11) EXERCISE AND TYPE 2 DIABETES
f) Proper Resistance Training
Aerobic exercise is most important to a person with diabetes, but resistance or anaerobic training also helps. Anaerobic means "without air" and is short term rapid high intensity exercise where the muscle groups have to change the chemistry which they use to produce the energy required for the exercise. Anaerobic exercise is where the muscles run out of oxygen and begin producing energy by partial oxidation of blood sugar to lactic acid rather than complete oxidation of blood sugar to carbon dioxide and water. The lactic acid causes the burning sensation in the muscles that it so common in anaerobic exercise (this is the origin of the "no pain no gain" phrase of body builders). The presence of lactic acid in a muscle signals the muscle building cells of the body to build more muscle into the area that has the lactic acid build-up. Anaerobic training is generally either resistance training using a machine or resistance training using weights. One useful technique is to use resistance training as the cool down period after a period of vigorous aerobic exercise.
If a person with diabetes has the time, they should consider adding anaerobic ("without air") resistance or weight training for muscle building. It is desirable to replace fat with muscle for any weight loss program but it is especially important for the person with type 2 diabetes; every ounce of fat replaced with muscle decreases insulin insensitivity. It is also especially important to build up the muscles of the lower legs as this helps the diabetic avoid peripheral arterial disease (PAD), a common underlying cause of death in diabetes.
Most "middle aged" people not into body building do resistance training incorrectly. Body builders typically do resistance or weight training by doing three "sets" of 10 to 15 repetitions of a given exercise over a span of 15 minutes or so, with several minutes of rest between each "set". The point to keep in mind is that the body builder is doing his top weight with each repetition and enters anaerobic conditions after only two or three repetitions. The weights that a body builder lifts can be so high that they have to be "spotted" and assisted by another bodybuilder as a safety precaution. Most individuals with type 2 diabetes are not doing anywhere near this high a weight.
For the typical individual with type 2 diabetes three "sets" separated by resting time is not the optimum procedure. The individual with diabetes is probably not doing anywhere near the resistance that a body builder would use, so the anaerobic conditions typically don't begin till ten or more repetitions. Thus this "three set" method is typically not very anaerobic and is relatively ineffective as the muscles have time to replenish their oxygen supply (the term "anaerobic" means without oxygen) between each of the three sets. It also consumes a lot of time where you're just walking around, not exercising! And the easy way to tell this technique is not effective is that the person doing the exercise will not feel any burning sensation, the lactic acid is not being produced. If lactic acid isn't produced the muscles will not increase in size. A better method is so-called "breakdown" training.
Breakdown training is to do as many slow resistance exercises (typically 6 to 12) at as high a weight as can be managed. It is important that the exercise be done slowly; muscle tears are very common if this type of exercise is done too rapidly. Then the amount of weight is immediately reduced by 20% and immediately 10 to 15 slow speed repetitions are done, again continuing the repetitions till the muscles give out. Then the amount of weight is immediately reduced by another 20% and immediately multiple repetitions are done until the muscles again give out (and by "giving out" we mean beginning to hurt, i.e. starting to have significant levels of lactic acid in them!). The number of repetitions in the last level could be as high as fifty. Rather than increasing the number of repetitions as the muscles get stronger, the weight should be increased. And the easy way to know if the technique is working is to watch for the burning sensation produced by lactic acid. It is important to produce the burning sensation. If an individual only allocates an hour to exercise and spends 45 minutes resting, that individual is not really doing a good workout. It is important to work up a sweat even with anaerobic exercise.
Current Chapter: 11) EXERCISE
a) Introduction
b) Exercise and low Blood Sugar
c) Exercise and Weight Lose
d) Aerobic Exercise and Heart Disease
e) Exercise and Peripheral Arterial Disease
f) Proper Resistance Training
g) Exercise Myths
h) Exercise, Stress and Diabetes
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