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Diabetes and Hystrength (sm)

diabetesBoth Sharon and I have a client with type 1 diabetes, and they both say that our workout program is very effective at regulating their blood sugar. As a matter of fact, one of them says that our exercise program is more effective than anything else she does. She swims and does cardio training, and they do help her regulate her blood sugar, but they do not come close to how long her blood sugar stays stable with our program. Additionally, when she reviews the data with her doctor, the doctor is so impressed with her results from our workouts that she insists my client keeps that up as part of her routine.

So what exactly is it that makes the Hystrength(sm) program so good at glucose metabolism? To answer that, we need to be on the same page about what the Hystrength(sm) exercise program entails. Then we can take a look at what the research says.

The Hystrength(sm) exercise program

A Hystrength(sm) exercise program has three components that I believe are invaluable to building a fit, shapely, and healthy body.

  • Core conditioning. This includes all of the exercises that work and develop the mid section, such as the rectus abdominus (the six pack look), the obliques and the deeper muscles of the core. This is very important for preventing lower back pain and good overall posture.
  • Functional training. These exercises are general whole body movements that we have our clients do with resistance that teach the body to work as coordinated unit. They are generally performed with a lighter weight/higher rep protocol. We also make our clients do these exercises with a faster tempo than the strength exercises. Functional exercises really get the heart rate up and makes the client train above the anaerobic threshold.
  • Strength training. Traditionally, strength training is performed by splitting up the body into different training days, and doing many sets for each body part. It is not uncommon to see someone doing upwards to 20 sets per body part this way and spending an awful lot of time in the gym. That is not our style. We believe that one set per body part can be just as efficacious as, say, five or ten sets per body part. It all has to do with having the appropriate resistance, cadence, and intensity of the set to bring about the desired result. Training this way makes a very big demand on all of the fibers of the muscle (fast twitch, intermediate twitch and slow twitch), and fatigues them in a thorough manner in a short amount of time. Moreover, we have our clients above the anaerobic threshold quite often during the workout with the strength training exercises (which does not happen with conventional strength training programs). Combined with the functional exercises, our clients are above the anaerobic threshold most of the workout.

Our approach is very similar to both High Intensity Training (HIT) that Arthur Jones and Dr. Ellington Darden made popular back in the 1980’s, and also in many respects similar to High Intensity Interval Training (HIIT) that is gaining popularity today.

High Intensity Training is strength training where the trainee does a whole body routine using basic strength lifts such as leg presses, squats, dead-lifts, chins and so on in a slow and controlled manner with a heavy enough load to fatigue the working muscle within 8 to 12 reps. HIT also minimizes the rest in between sets so that the heart and lungs work very hard as well.

High Intensity Interval Training is a combination of brief, very intense cardio exercise followed by longer periods of rest. A common method is to use a stationary bike and pedal as hard as one can for sixty seconds at a hard grade and then back off to an easy level of pedaling for a couple of minutes, then do another bout of hard pedaling for sixty seconds, repeating this cycle for 10 minutes or so.

The common feature to both of these exercise programs is the fact that they both push the body above the anaerobic threshold and attempt to keep it there for a good amount of time. The difference between the two lies in the fact that High Intensity Training will work all of the muscle groups, whereas the High Intensity Interval Training group will only do that with the legs. It is my belief that training above the anaerobic threshold that both protocols employ, and the whole body exercises that High Intensity Training does in particular, have a strong response to glucose regulation.

The Research…and other interesting sources

The study Resistance Training in the Treatment of Non-Insulin-Dependent Diabetes Mellitus conducted by J Ericksson et al. demonstrated that there was a significant improvement in the HbA1c, which is a way to measure the average blood sugars over a period of time. Furthermore, there is an inverse relationship with HbA1c and cross sectional muscle mass. In other words, the more muscle mass that the subjects developed, the lower the HbA1c (the lower, the better).

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Another study, Strength training improves muscle quality and insulin sensitivity in Hispanic older adults with type 2 diabetes also found that strength training improved both muscle quality and insulin sensitivity in older Hispanic adults.

As for the benefits of High Intensity Interval Training and diabetes, here is a study by Monique Francois and Jonathon Little,  Effectiveness and Safety of High-Intensity Interval Training in Patients With Type 2 Diabetes. They discovered that HIIT is effective in glucose control and overall cardiovascular health.

I found plenty of studies confirming these outcomes, so there is no question that both HIT and HIIT can be beneficial to glucose metabolism. However, intense strength training has better upside potential because intense muscular contractions will drain the glycogen stores of not only the slow twitch fibers (which cardio exercise does), but also the fast twitch fibers that hardly get used in daily activities. Depleting muscle glycogen stores make the muscle more sensitive to insulin which is great for both type 1 and type 2 diabetics. The more sensitive the muscles are to insulin, the less the body has to produce to get the job done, and the easier it is for the type 1 diabetics to self administer the needed insulin.

Moreover, glucose uptake by the muscles happen after a hard strength training workout without the need for insulin (See the above link for more information). This, I believe is what makes HIT beneficial for our type 1 diabetics. It can help with steady glucose levels without needing so much insulin.

The final benefit I want to point out comes from the Poliquin Group (Charles Poliquin heads up this organization. He works in large part with elite athletes). Building lean tissue (muscle) increases overall demand for energy, and he says that for every 10% increase in muscle mass, there is an 11% decrease in insulin resistance. Exciting and important news indeed.

Conclusion

Living a  healthy and active lifestyle most certainly can mitigate the problems of both types of diabetes. I think all the health care practitioners are on board with that. Most people consider some form of cardio training as exercise, and really do not understand the benefits of both high intensity training (HIT) and high intensity interval training (HIIT) (yes, I believe that most doctors that treat people with diabetes are not aware of the benefits of high intensity training too). Both forms of exercise help improve insulin sensitivity. Both forms of exercise help control blood sugar. High Intensity Training, in particular, is especially beneficial because it will tax the glycogen stores of all of the muscles, and apparently in a way that does not trigger an insulin response. Moreover, the effects of an exercise bout with both HIT and HIIT last much longer than the benefits from a cardio workout. It is for these reasons that the Hystrength (sm) exercise program works as well as it does with our diabetic clients.

Regards,

Gregg Hoffman

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