EXERCISING WITH THE RIGHT WORKOUT PLAN IS AN EXCELLENT METHOD OF CONTROLLING TYPE 2 DIABETES (T2D)
Around 90% of diabetics are diagnosed with Type 2 diabetes and this is often referred to as a chronic lifestyle disease (The American Council on Exercise, 2009). Doctors frequently treat this chronic condition with diabetes medication and/or insulin therapy to control the patient’s blood sugars levels. Other key variables that play a major role in the management plan of T2D are: stress management, hormone regulation, weight control, nutrition and the right type of exercise program.
It is far easier for your doctor to write a prescription for the medication needed to control blood sugars and to refer you to a surgeon for a fat removal operation; than it is to place you on a healthy eating and exercise plan. However, the following questions need answering: “Why are so many doctors by-passing the right exercise programs for the use of these traditional medicines?” “Which is more cost-effective in terms of the patient’s long-term health: medication or a solid exercise plan?”
THE RIGHT TYPE OF EXERCISE PLAN
Prevention is better that cure when it comes to Type 2 diabetes, and many of the following conditions that are associated with the risks of diabetes can be controlled, managed and reversed with resistance and aerobic-type exercise:
- Obesity or being overweight
- High LDL cholesterol and low HDL cholesterol levels
- High triglyceride levels and high blood pressure
- Over 50s are more susceptible to getting diabetes as the body ages it becomes less tolerant of high glucose levels
Strength training helps to manage diabetes in several ways. Firstly, it improves glucose absorption into the muscle, which lowers the blood glucose and spikes in the insulin levels. This mechanism is important as improving muscle mass can improve metabolic function and energy production. It also stimulates growth hormone production, testosterone and IGF-1. Insulin like growth hormone factor-1 binds to the same receptors as insulin, however it is totally different because it is released from the liver when blood sugars are low. Also, it acts upon the skeletal muscle tissue to bind to the sarcomere, thus producing stronger, harder and larger muscle mass (Wilmore & Costill, 2009). This is good news for insulin resistance, as this increased muscle mass facilitates improved glucose uptake and improved insulin sensitivity.
Therefore, resistance training has amazing benefits, especially if incorporated into the correct order into the workout program and performed with heavy weights to exhaustion. Taylor (2008) reported that individuals, who strength trained over a 2-month period, gained 2 pounds of muscle and lost 4 pounds of fat. This equated to around 40-50 calories more burned per pound of muscle per day and this adds up over time. Muscle is metabolically more active than fat, which makes a big difference to your resting metabolic rate, will keep your metabolism fired up all day, and helps to burn fat!
Resistance training with heavy weights at a high intensity using large muscle groups, can stimulate the production of hormones that can build muscle and generate existing muscle cells (Godfrey, 2004). The following techniques should be performed with heavy weights, as these large muscle movements improve fat-burning potential:
- Barbell squats
- Explosive power cleans
- Maximal dead lifts
- Full body weight exercises like squats, press ups, pull ups and explosive jumps
You should execute the above exercises to mechanical failure and if performed correctly, it will activate the Type 2 fibers in the muscles, and enhance HGH and testosterone secretion. Strength work out programs that stimulate the production of testosterone, human growth hormone, IGF-1 and catecholamines can improve energy production within the body, control body fat and enhance the functional lifespan of all adults (Chan, 2012). Why? Because all of the hormones being activated help to maintain a good level of muscular strength/power in the human body and help to burn fat.
AGING, MUSCLE MASS LOSS AND DIABETES
The American Council on Exercise (2009) reported that between the ages of 30-80 years, sedentary adults can experience as much as 30-40% reduction in muscular strength. This has been attributed to sarcopenia or loss of muscle mass, particularly in the Type 2 fibers, which are required for strength and power. This can equate to humans losing 10% of muscle mass per decade after the age of 30 years, and after 40 years plus explosive strength/power is significantly reduced.
Is this reduction in active muscle mass really related to the increase in prevalence of diabetes in the over 50s age group? The answer to this question is “yes”, due to the reduction in the body’s capacity to absorb glucose at a muscular level and this increases floating blood glucose. This activates the pancreas to secrete insulin and this whole process over-stresses the pancreas. This statement really does paint a picture of how important maintaining muscle mass is via resistance training!
Therefore, resistance training with a higher intensity can have the following benefits on the body:
- An improved quality of life via improved muscle mass, strength and power
- Enhanced type II muscle utilization, muscle fiber size, energy production, a higher basal metabolic rate and resting metabolic rate
- Improved glucose tolerance, insulin sensitivity and fat-burning effects
- Reduces LDL cholesterols, blood triglycerides and increases HDL cholesterols
- Improves posture core stability and joint health
- Reduction in back pain symptoms
AEROBIC EXERCISE IMPACT ON CARDIOVASCULAR ENDURANCE
In terms of metabolic function aerobic efficiency is reduced by 10% every decade after the age of 25; likewise a reduction in the catecholamines is related to a decreased energy production and a 30-50% reduction in maximal heart rate. This decreased cardiac output and lower mitochondrial density can lead to reduced aerobic capacity and a loss of physical activity. This is a vicious cycle as this can lead to impaired glucose tolerance, insulin resistance, hypertension, high cholesterol, peripheral vascular disease, Type 2 diabetes and weight gain. Research has indicated that aerobic exercise at a higher intensity can have the following positive effects within the body:
- Increment in cardiac output and VO2 max
- Improved blood flow to muscle tissue
- Enhanced catecholamine response
- Boost energy which is important for weight management
- Improved mitochondrial density
- Boost anabolic hormone production
- Improved insulin and cortisol control
- Enhanced glucose sensitivity
- A reduced risk of CHD, high blood pressure and cholesterol levels
- Enhanced moods and decrease in bouts of depression via the release of endorphins
- Lowers blood pressure
- Lower resting HR and HR at a given exercise intensity
- Increase in lactate acid threshold and tolerance
- Reduces LDL cholesterol and increases HDL cholesterol in the blood
- Thicker cartilage and bones from weight bearing
- Improved sleep and the ability to relax
- Improved tolerance to stress and a reduction in anxiety due to better cortisol control
High intensity interval training (HIIT) is the recommended aerobic training model used to improve insulin sensitivity, enhance glucose uptake within the muscle and reduce insulin levels while exercising. HIIT training involves working at 85% maximum heart rate for short bursts of time and to have active rests in between the bouts; it should last for about 12-15 minutes. Talanian (2007) reported that to get the best result with a HIIT training program, you should be exercising no more than 3 times per week. However, conventional cardio programs dictate that for the best fat-burning results you should be exercising at 65% of your heart rate maximum for between 30-50 minutes, at least 5 times per week. This is a training myth, as this time consuming conventional approach is detrimental to muscle gain and does not shred as much fat as HIIT training. The question is why? Well, conventional cardio has the following adverse effects on muscle growth and is very much catabolic in terms of muscle growth:
- It breaks down the muscle tissue and has a catabolic effect
- Decreases testosterone levels in the body and reduces fat metabolism
- Decreases glucose absorption after training
- Blocks the mTOR pathway which is important for muscle growth
On the other hand, research has indicated that HIIT training increases the muscular oxidative capacity of the mitochondrial enzymes, increases testosterone levels, raises Glut 4 levels and increases the myofibrillar cell size. All of these factors are all hugely important in gaining muscle size and mass. After a HIIT session there is evidence to suggest that human growth hormone is increased by 450% and this important catalyst is extremely important for muscle growth and fat metabolism. Also, insulin sensitivity is enhanced; which translates to glucose entering into the muscle instead of being stored as fat and carbohydrate metabolism is more efficient post exercise (Talanian, 2007).
Due to the higher intensity of the work intervals being performed for a longer duration than during a steady state protocol; there is a higher amount of fat being shredded. This fat shredding also occurs up to 24 hours post exercise and this process is called the “excess post exercise oxygen consumption” or the “after burn effect.” However, this fat burn burning mechanism is not evident in conventional cardio. HIIT training improves aerobic capacity, enhances glycogen utilization, and the lactate threshold is raised so that you can train for longer periods; and subsequently burn more body fat (Sijie, 2012).
THE AFTER BURN OR EPOC
EPOC is described as the “amount of oxygen above resting requirements for a period of time after exercise has finished” and is similarly termed the “after burn.” It normally occurs following a demanding activity and eliminates the oxygen debt within the body. EPOC is the process of returning the body back to its resting state by the use of oxygen and to counteract the metabolic actions that have occurred while exercising. These include repairing damaged cells, refueling energy stores, balancing hormones and neutralizing lactic acid and all of these tasks need energy to perform them. After a HIIT session the following benefits can occur up to 24 hours post exercise (Wilmore & Costill, 2009):
- Increased fat stores being used by the release of free fatty acids into the blood stream
- Increased insulin sensitivity, fat and calorie burning
- Increased liver and muscle take up of the carbs, instead of being stored as adipose tissue
- Increased growth hormone levels which are required for fat transportation within the body
- Increased catecholamine levels, these are used in lipolysis and used to burn fat stores, e.g., subcutaneous fats
It is these benefits with the combination of EPOC that contribute to the significant difference in fat-burning potential compared to conventional cardio, which is all excellent news for controlling your diabetes.
EXERCISING IN THE RIGHT ORDER
A study published in the Journal of Strength and Conditioning in 2008, compared two workout sessions with identical exercise volume in terms of number of sets, reps, weight used and cardio intervention. However, the exercises were performed in a different order. During the first workout the resistance and cardio were performed separately and one after another. Yet the second workout was performed with cardio exercise inserted between the sets of the resistance training. Remarkably, the second work out produced 10 times as much fat loss compared to the first workout, with improved muscle mass gains, lower body strength and endurance; this was attributed to the inter mixing of the exercises.
The second workout or the intermix exercise results were extremely impressive and there is a strong correlation between these outcomes and activation of the 3 energy systems used in metabolic conditioning. These energy systems are as follows:
- The phosphagen system (short bursts of energy)
- The glycolytic system (anaerobic metabolism)
- The oxidative system (aerobic metabolism)
In addition it activates “EPOC” or the after burn via the release of the catecholamines, cortisol and this in turn releases the growth hormones and testosterone. This suppresses/controls blood insulin and this mechanism increases the body’s metabolism to burn fat and to mobilize muscle/liver glycogen (Linnan, 2005). The metabolic and mechanical stress of heavy weights, high-intensity sprints and high number of reps is the catalyst of these key hormonal responses. Therefore, it is very much a training adaptation via an increase in exercise tolerance and utilizing lactic acid regeneration.
WORK OUT PLANS
The following two work out plans have been designed using the intermix theory and exercising large muscle groups to burn fat and increase lean body mass. You can mix and match the exercises with squats, press-ups, explosive jumps, power cleans, squats and deadlifts. However, stick to the rest times between each set as this is an important element in strength training and improves glucose absorption into the muscle. Remember to monitor your blood sugars before and after the exercise session and if you are feeling weak, dizzy and drained; this means that you may have low blood sugars. However, plan your next exercise session and reduce the intensity or number of reps until you build up your exercise tolerance to the workouts. This training adaptation will definitely happen; just keep on going and remember that an adventure begins with one step in the right direction …
|Warm-Up||Build up to 85% of MHR for the last minute & Stretch Off||10 minutes|
|Flat Dumbbell Chest Press||30 seconds rest between sets||3 x 15 -12 reps|
|Dumbbell Lateral Raises||30 seconds rest between sets||3 x 15 -12 reps|
|Seated Leg Curls||30 seconds rest between sets||3 x 15 -12 reps|
|Cardio – On Exercise Bike or Stair Climber||8 intervals of 20 seconds and 10 seconds rest- HIIT Protocol||7 minutes|
|Seated Rowing||30 seconds rest between sets||3 x 15 -12 reps|
|Lat Pull Downs to Chest|
|Ball Crunch Reverse Ball Crunch||One set only||1 x 30 seconds1 x 30 seconds|
|Barbell Curls Shoulder Width||30 seconds rest between sets||3 x 15 -12 reps|
|Cool Down||Moving and stretching||10 minutes|
|Warm-Up||Build up to 85% of MHR for the last minute & Stretch Off||10 minutes|
|Seated Twisting Dumbbell Presses||30 seconds rest between sets||3 x 15 -12 reps|
|Barbell Squats||30 seconds rest between sets||3 x 15 -12 reps|
|Leg Raises||30 seconds rest between sets||3 x 15 -12 reps|
|Seated Incline Curls||30 seconds rest between sets||3 x 15 -12 reps|
|Cardio – On Treadmill or Exercise Bike||10 intervals of 20 seconds all-out effort followed by 50 seconds of minimum effort||10 minutes|
|Supermans||30 seconds rest between sets||3 x 15 -12 reps|
|Swiss ball and Medicine Ball Pullover Throw||30 seconds rest between sets||3 x 15 -12 reps|
|Dumbbell Upright Rowing||30 seconds rest between sets||3 x 15 -12 reps|
|Cool Down||Moving and stretching||10 minutes|
After reading about all of the benefits of resistance and aerobic HIIT exercise; ‘Why would you not start the above two work out plans?’ They are an easy to follow guideline that will definitely facilitate rapid results. This will help you to take control of your blood sugars and improve your insulin sensitivity. In terms of long-term health, the impact of the right exercise program will be absolutely priceless on your health and will aid you to regain control of your waistline, manage your condition more robustly and reduce the number of visits to the doctors to get your medication (which hopefully will not be needed)!
American Council on Exercise (2009). ACE Advanced Health and Fitness Specialist Manual. San Diego: American Council on Exercise.
Chang, Y. et al. (2012). Effect of resistance-exercise training on cognitive function in healthy older adults: A Review. Journal of Aging and Physical Activity, 20, 497-517.
Ciolac, E.G., Brech, G.C. and Greve, J.M.D. (2010). Age does not affect exercise intensity progression among women. Journal of Strength and Conditioning Research,24, 11, 3023-3030.
Godfrey, R, and Blazevich, A. (2004). Exercise and growth hormone in the aging individual, with special reference to the exercise-induced growth hormone response.International SportMed Journal, 5, 4, 246-260
Linnam, V. et al. (2005). Acute hormonal responses to submaximal and maximal heavy resistance and explosive exercises in men and women. Journal of Strength and Conditioning Research, 19, 3, 566-571.
Sijie T (2012) High intensity interval exercise training in overweight young women J Sports Med Phys Fitness. Jun;52(3):255-62.
Taylor, A. and Johnson, M. (2008). Physiology of Exercise and Healthy Aging. Champaign, Ill.: Human Kinetics.
Talanian .J. (2007). Two weeks of high-intensity aerobic interval training increases the capacity for fat oxidation during exercise in women Journal of Applied Physiology vol. 102 no. 4 1439-1447
Wilmore. J.H, Costill D,J (2009)Physiology of Sport and Exercise. Human Kinetics.