Resistance Training for Diabetes

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Resistance Training for Diabetes

Research shows that physical activity has numerous health benefits for people with diabetes and prediabetes. Indeed, it can improve blood glucose management as well as overall health. Many people with diabetes focus their exercise goals on aerobic exercise, such as cycling or walking at a brisk pace. But while aerobic exercise is important, resistance training (strengthening your muscles) is another significant part of achieving maximum health benefits when you have diabetes.

What is resistance training?

The term resistance training, or strength training, often conjures images of buff men and women in the gym lifting heavy weights. The truth is that routine strength training is appropriate and beneficial for most people with diabetes. Resistance training consists of exercise movements that put tension on your muscles using some type of resistance. This resistance helps build muscle and increase strength. A common kind of resistance training is the use of free weights, but that is not the only way to strengthen your muscles. You can also use resistance bands, weight machines and even exercises that rely on your own body weight to get the same results. The good news is that you certainly do not have to be a bodybuilder to reap the benefits of resistance training, and you don’t even have to step foot in a gym. With just a few items, you can develop and maintain an effective strength-training routine from the comfort of your own home.

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Benefits of resistance training for diabetes

As noted earlier, resistance training has many health benefits for people with diabetes. Such training can provide a safe and effective way to optimize blood glucose levels, increase strength and improve quality of life. It can also lead to lowered insulin resistance, fat mass and blood pressure, as well as improvements in lean body composition, bone density and cardiovascular health. Having diabetes can put you at risk for decline in both muscle strength and functional status (the ability to perform normal daily activities) as you age. Incorporating strength training into your exercise routine can help combat those effects of aging. Improved mood and well-being are also great benefits when you add resistance training to your exercise regimen.

Better blood glucose control

When you do strength-training exercises, your body uses glucose from your bloodstream to power your muscles. Think of your muscles as a lot of little “gas tanks” that store glucose. Since glucose from food is absorbed largely by muscle tissue, exercise that improves muscle mass is particularly good at improving blood glucose levels. Because of this, you may actually see an improvement of your hemoglobin A1C (HbA1c, a measure of glucose control over the previous two to three months).

Improved insulin sensitivity

If you have type 2 diabetes, your body’s cells have become resistant to insulin. Insulin is the hormone needed to move glucose from the bloodstream into your body’s cells to be used for energy. If you have insulin resistance, this process does not work correctly, and your blood glucose becomes elevated over time. Studies have shown that resistance training makes your body sensitive to insulin for about 24 hours. Thus, adding strength training to your routine can help improve your body’s sensitivity to insulin.

Weight loss and improved body composition

Another benefit of resistance training is that you use a lot of energy to build and maintain muscles. The more muscle you have, the more calories you burn, even when you are not exercising. This makes strength training an excellent strategy for weight loss and maintenance. While aerobic exercise can result in loss of both fat and lean body weight, strength training actually helps preserve and build lean body weight as you lose fat.

Improved functional status

Resistance training helps improve overall functional status for people with diabetes. A strength routine of any intensity is recommended for improvement in strength, balance and the ability to do activities of daily living. Training can improve bone density and lower the risk of developing osteoporosis, as well as strengthen your joints, which is important to maintain mobility as you age.

Getting started

If you have never done strength training before, it is best to start slowly and progress gradually. Resist the urge to do too much too quickly. A strength routine should be individualized for your age, fitness level and specific health issues. Working with a fitness professional, particularly one who is knowledgeable about diabetes, is a great way to develop a safe and effective exercise prescription to learn proper form and avoid injury. The intensity and duration at which you begin will vary, so concentrate on making progress. Steady progression is the key.

The American Diabetes Association recommends that people with diabetes start with two to three nonconsecutive weekly sessions of resistance-training exercises. Each session should consist of five or more different strength-training exercises. A good starting point is one to three sets per exercise. (A set is simply a group of consecutive repetitive exercise motions.) Start with a weight that you can do eight to 10 repetitions with in each set. Focus on doing exercises that use large muscle groups, such as your thighs and upper arms, versus those that use smaller ones. Using resistance bands or body weight to strength train is a great option if you do not have free weights. These methods are inexpensive and can be done anywhere.

It is essential to take time for a proper warm-up before you begin your strength routine. A five-minute warm-up with a combination of stretching and light aerobic exercise (such as walking in place) is all it takes to warm up your muscles. Strength training without a proper warm-up can lead to injury. In addition, always rest between sets. A 30- to 60-second rest period is appropriate in most situations. Finally, set aside five minutes at the end of your workout for a cool-down period.

Resistance training should be done on nonconsecutive days, meaning you will need to rest your muscles at least one day between strength-training sessions. Muscle fibers develop microscopic tears during a workout. Don’t worry — this is how they grow, but it is important that you let your muscles rest between sessions. If you feel sore, take it easy until you feel better. Forget the old motto “no pain, no gain.” It is no fun to work out in pain, and doing so increases your risk of injury.

Blood glucose during strength training

As with any exercise, resistance training affects blood glucose levels, so you should monitor your glucose level before, during and after exercise. Glucose monitoring is how you can see the effect training has on your body. Individual response to exercise is different based on fitness level, duration and intensity of the activity, as well as pre-exercise blood glucose levels.

If you take insulin or glucose-lowering medications that can cause hypoglycemia (low blood glucose), the risk can increase during exercise. It is important to know the warning signs of hypoglycemia. In some cases, it may be good to have a light meal or snack before your exercise session. You may need to adjust your insulin dose and/or carbohydrate intake based on the intensity and duration of your workout. Low blood glucose levels can happen for several hours after exercise, so it is important to continue to monitor. For those with type 1 diabetes, exercising with hyperglycemia (high blood glucose) and elevated blood or urine ketones is not recommended.

Other considerations

If you are new to resistance training, it is a good idea to consult with your diabetes provider to see if there are any precautions you need to take. Ask if you might benefit from an exercise stress test before starting a new exercise routine. Especially if you have uncontrolled blood pressure, heart problems, severe neuropathy (nerve damage) or other serious illnesses or conditions, you should check with your diabetes care provider before beginning a strength-training regimen. Resistance training is not recommended in anyone with severe nonproliferative or unstable proliferative diabetic retinopathy because the condition may worsen. Make sure to wear proper, well-fitting footwear and examine your feet daily for any sign of injury. Lastly, stay hydrated and avoid exercise in extreme weather conditions.


Adding resistance training is a great way to improve blood glucose control, strength and ability to participate in activities of daily living. Ideally, a well-rounded fitness program for someone with diabetes includes both aerobic and resistance exercises. In addition to two to three resistance training sessions per week, at least 150 minutes of weekly moderate-intensity aerobic exercise is recommended. Research shows that the greatest health benefits come from a combination of aerobic exercise and strength training. Start today with a new and improved fitness routine!

Want to learn more about exercising with diabetes? Read “Add Movement to Your Life,” “Picking the Right Activity to Meet Your Fitness Goals” and “Seven Ways to Have Fun Exercising.”

Laura Hieronymus, DNP, MSEd, RN, MLDE, BC-ADM, CDCES, FADCES

Laura Hieronymus, DNP, MSEd, RN, MLDE, BC-ADM, CDCES, FADCES

Laura Hieronymus, DNP, MSEd, RN, MLDE, BC-ADM, CDCES, FADCES on social media

A doctor of nursing practice, master licensed diabetes educator, and Practical Diabetology editor. Hieronymus is the associate director of education and quality services at the UK HealthCare Barnstable Brown Diabetes Center, University of Kentucky, Lexington, Kentucky.

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