When most people think of diabetes exercise, they picture walking, jogging, or cycling. But there's another type of exercise that's equally important: strength training.
Building muscle through resistance training is one of the most effective ways to improve blood sugar control—yet it's often overlooked.
Let's explore why strength training matters for diabetes and how to get started.
Why Muscle Matters for Blood Sugar
Muscle: Your Body's Glucose Disposal System
Here's something most people don't know: skeletal muscle is the primary site where your body disposes of glucose.
| Tissue | Glucose Disposal |
|---|---|
| Skeletal muscle | ~80% of insulin-stimulated glucose uptake |
| Adipose (fat) tissue | Minor contributor |
| Liver | Stores glucose as glycogen |
More muscle = more "parking spaces" for glucose.
How Strength Training Helps
| Benefit | How It Works |
|---|---|
| Increases muscle mass | More tissue available to absorb glucose |
| Improves insulin sensitivity | Muscles become more responsive to insulin for 24-72 hours after training |
| Raises resting metabolic rate | More muscle = more calories burned at rest |
| Improves body composition | Lose fat while maintaining or gaining muscle |
| Enhances functional ability | Daily activities become easier |
The Evidence
Research on strength training and diabetes shows:
- 0.5-1.0% A1C reduction (similar to aerobic exercise)
- Increased muscle mass with concurrent fat loss
- Improved insulin sensitivity lasting 1-3 days after each session
- Lowered blood pressure and improved cholesterol
- Reduced visceral fat (dangerous belly fat)
The 2025 ADA Recommendations
Strength Training Guidelines
The American Diabetes Association recommends:
| Recommendation | Details |
|---|---|
| Frequency | 2-3 times per week on non-consecutive days |
| Volume | 5-10 exercises per session |
| Sets | 2-4 sets per exercise |
| Repetitions | 8-12 reps per set (to near fatigue) |
| Intensity | Moderate to vigorous (hard to very hard) |
| Rest | 1-2 minutes between sets |
Important Note
Strength training should be in addition to aerobic activity, not a replacement. The ideal exercise program includes both.
Getting Started: Equipment Options
No Equipment (Bodyweight)
| Exercise | Primary Muscles |
|---|---|
| Push-ups | Chest, shoulders, triceps |
| Squats | Legs, glutes |
| Lunges | Legs, glutes |
| Plank | Core |
| Wall sit | Legs |
| Glute bridge | Glutes, hamstrings |
| Dips (using chair) | Triceps |
Pros: Free, can do anywhere, no equipment needed Cons: Limited progression options
Resistance Bands
| Exercise | Primary Muscles |
|---|---|
| Chest press (band) | Chest |
| Rows (band) | Back |
| Shoulder press | Shoulders |
| Bicep curls | Biceps |
| Squats with band | Legs |
| Lateral walks | Hips, glutes |
Pros: Inexpensive, portable, progressive resistance Cons: Bands can break over time, less intuitive than weights
Dumbbells
Recommended starter set: 5, 10, 15, 20 lb pairs (or adjustable dumbbells)
| Exercise | Primary Muscles |
|---|---|
| Chest press | Chest |
| Rows | Back |
| Shoulder press | Shoulders |
| Bicep curls | Biceps |
| Tricep extension | Triceps |
| Goblet squats | Legs |
| Lunges with weights | Legs |
| Deadlift | Legs, back, glutes |
Pros: Versatile, compact, progressive Cons: Need multiple weights for progression, limited max weight
Weight Machines
| Exercise | Primary Muscles |
|---|---|
| Chest press | Chest |
| Lat pulldown | Back |
| Seated row | Back |
| Leg press | Legs |
| Leg extension | Quadriceps |
| Leg curl | Hamstrings |
| Shoulder press | Shoulders |
Pros: Safe, guided movement, easy progression Cons: Requires gym membership, less functional than free weights
A Complete Strength Training Program
Full-Body Workout (Beginner)
Perform 2-3 times per week with at least one rest day between sessions.
| Exercise | Sets | Reps | Rest |
|---|---|---|---|
| Bodyweight squats | 2-3 | 10-12 | 60 sec |
| Wall or knee push-ups | 2-3 | 8-10 | 60 sec |
| Dumbbell rows | 2-3 | 10-12 | 60 sec |
| Overhead press (light dumbbells) | 2-3 | 8-10 | 60 sec |
| Glute bridges | 2-3 | 12-15 | 60 sec |
| Plank | 2-3 | Hold 20-30 sec | 60 sec |
Intermediate Full-Body Workout
| Exercise | Sets | Reps | Rest |
|---|---|---|---|
| Goblet squats | 3 | 10-12 | 90 sec |
| Bench or chest press | 3 | 8-12 | 90 sec |
| Bent-over rows | 3 | 10-12 | 90 sec |
| Walking lunges | 3 | 10 each leg | 90 sec |
| Shoulder press | 3 | 8-10 | 90 sec |
| Deadlifts | 3 | 8-10 | 90 sec |
| Plank | 3 | Hold 30-60 sec | 60 sec |
Upper/Lower Split (Intermediate/Advanced)
Day 1 - Upper Body:
- Bench press: 3×8-12
- Rows: 3×10-12
- Shoulder press: 3×8-10
- Bicep curls: 3×10-12
- Tricep extensions: 3×10-12
Day 2 - Lower Body:
- Squats: 3×10-12
- Deadlifts: 3×8-10
- Lunges: 3×10 each leg
- Leg curls: 3×12-15
- Calf raises: 3×15-20
Day 3 - Rest or light cardio
Day 4 - Upper Body (repeat Day 1)
Day 5 - Lower Body (repeat Day 2)
Days 6-7 - Rest or light activity
Progressive Overload: The Key to Improvement
What Is Progressive Overload?
Gradually increasing the demands on your muscles so they continue to adapt and grow stronger.
How to Progress
| Method | Example |
|---|---|
| Add weight | Go from 10 lb to 12 lb dumbbells |
| Add repetitions | Increase from 8 reps to 10 reps |
| Add sets | Go from 2 sets to 3 sets |
| Decrease rest | Reduce rest from 90 to 60 seconds |
| Improve form | Focus on controlled movement through full range |
When to Progress
When you can complete all sets and reps with good form and the last few reps feel challenging but doable, it's time to progress.
Safety Considerations
General Safety Rules
- Warm up first - 5-10 minutes of light movement
- Use proper form - quality over quantity
- Breathe properly - exhale on exertion, inhale on release
- Start light - master form before adding weight
- Don't hold your breath - especially important if you have hypertension
- Stop if you feel pain - discomfort is normal, pain is not
For People with Diabetes Complications
| Complication | Considerations |
|---|---|
| Retinopathy | Avoid heavy lifting, head-down positions, straining (Valsalva maneuver) |
| Neuropathy | May have reduced sensation; use machines to avoid dropping weights |
| Kidney disease | Avoid very high intensity; moderate is safe |
| Cardiovascular disease | Get medical clearance first; avoid breath-holding |
Exercise with High Blood Sugar
- Avoid vigorous exercise if blood sugar > 300 mg/dL with ketones
- If > 250 mg/dL (type 1), check ketones before exercising
- Monitor blood sugar before and after exercise
Exercise with Low Blood Sugar
- Avoid exercise if blood sugar < 70 mg/dL
- If < 100 mg/dL and on insulin/sulfonylureas, have a snack first
- Always carry fast-acting glucose when exercising
Sample Weekly Schedule
Integrating Strength and Cardio
| Day | Activity | Duration |
|---|---|---|
| Monday | Strength training (full body) | 30-45 min |
| Tuesday | Aerobic exercise (walk, cycle, swim) | 30 min |
| Wednesday | Rest or light activity | — |
| Thursday | Strength training (full body) | 30-45 min |
| Friday | Aerobic exercise | 30 min |
| Saturday | Rest or enjoyable activity | Variable |
| Sunday | Rest | — |
Time-Saving Option: Circuit Training
Combine strength and cardio in one session:
- Perform exercises back-to-back with minimal rest
- Rest 1-2 minutes after completing all exercises
- Repeat 2-3 times
Benefits:
- More efficient (finish in 30-35 minutes)
- Cardiovascular benefits from continuous movement
- Time-saving
Tips for Success
1. Start Where You Are
If you're new to strength training:
- Begin with bodyweight exercises
- Focus on learning proper form
- Start with 2 sessions per week
- Gradually add weight/resistance
2. Be Consistent
Two consistent sessions per week beats four sporadic ones. Schedule your workouts like appointments.
3. Track Your Progress
Record:
- Exercises performed
- Weight used
- Sets and reps completed
- How you felt
This helps you see progress and know when to increase difficulty.
4. Listen to Your Body
- Some muscle soreness is normal (DOMS - delayed onset muscle soreness)
- Sharp pain is not normal—stop and reassess form or weight
- Rest days are when muscles grow and repair
5. Combine with Protein
To build muscle effectively:
- Aim for 1.0-1.2 grams of protein per kg body weight daily
- Include protein with each meal
- Consider protein within 2 hours after strength training
Key Takeaways
- Muscle is your body's primary glucose disposal site—building muscle helps blood sugar
- Strength train 2-3 times per week on non-consecutive days
- Start with bodyweight or light weights and focus on form
- Progress gradually by adding weight, reps, or sets
- Combine with aerobic exercise and adequate protein for best results
- Safety first—especially if you have diabetes complications
FAQ Section
Does strength training lower blood sugar?
Yes, strength training improves blood sugar control by increasing muscle mass (more tissue to absorb glucose) and improving insulin sensitivity. Studies show resistance training can lower A1C by 0.5-1.0%, similar to aerobic exercise.
Can I lift weights with diabetes?
Yes, strength training is recommended for people with diabetes. If you have complications (retinopathy, neuropathy, cardiovascular disease), discuss with your healthcare provider first and modify exercises as needed.
How often should I do strength training?
The ADA recommends strength training 2-3 times per week on non-consecutive days. Rest days between sessions allow muscles to recover and grow stronger.
What are the best strength exercises for diabetes?
Compound exercises that work multiple muscle groups are most effective: squats, deadlifts, lunges, push-ups, rows, and chest press. These exercises build the most muscle mass and improve insulin sensitivity.
Will strength training build too much muscle?
No, building significant muscle takes years of dedicated training. Most people with diabetes will simply become stronger, leaner, and more insulin resistant without becoming "bulky." Women, especially, typically don't bulk up without specific training for that goal.
Sources:
- American Diabetes Association. Standards of Care in Diabetes—2025. Diabetes Care 2025; 48(Suppl 1)
- Brazeau AS, et al. Diabetes Care 2021;44:299-313 (Resistance Training and Diabetes)
- CDC Strength Training Guidelines