IS RESISTANCE EXERCISE TRAINING AN EFFECTIVE ADDITION to anti-diabetic pharmaceutical agents for managing type 1 and type 2 diabetes? The answer appears to be yes. Moreover, for the one in three adults in the USA who have pre-diabetes, this article about weightlifting and diabetes risk is for you, too.
Most physical activity guidelines call for the performance of 150 minutes of moderate-to-vigorous or 75 minutes of vigorous aerobic exercise training weekly to reduce chronic disease risk. Stay active, and you are less likely to suffer cardiovascular disease, type 2 diabetes, cancer, and mobility disability.
However, an emerging body of clinical literature shows that resistance exercise training may be as effective as aerobic-type activities in reducing chronic disease risk.
Let’s examine whether resistance-exercise training (such as weightlifting) is a potent countermeasure against diabetes mellitus.
Type 2 diabetes
The United States Centers for Disease Control and Prevention explains that diabetes is a chronic health condition that influences how your body turns fuel into energy.
Your body breaks down most of the food we consume into sugar (glucose) and releases it into the bloodstream. As your blood sugar rises, the pancreas responds by releasing insulin. Insulin is a key to blood sugar entering the body’s cells for use as energy.
If you have diabetes, your body does not make enough insulin (or cannot use it as effectively as normal). Over time, as there is insufficient insulin (or the cells stop responding to it), too much blood sugar lingers in your bloodstream.
With time, the elevated sugar in the bloodstream can lead to health problems, including kidney disease, vision loss, or heart disease.
Type 2 diabetes types
There are three types of diabetes:
- Type 1 diabetes. This form of diabetes is secondary to an autoimmune reaction; the body attacks itself by mistake. This reaction stops the body from making insulin. Type 1 diabetes represents about five to 10 percent of those with diabetes. Type 1 diabetes is associated with rapid symptom development, often in children, teens, and young adults. To survive, those with type 1 diabetes must take insulin.
- Type 2 diabetes. Those with this form of diabetes don’t use insulin well and thus cannot keep their blood sugar at normal levels. Type 2 diabetes is the most common form; approximately 90 to 95 percent of those with diabetes have type 2. Some don’t notice symptoms; getting your blood sugar is important if you are at risk. The good news? Type 2 diabetes can be prevented or delayed with healthy lifestyle changes, such as: Eating well, losing weight, and being active.
- Gestational (while pregnant) diabetes. This form of diabetes develops in pregnant women (who have no history of diabetes). If you have gestational diabetes, your baby may have a higher risk of health issues. Fortunately, gestational diabetes typically resolves after the baby is born. Gestational diabetes can increase the risk of type 2 diabetes later in life. The baby is more likely to have obesity as a child and to develop type 2 diabetes later in life.
Let me say a few words about pre-diabetes. More than one in three adults in the United States have pre-diabetes, a condition in which blood sugar levels are above normal but not high enough for a type 2 diabetes diagnosis.
Unfortunately, pre-diabetes raises the risk of heart disease, type 2 diabetes, and stroke. The US Centers for Disease Control offers hope: A lifestyle change program can help many reverse pre-diabetes.
Exercise as a diabetes management tool
Along with cardiovascular disease and cancer, type 2 diabetes is a leading cause of morbidity and mortality in adults over 65. Aging is a key predictor of mobility impairments; such impairment increases chronic disease risk.
Aging is the biggest predictor of mobility impairments, raising the chances of chronic disease.
However, routine exercise can variably mitigate the age-related reduction in physical mobility and reduce chronic disease risk to an appreciable extent.
WEIGHTLIFTING and type 2 diabetes
As we age, the progressive loss of skeletal muscle mass and strength is known as sarcopenia and is prognostic for mobility disability and chronic disease.
Fortunately, strength training (for example, in frail older individuals) is accompanied by physical function improvements. Regular physical activity is a central pillar in reducing your risk of chronic diseases and can mitigate the risk of mobility disability as you become older.
I often write about aerobic exercise but not frequently about resistance training. You may conceptualize these two exercise approaches on opposite ends of the spectrum. But the approaches often have similar health upsides.
Numerous physical activity guidelines convey that we should get at least 150 minutes of moderate-to-vigorous activity or 75 minutes of vigorous aerobic-style exercise each walk. I am to walk at least 150 minutes and typically get in much more than that.
But are we missing out on the utility of resistance exercise training in dropping our chances of suffering from chronic disease? Can we better optimize our functional abilities by getting in some resistance training? The answer, I think, is yes to both questions. Today, we look at how resistance exercise training can reduce your risk of diabetes and its associated complications.
Specifically, I want to examine the role of weightlifting and resistance exercise training in fighting type 2 diabetes.
There are many drawbacks to aging, including the progressive deterioration of our sensitivity to natural insulin (with resultant challenges with blood sugar control). Changes such as these raise our risk of developing type 2 diabetes.
It makes sense that resistance work might help combat diabetes. After all, approximately 80 percent of our body sugar (glucose) is deposited in our skeletal muscles after we eat.
Our loss of muscle mass (and metabolic efficiency) with age probably drives insulin resistance and the development of type 2 diabetes mellitus. There is an inverse relationship between lean body mass and insulin resistance. In addition, as our muscle strength diminishes with age, we often reduce our daily physical activity, leading to suboptimal metabolism.
Let’s turn to the effectiveness of lifestyle interventions for the prevention and management of diabetes. The Diabetes Prevention Program showed the power of lifestyle modification, as reported in the prestigious New England Journal of Medicine in 2002:
Diet and exercise appeared to be associated with a greater reduction in type 2 diabetes (T2D) risk compared with a primary drug for type 2 diabetes, metformin. The crude incidence was 11, 7.8, and 4.8 cases per 100 person-years for the placebo, metformin, and lifestyle-intervention groups, respectively
The study focused on the effects of aerobic exercise training on blood sugar control, with little thought given to resistance exercise training.
What about resistance exercise training and diabetes risk? Brenda Davy, Ph.D., RDN of Virginia Tech (USA), showed that after only three months of twice-weekly resistance training (progressive, supervised, and whole body), about one-third of overweight or obese pre-diabetic older adults achieved normal glucose tolerance.
A separate analysis of approximately 32,000 men, ages 40 to 75, in the Health Professional’s Study showed these encouraging results:
Men engaging in a minimum of 150 minutes of resistance exercise training had a one-third (34 percent) lower risk of developing diabetes over 18 years.
I wish I could give you the preferred statistic of absolute risk reductions, but the study authors only provide relative risk drops.
Finally, a meta-analysis of 360 older patients with type 2 diabetes showed that resistance exercise training for at least eight weeks appeared to be associated with improved blood sugar control, a measure known as hemoglobin A1c (HbA1c). Not surprisingly, resistance training appeared linked to better strength, too.
Do you do resistance exercise training? Thank you for joining me in this look at weightlifting, resistance training, and type 2 diabetes.
One more thing:
The information I provided in this blog is for educational purposes only and does not substitute for professional medical advice. Please consult a medical professional or healthcare provider if you seek medical advice, diagnoses, or treatment. I am not liable for risks or issues associated with using or acting upon the information in this blog.
