Resistance Training in Patients with Diabetes

Exercise is an effective lifestyle intervention for managing diabetes. It improves body composition, muscle strength, insulin sensitivity, and glycated hemoglobin levels. However, fluctuations in blood glucose during exercise can discourage participation among individuals with diabetes. The direction and extent of these changes depend on pre-exercise glucose levels, insulin dosage, medications, and exercise type, intensity, and duration. Aerobic exercise lowers glucose by enhancing insulin sensitivity for up to 72 hours post-activity, whereas resistance training may reduce the risk of exercise-induced hypoglycemia. During resistance exercise, catecholamines (epinephrine and norepinephrine) are released, stimulating hepatic glucose production, inhibiting peripheral glucose uptake, and increasing lactate formation through anaerobic glycolysis. Consequently, blood glucose may decrease only slightly or even rise transiently during and after exercise recovery. Resistance training enhances glucose regulation by promoting GLUT4 translocation and increasing muscle mass, leading to improved insulin sensitivity, reduced adiposity, and greater muscular strength. Individualized resistance training with proper glycemic monitoring is therefore an essential component of optimal diabetes management.