Resistance exercise

What is Resistance Training?

Resistance Training is a form of exercise that uses external forces to cause muscles to contract, you move your body against resistance such as weights. This particular type of exercise can help increase strength and can tone the body.(1)

Examples of resistance exercise includes, squats, resistance bands and lifting weights.(1)(2)

Simple resistance training exercises to try :

  1. Three sets of 10 bicep curls. Hold equal weights in each hand with your palms at your thighs. Gently bring the weights up to your shoulders before lowering back to your thighs.(14)
  2. Eight to twelve reps of Lunges on either side. Stand with legs apart and extend a foot forward and bend the knee downwards. (14)
  3. While laying on your back , hold two dumbbells in either arm at chest level and raise upwards. Repeat for three Reps. (14)

Resistance Training is also a convenient and cost effective exercise to do. Resistant bands and weights are easily accessible to everyone and can be done in the comforts of your own home for free or in a gym which provides equipment for other forms of exercise such as high intensity-interval training and endurance exercises. Both proven beneficial for type two diabetes.

 

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Why choose Resistance Training?

The number of people with diabetes is increasing, therefore new methods of controlling and maintaining the disease need to be discovered,(3) as prescription medication can be expensive. Physical activity and diet control are important factors in managing Type Two Diabetes Mellitus (T2DM).

Resistance training is known to help lower blood glucose levels as well as improve glucose control and insulin sensitivity.(4)(5) Potentially beneficial to T2DM patients as T2DM is known as insulin resistant and a minimum of two days per week of resistant training can promote insulin sensitivity in T2DM patients .(6) In addition, one in four adults in the UK suffer from obesity and 80-85% of those adults are thought to have a risk developing T2DM.(7)

Consequently, performing endurance exercises such as swimming or running for 20 plus minutes could be taxing for those with both T2DM and obesity, since obesity is a common cause of T2DM in patients, the body may be physically unable and resistance training would be an easier yet effective alternative.(5) Diabetes is much higher in the elderly population with 26% of 65 year olds or older having diabetes and 90-95% of those having T2DM.(13) Long endurance exercises can be difficult for the elderly aswell.

Key information

  1. Exercise is  beneficial for treating/ preventing T2DM
  2. Exercise is one of the first steps for newly diagnosed T2DM patients along with a change of diet.(8)
  3. Resistance training increases glycogen stores (5)
  4. Resistance training has proven to increase glucose regulation (8)
  5. Other body functions also improve when exercising such as adipose tissue, skeletal muscle, liver and pancreatic function.(8)

What does it do?

Blood Glucose Control

There is an increasing incidence for T2DM patients to develop cardiovascular disease due to complications of diabetes. Therefore, high haemoglobin A1c levels are common and exercise has proven to reduce those high/elevated levels.(8)(9) In a study, 266 adults with T2DM were tasked with doing 20 weeks of consistent exercise, which showed an increase in aerobic capacity (VO2max). The increase of the (VO2max) from 50% to 75% indicated clear improvements in reducing haemoglobin A1c levels and cardiovascular fitness.(8) The decrease in haemoglobin A1c levels has lead to improvements in blood glucose control. There is a positive correlation in the increase of blood glucose control and exercise intensity.

Muscle Strength

Suffering from diabetes also comes with the risk of low muscular strength and a rapid decline in muscle strength.(10) During a randomised trial ran by The Look AHEAD (Action for Health in Diabetes) which assessed if lifestyle intervention had an impact on older adults with T2DM, the group of adults undertook a minimum of 175 minutes of unsupervised exercise. Those that took part in the trail had an increased muscular strength by 50%.(10)A similar trial ran with young adults mimicked the older adults results and weight loss, subsequently providing a possible solution for both diabetes and obesity.(10)

 Muscle and Fat Mass

In another study, 28 women with both type 2 diabetes and overweight issues were given the responsibility of completing three days per week of resistance training using resistance bands for an average 60 minutes each time, for 12 weeks.(11) The women were then examined of; their abdominal fat using computed tomography, their muscle mass using dual-energy x-ray absorptiometry and muscle strength with a leg press. Simultaneously, insulin sensitivity was measured. The investigation ended with the woman having a rise in muscle mass (3.0%) and a decline in fat mass and abdominal fat, the waist circumferences of the woman decreased (2.4 ± 2.8 cm; P = 0.009).(11)

 

Figure 1: Table representing the changes in muscle mass, fat mass, regional fat (abdominal), muscle strength and aerobic capacity.(11)

 Glycaemic Control

A 16-week study trialled 62 Latino adult with T2DM to assess the effect of resistance training on glycaemic control. 40 women and 22 men were randomised into a control group and a resistant training group.(12) The training group took part three times a week in supervised 45-minute sessions. The plasma glycosylated haemoglobin levels increased within the group that took part in the training sessions as well as muscle glycogen stores. Resistance training enhanced the diabetic patients body to have a better response in its uptake for glucose. In addition, 72% of adults in the training group had diabetic medication reduced compared to a 42% increase in medication for members of the control group.(12) The positive results of its  improvement of glycaemic and metabolic control suggests that suitable levels of resistance training would be effective even among high risk adult T2DM patients. Other studies have also indicated this along with improvements in skeletal muscle strength within four to six weeks.(13)

 In conclusion, resistance training is an important first step in treating diabetes. It has been proven to increase insulin sensitivity, improve glycaemic control, increase muscle strength and decrease fat and muscle mass.

 

Reference list:

  1. Resistance Training Exercises: Benefits, Definition & Examples [Internet]. eMedicineHealth. 2019 [cited 26 November 2019]. Available from: https://www.emedicinehealth.com/strength_training/article_em.htm#why_resistance_training
  2. Dan’s top ten ‘most functional’ resistance exercises [Internet]. Ptdirect. 2019 [cited 26 November 2019]. Available from: https://www.ptdirect.com/training-design/training-tools/dan2019s-top-ten-2018most-functional2019-resistance-training-exercises
  3. Pesta D, Goncalves R, Madiraju A, Strasser B, Sparks L. Resistance training to improve type 2 diabetes: working toward a prescription for the future. Nutrition & Metabolism. 2017;14(1).
  4. Exercise helps control type 2 diabetes [Internet]. nhs.uk. 2019 [cited 8 December 2019]. Available from: https://www.nhs.uk/news/diabetes/exercise-helps-control-type-2-diabetes/
  5. Eves N, Plotnikoff R. Resistance Training and Type 2 Diabetes: Considerations for implementation at the population level. Diabetes Care. 2006;29(8):1933-1941.
  6. Strasser B, Pesta D. Resistance Training for Diabetes Prevention and Therapy: Experimental Findings and Molecular Mechanisms. BioMed Research International. 2013;2013:1-8.
  7. Diabetes and obesity [Internet]. Diabetes. 2019 [cited 8 December 2019]. Available from: https://www.diabetes.co.uk/diabetes-and-obesity.html
  8. Kirwan J, Sacks J, Nieuwoudt S. The essential role of exercise in the management of type 2 diabetes. Cleveland Clinic Journal of Medicine. 2017;84(7 suppl 1):S15-S21.
  9. Haddad E, Wells G, Sigal R, Boul N, Kenny G. Meta-analysis of the effect of structured exercise training on cardiorespiratory fitness in Type 2 diabetes mellitus. 2003;46(8):1071-1081.
  10. Colberg S, Sigal R, Yardley J, Riddell M, Dunstan D, Dempsey P et al. Physical Activity/Exercise and Diabetes: A Position Statement of the American Diabetes Association. Diabetes Care. 2016;39(11):2065-2079.
  11. Kwon H, Han K, Ku Y, Ahn H, Koo B, Kim H et al. The Effects of Resistance Training on Muscle and Body Fat Mass and Muscle Strength in Type 2 Diabetic Women. Korean Diabetes Journal. 2010;34(2):101.
  12. Castaneda C, Layne J, Munoz-Orians L, Gordon P, Walsmith J, Foldvari M et al. A Randomized Controlled Trial of Resistance Exercise Training to Improve Glycemic Control in Older Adults With Type 2 Diabetes. Diabetes Care. 2002;25(12):2335-2341.
  13. Lee J, Kim D, Kim C. Resistance Training for Glycemic Control, Muscular Strength, and Lean Body Mass in Old Type 2 Diabetic Patients: A Meta-Analysis. Diabetes Therapy. 2017;8(3):459-473.
  14. Slideshow: 10 Muscle Moves to Help Tame Diabetes [Internet]. WebMD. 2019 [cited 13 December 2019]. Available from: https://www.webmd.com/diabetes/ready-to-lower-17/slideshow-diabetes-strength-training

Image 15: https://www.biofitny.com/resistance-exercise-reverses-aging/

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