found in gyms or home weight equipment. |
Power Lifting – A sport that involves lifting the heaviest weight possible for one repetition (e.g., Squat, Bench Press and Dead lift). |
Progression - To methodically increase the stress a muscle tolerates during an exercise. This can be accomplished by increasing the weight, number of repetitions, number of sets, or by decreasing the rest interval between sets. |
Repetition – Is often called a “rep” and involves moving a body part through a complete range of motion and back to the starting point. When an exercise has progressed through one complete range of motion and back to the beginning, one repetition has been completed. (i.e. lifting a weight up and down once). |
Resistance - The actual weight against which a muscle is performing. This can be free weights, machines, rubber bands, or even one’s own body weight. |
Rest Interval - A breather between sets that permits the body to recover and get ready for the next set of exercises. This may consist of a break from between 30s and 3 minutes rest between sets. |
Routine – A program with a distinct schedule of exercises (upper body routine or lower body routine). |
Set - A succession of repetitions done without rest (10 reps = 1 set). |
Spotter – A person who stands close by to give some assistance when performing an exercise. A spotter is usually needed when lifting free weights or weights that are too heavy for an individual. |
Their goal is to build large, defined, symmetrical muscles. A person may want to “tone up” which may involve1-3 sets of 10-15 reps 2-3 times per week. People may vary in the rate they gain strength. Some of these differences can be credited to the proportion or type of fibers a person has.
Endurance athletes will tend to have more slow-twitch fibers whereas strength athletes will have more fast-twitch fibers. People with more fast-twitch fibers tend to gain strength faster. The bottom line is that genetics plays a role but training can influence strength gains as well.
Safety Precautions
Some basic guidelines or safety precautions for a person with diabetes who wants to start a weight training program are as follows:
- Keep your diabetes team involved when starting a weight training program and note if any problems with your control arise during it.
- Start with lower weights and higher reps concentrating on form. It is probably a good idea to enlist the help of a personal trainer for a couple sessions to make sure you are doing proper form and it is the right program for you.
- Try to avoid holding your breath (Valsalva Maneuver) when you lift weights. You will be able to lift more weight but this will create blood pressure to increase and well as pressure around your eyes.
- If using free weights (i.e. free weight bench press) use a spotter when necessary.
- Avoid doing an exercise that causes a sharp pain. A burn is okay in the muscle but any pain within the joint is not usually a good sign.
Getting Started
Before starting a weight training session it is best to undertake a general aerobic warm up to increase your body temperature and literally warm up the muscles that you will be using. This can be accomplished by walking on a treadmill or riding a stationary bike for 5-7 minutes. A good indicator that you are warm enough is when you have a light sweat across your forehead. Spending 30-45 minutes doing 5-7 weight training exercises is plenty when first getting started.
Remember the muscles need time to recuperate so never work the same muscle group two days in a row. For someone who trains three days a week, a Monday, Wednesday, Friday schedule or Tuesday, Thursday, Saturday is ideal. A good rule involving the order of exercises is to start with large muscle groups (chest) then followed by small muscle groups (biceps).
To determine the amount of weight to use, the correct weight should cause fatigue by the last couple of repetitions in each set. If you are lifting at 3 sets of 10 reps the 9th and 10th rep should be difficult while maintaining proper form. Good lifting technique should maintain proper posture while moving through the lift in a controlled fashion.
A 1-2s count for the push or pull and a 2-4s count on the recovery phase or return to starting position are recommended. Below are three sample weight training programs based on three individuals with separate goals. It is best to change the program to get the best results about every 6-8 weeks.
A middle-aged mom with Type 1 diabetes who wants to start a strength training program because she is concerned about Osteoporosis and wants to tone up:
Monday, Wednesday, and Friday – 1-3 sets of 10 reps, rest 1 minute between sets Chest Press, Seated Row, Bicep Curls, Triceps Press, Leg Press, Knee Flexion, Crunches
A competitive athlete with diabetes who wants to increase speed and strength as well as prevent injuries prior to the season:
Tuesday and Friday – 3-6 sets, 2-4 reps (80-90% of Maximum Lift), 3-4 minutes rest between sets. Dead Lift, Squats, Power Cleans, Free Weight Bench Press, Bent Over Row
An older male with Type 2 diabetes was told by his doctor to start an exercise program that includes strength training.
Tuesday, Thursday, and Saturday – 3 sets 8 reps, 1-2 minutes rest betweens sets Chest Press, Seated Row, Shoulder Press, Lat Pull down, Leg Press, Knee flexion, Crunches
This article was adapted from Weight Training and Diabetes by Rick Philbin and first appeared in the Challenge fall 2004
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