Lift a Heavy Load

We’ve all heard about the importance of physical activity in helping to manage our health, and there are innumerable articles across this vast Web expanse that promote exercise routines for better management of your diabetes and to help prevent those complications that so often accompany our pancreatic malady.


So how about another piece of writing to add to the pile. You’d like more on the subject, right? Perhaps not, but I’m going to give it to you anyway.

Let me begin by telling you what I said to my wife last night around 10 o’clock, as we were getting ready for bed. I’d just checked my blood glucose and it was at 87 mg/dl. We’d had a very low-carb dinner, and I’d actually bolused only for about half of those carbohydrates. It was nice to see the numbers back down around 100, because over the past weekend they’d shot up in the 200s and I was having a heck of a time getting them back down. I suspected it was because circumstances the week prior prevented me from my workouts.

“You see,” I told Kathryn, “this is why I’ve become somewhat obsessive about making it to the gym.”

Ah, the gym. Used to be I’d have to convince myself it was something I needed to do. I’d often have to fight the urge after work to keep on driving and just go home, make an early dinner, and settle down for a movie or a TV show. There was a time I believed that the 40-minute dog walk in the morning was adequate exercise for the day.

Then about a year ago I made a commitment to spend some time at the gym — three, maybe four times a week. I planned to combine aerobic work with resistance training. Yes, weight lifting. Free weights, too, in that (what I thought of as) forbidden and scary area where the muscleheads roamed. It was something I was always hesitant about.

Finally I sucked it up and ventured in. And I stuck with it. These days I look forward to my workouts, both the cardiovascular side as well as the weight lifting portion.

In fact, I often feel more enthusiastic about the lifting.

A couple years ago my primary-care physician explained to me the importance of weight resistance and its benefits for people with diabetes. Her words kind of fell on deaf ears. At first. For the longest time, I wanted to believe that I mostly needed to focus on aerobic exercise. Couldn’t I just go to the gym and take those spinning classes (which I really liked)? Wouldn’t that be enough? Turns out that while it was better than nothing, it wasn’t all.

Here is an excerpt from the opening of an article titled “Strength Training in Diabetes Management”:

There is now a substantial and ever-growing body of evidence demonstrating the merits of strength training. When combined with aerobic exercise, some of the benefits are additive, whereas others are unique to strength training and cannot be achieved through aerobic activity alone. Many of these benefits may be particularly useful when employed in the management of chronic diseases such as diabetes. Health care providers, however, often remain unfamiliar, unconvinced, or both regarding recommendations for strength training exercise for their patients.

David Spero’s also written about this topic, and there are many other articles on Diabetes Self-Management about resistance training. Try throwing “resistance training” into the search feature of this site, or “weight training”. You just might spend all morning reading on the topic.

My gym routine is in full force this week, which is why the glucose was trending back down to more acceptable numbers before bed. While 87 mg/dl was a bit low for me, all it meant was that I’d take in about 15 grams of carbohydrate before falling asleep. That sure beats worrying because my numbers were in the upper 200s.

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  • Steve Parker, M.D.

    Judging from improvement in hemoglobin A1c, the combination of aerobic and strength training is needed to improve diabetic blood sugar levels. Both types of exercise—when considered alone—did not improve diabetes control, according to the latest research in the Journal of the American Medical Association.

    Prior studies had shown exercise-induced improvements (reductions) in hemoglobin A1c, a great test for overall diabetes control, in the range of o.66% to 1.0% (absolute change, not relative). That’s comparable to what we see with many drugs. Much easier to pop a pill though, huh?

    One earlier study showed hemoglobin A1c lowered by 0.4% with resistance training, 0.5% with aerobic training, and 1.0% with combined resistance/aerobic. But folks doing both aerobic and resistance were exercising 270 minutes a week—39 minutes a day—which was significantly more than the people just doing one type of exercise. [This was the DARE study: Diabetes Aerobic and Resistance Exercise.]

    The combination training group in the JAMA study dropped their hemoglobin A1c average by 0.34% (p = 0.03). The pure resistance and aerobic exercisers didn’t show any improvement over the control group.


    Reference: Church, T., Blair, S., Cocreham, S., Johannsen, N., Johnson, W., Kramer, K., Mikus, C., Myers, V., Nauta, M., Rodarte, R., Sparks, L., Thompson, A., & Earnest, C. (2010). Effects of Aerobic and Resistance Training on Hemoglobin A1c Levels in Patients With Type 2 Diabetes: A Randomized Controlled Trial JAMA: The Journal of the American Medical Association, 304 (20), 2253-2262 DOI: 10.1001/jama.2010.1710

  • Brad

    My blood sugar jumps 30-50 points after lifting weights but drops 20-30 points after an hour on the treadmill.

    None of my doctors can explain the jump after lifting weights.

  • Felix

    Same problem with Brad here. Just did a heavy session in the gym (just benched a PB of 245) , my BG is around 10.5 (super high). I did some reading before and it seems that the reason for that is because during intensive weight training, adrenaline is released in order to cope with the added weight, which in turn leads to elevated blood sugar levels.

    Just took my metformin. BG levels should retreat back to less than 6 in 2 hours. Worrying that every workout I do, I need to rely immediately on medication to bring my BG levels back down.

    So, I have a theory. Do heavy weights (fun and macho) and do an hour of cardio after (bring the BG levels back down). Will try this out and see if it works. Problem is, I can never get out of bed early enough not to be late for work if I do that.