Cardio vs. Resistance

Certain diabetes-related controversies get widespread coverage in the media: low-carb vs. low-fat diets, drug safety, tight blood glucose control. Exercise is less often a topic of controversy; while the merits of various diets are parsed without end, exercise is often simply considered, well, good. There may be a good reason for this discrepancy: Everyone has to eat and generally eats enough, while studies consistently show that most people with diabetes, especially Type 2 diabetes, do not get the recommended amount of exercise. For most people, getting the maximum benefit from exercise is a concern secondary to finding ways to simply get up and moving more regularly.


But once you’ve decided to exercise, an obvious question arises: What should I do? Many people assume that aerobic, or cardiovascular, exercise — which elevates the heart rate for an extended period of time — is the variety most important to their health. But there are also proven health benefits from resistance exercise, which involves putting stress on muscle groups using weights, resistance bands, or one’s own body weight. (Other forms of exercise, such as anaerobic — which involves elevating the heart rate in intense, short bursts — and flexibility-building exercises, are less well researched.) How important, then, is each type?

A recent study, whose results were presented at the Obesity Society 2010 Scientific Meeting in San Diego, showed — perhaps not surprisingly — that a mix of aerobic and resistance exercise was superior to either form of exercise alone in people with Type 2 diabetes, at least where HbA1c level was concerned. According to an article published in Endocrine Today, the study — known as Health Benefits of Aerobic and Resistance Training in Individuals with Type 2 Diabetes, or HART-D — randomly assigned one of four exercise regimens to each of its 262 participants, who were men and women ages 30–75 with Type 2 diabetes. The four regimens were supervised aerobic training, supervised resistance training, supervised aerobic plus resistance training, and self-directed exercise (the control group, against which all the others were compared). Each regimen was designed to give participants at least 150 minutes of exercise per week. After nine months, the aerobic-plus-resistance group experienced an HbA1c level 0.20% lower, on average, than at the start of the study. The aerobic-only group saw a 0.16% drop, and the resistance-only group saw a 0.08% drop (too small to be statistically significant). The self-guided group, by comparison, saw a 0.24% HbA1c increase.

One notable aspect of this study’s design is that it studied exercise regimens of similar durations, with the type but not overall quantity of assigned exercise varying from group to group. In contrast, a 2007 study on exercise in people with Type 2 diabetes assigned the full aerobic and resistance regimens to its aerobic-plus-resistance group, meaning they were at the gym for twice as long as the other groups. For people deciding how to allocate scarce time to exercise, this older study was therefore perhaps less useful than the new one. But not all evidence favors aerobic and resistance training for everyone. A study by the University of London (UK) released earlier this year, designed to test which forms of exercise help prevent Type 2 diabetes, found that some 20% of participants gained no measurable benefit from aerobic exercise.

What do you think — do you find studies on the relative merits of aerobic and resistance training to be helpful when planning your own exercise? Do you find one type of exercise or the other more enjoyable or manageable, making it more likely that you will follow through with exercise plans? Have you found certain types of exercise to be more or less beneficial to your health? Are there any favorite forms of exercise you’d like to share? Leave a comment below!

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  • Joan Heath

    I like walking the best. I’ve found, with a “walking tape” I can get my heartbeat up and take care of the “aerobic” part that’s supposedly needed. I like being outside. I’ve tried gyms and don’t like being inside, the smell and the mentality! I’m trying resistance bands and Pilates (which I don’t see mentioned very often)at home. Because of a bad back and ankle injury a lot of exercise is off limits. Oh well.


  • Sue Daveler

    I like water aerobics for an hour four days a week and resistance on machines also on those days. I also golf 2-3 times a week. I have a 6.2 HAIc after teb years of meds and Lantus.

  • oliver

    If someone had a source for exercise options that included both aerobic and resistance routines, that would be helpful.

  • Karen

    When I was first diagnosed in 2009 I slowly got back into working out… walking, step aerobics and weights and I saw a really great drop in my HbA1C going from 10 down to 6.4. I also began losing some weight.
    Shortly after I dropped the extra exercise and just walked for an hour most days thinking this would be enough. It wasn’t. I put back on 10 pounds and although I have kept my HbA1C down to 6.4 I also haven’t lowered it either.
    Therefore I have once again added the extra workouts and I feel the weights in addition to the aerobic component are most important and will be what helps me to progress in my goals of losing weight again and lowering my HbA1C.

  • calgarydiabetic

    I don’t know how much exercise helps diabetes. I can’t loose any weight with it.

    Bicycling is excellent for my knees. and since I started to lift weights I have not had any back pain.

  • Ted Meier

    I am 71, work out daily with both aerobic and weights for 60 to 90 minutes. It is a tremendous help (with portion control) in keeping my A1C at around 6.0. When I go off this discipline my A1C begins to climb. I am on no meds. Just exercise and portion control.. Ted

  • Cathy A,

    I love to walk, be it with the dog, by myself, or behind the lawnmower. Living in an area with lots of hills helps even more. Added to that are weights and flex work, which is a series of stretching exercises while I watch TV at night. at almost 60,the stretching seems to help a lot to enable me to garden and do any kids of heavy work without waking up the next morning feeling like I have been run over by a truck.

    12 years ago when I was diagnosed with Type II, my A1c was over 12. Now it is 6.3. I am also about 70 lbs lighter. How did this all happen? I learned the hard way when I had a heart attack 6 years ago. People, cardiac rehab will teach you all of these things, but do you really want to do it that way?