Aerobic Exercise or Resistance Training for Glycemic Control?

Exercise is a vital part of the management of diabetes. Exercise can improve glycemic control. I have seen several clients who have been able to lower their glucose and either decrease their diabetes medications, or not even have to start on meds, because they exercised regularly. This is especially true for older adults who have lost muscle mass with aging.

Recommendations from the ADA

The American Diabetes Association recommends 150 minutes per week of moderate-intensity aerobic physical activity such as brisk walking, spread over three days. The ADA also stipulates that you shouldn’t go more than two consecutive days without exercise. And, in addition to these aerobic workouts, the ADA also recommends at least two sessions per week of resistance training—sometimes called "endurance" exercises--activities like weight lifting, resistance bands, or pull-ups and push-ups. In other words, both aerobic exercise and resistance training are important.

Glycemic control

Several studies have shown that resistance exercises improve insulin sensitivity; however, aerobic (or endurance) exercises can accomplish this as well. So the question is, which will improve glycemic control more, aerobic exercise or resistance training?

Answering this question

A study published in Diabetologia from the Netherlands gives a clear answer. All the participants had either type 2 diabetes or prediabetes and all wore continuous glucose monitors that assessed their glycemic control. The interventions being tested were: no exercise, resistance exercise, or aerobic/endurance exercise. All participants ate a standardized diet so that diet changes would not be a complicating factor.

The results showed that…

  • Resistance exercise reduced the amount of hyperglycemia (defined as glucose >180 mg/dl) by 35 percent over the next 24 hours following the exercise.
  • Aerobic exercise reduced hyperglycemia by 33 percent for 24 hours post exercise.

Since the two kinds of exercise improved glycemic control about equally--no statistical difference was found between their effects—the researchers concluded that both types of exercise can be used interchangeably.

Your workouts

So what does all this mean? First, if you don’t exercise regularly, maybe hearing about this study’s results will give you some motivation to start: Exercise reduced hyperglycemia by over 30 percent for the 24 hours following a workout. If you already exercise, make sure that your regimen includes both aerobic and resistance exercises—and remember that you don’t have to do both types of workout on the same day. Spread them out and enjoy the benefits of improved glycemic control.

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