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Best strength exercises for type 2 diabetes: 7 moves and a sample week

Muscle is one of the main places your body uses blood sugar. Strength work supports your care, alongside the medicine and diet your clinicians set. It doesn't replace them. Lift, walk, break up the sitting.

By Susmit Jalan, coach at Online Fitness Worldwide.

Your doctor said type 2 diabetes. Or "borderline". You are not alone. A national survey of more than 1 lakh (100,000) adults across India found diabetes in 11.4% and prediabetes in 15.3%.[7]

Muscle is part of the plan. A review of 47 trials found structured resistance training was linked with an HbA1c about 0.57 percentage points lower than in control groups.[3]

The American Diabetes Association (ADA) says adults with type 2 diabetes should ideally do both aerobic and resistance exercise, with 2 to 3 resistance sessions a week on non-consecutive days.[2] WHO advises muscle-strengthening work on 2 or more days a week for adults living with type 2 diabetes too.[1]

This list is simple strength work for big muscles, at home, with a chair, a step and a bag.

This is training, not treatment. Take insulin or tablets that can cause a hypo? Read "Before you start" first.

See also: Best exercises for desk workers: 7 moves that fit a workday · Best exercises for getting back into exercise after a long break: 7 to start with · Best strength exercises for high blood pressure: 7 moves and a sample week

The 7 best strength exercises for type 2 diabetes

  1. Sit-to-stand

    Why
    Thighs and hips, the big muscles you use every time you get up. Half-squats were one of the simple moves used to break up sitting in a type 2 diabetes trial.[6]
    How
    Sit near the front of a sturdy chair, feet flat, hip-width. Arms forward. Lean in and stand up tall. Sit back down slowly, don't drop. Breathe out as you stand. Don't hold your breath. Too easy? Hold a bag of rice at your chest.
    Dose
    1 to 3 sets of 10 to 15, stopping near tired.[2]

  2. Wall push-up

    Why
    Chest, shoulders and arms. Start on the wall, move to a kitchen counter, then a low step. The angle sets the load.
    How
    Hands on the wall at shoulder height, a little wider than your shoulders. Step your feet back. Body straight from head to heels. Bend your elbows and bring your chest towards the wall. Push away. Breathe out as you push.
    Dose
    1 to 3 sets of 10 to 15.[2]

  3. One-arm row

    Why
    Upper back and arms. Pulling balances the pushing, and it keeps your head up, not down.
    How
    One hand on a table, feet a step apart, back long. Hold a water bottle, a bag or a dumbbell in the other hand. Pull it up towards your hip. Lower slowly. All reps one side, then the other.
    Dose
    1 to 3 sets of 10 to 15 each arm.[2]

  4. Glute bridge

    Why
    The hips and the back of the legs, from the floor. No balance needed.
    How
    Lie on your back, knees bent, feet flat. Press through your heels and lift your hips until knees, hips and shoulders line up. Squeeze. Lower slowly. Breathe out as you lift. Easy? Do it on one leg, or with a weight on your hips. One leg only after two legs is easy, and only if you can feel your feet well.
    Dose
    1 to 3 sets of 10 to 15.[2]

  5. Step-up

    Why
    One leg at a time, like the stairs. Strength and a little heart rate together.
    How
    Start on the bottom stair. Whole foot on the step. Push through it and stand tall. Lower the other foot slowly. Hold the rail. Go higher only when it stays smooth. Good shoes on, not bare feet. Nerve damage in the feet, or balance worries? Always use the rail and a low step.
    Dose
    1 to 3 sets of 10 to 12 each leg.

  6. Calf raise

    Why
    Calves and ankles. Calf raises were one of the moves in the sitting-break trial, too.[6] You can do them while the kettle boils.
    How
    Stand tall, hands on a counter. Rise up onto the balls of your feet. Pause. Lower slowly. Easy? One foot at a time.
    Dose
    1 to 3 sets of 12 to 15.

  7. Farmer's carry

    Why
    Grip, shoulders, trunk and legs all at once. It's walking, with load.
    How
    Hold a heavy bag or water bottle in each hand. Stand tall, shoulders down. Walk slowly across the room and back. Breathe normally. Put them down before your grip fails. Check your feet and shoes afterwards.
    Dose
    3 walks of 20 to 40 seconds.

How much, how hard, how often

ADA's starting dose for resistance work: 8 to 10 exercises, 1 to 3 sets of 10 to 15 reps, each set to near tired, on at least 2 non-consecutive days a week, preferably 3.[2] These 7 cover the big muscles. Add more when you're ready.

Lift and walk. In one trial, combined training lowered HbA1c more than either alone: an extra 0.46 points compared with aerobic training alone, and 0.59 compared with resistance training alone.[4] In another, only the combined group improved HbA1c compared with no exercise. Resistance alone (-0.16) and aerobic alone (-0.24) were not statistically significant.[5] So the trials differ on how much lifting alone does. They agree on the pair.

Most adults with diabetes: 150 minutes or more of moderate to vigorous activity a week, over at least 3 days, with no more than 2 days in a row without activity.[2] In the review, structured exercise of more than 150 minutes a week was linked with a bigger HbA1c drop (0.89) than 150 minutes or less (0.36).[3]

Break up the sitting. ADA advises light activity every 30 minutes of sitting, at least for adults with type 2 diabetes.[2] In one trial, 24 inactive adults with type 2 diabetes did 3 minutes of light walking, or simple moves like half-squats and calf raises, every 30 minutes. The rise in blood sugar after meals was about 39% smaller than on a day of sitting.[6] Small breaks, real effect. But it was 8-hour lab days, not months.

When you beat 15 good reps by 1 or 2, add a little: 2 to 10% more load.[9] No heavier weight? Slow down the lowering, or add a set.

A sample week of strength training for type 2 diabetes

Sample only. Not a prescription. Adjust it with your doctor to your body, your medicines and your history.

  • Monday, about 30 minutes: sit-to-stand, wall push-up, one-arm row, glute bridge. 1 to 3 sets each.
  • Tuesday: a 30-minute walk.
  • Wednesday, about 30 minutes: step-up, wall push-up, one-arm row, calf raise, farmer's carry.
  • Thursday: a 30-minute walk.
  • Friday, about 30 minutes: Monday's session again.
  • Saturday: something you enjoy. A long walk, a swim, a ride.
  • Sunday: rest, or an easy walk.
  • Every day: after 30 minutes of sitting, 3 minutes up. Sit-to-stands, calf raises or a walk round the house.
  • Taking insulin or a secretagogue? Keep your meter and a fast sugar snack with you every session.
  • Pain check: mild discomfort that settles soon is fine. Pain that rises during a set means make it easier: less range or less load. Sharp pain, swelling, pain spreading down a limb, numbness, a joint giving way or locking means stop and get it checked. I'm a coach, not a physio or doctor.

Want it coached live?

Lean Reset is 20 sessions a month, 1:1. Enough that you rarely go two days without training.

Iron Hour is 60 minutes, 1:1. Set-up at minute 0: water and a quick snack within reach, your meter nearby if your doctor wants you to check. Warm-up from minute 4. The primary lift at 14. Accessories at 28. Cool-down at 50.

Return is 45 minutes, 1:1, 12 alternate-day sessions a month, if you haven't trained in years. Open Floor is a small group. I'm a coach, not your doctor: your doctor sets the medicine and the limits, and we train inside them.

Coached live on Google Meet, Zoom or FaceTime, in your own living room. In Hindi or English. On IST. Not sure yet? Start with a 30-minute consultation. It is a conversation, not training. Booking holds a time. The fee is agreed directly.

How Lean Reset works: 20 coached 1:1 sessions a month

See the programsAsk on WhatsApp (opens in a new tab)

Before you start

General information, not medical advice. ADA says medical clearance is generally not needed before low or moderate activity, no harder than brisk walking or everyday living, if you have no symptoms.[2] ACSM's screening model is stricter: if you are inactive and have diabetes, get medical clearance first, even for light exercise.[10] They differ, so talk to your doctor before you start. ADA flags a risk of low blood sugar during and after exercise for people taking insulin or insulin secretagogues (medicines that make the body release more insulin).[2] Any change to your dose is your doctor's call. The NHS lists hypo symptoms including feeling hungry, dizzy, shaky or sweaty, a pounding heart, feeling tired or weak, blurred vision and confusion. If you have symptoms or your blood sugar is below 4 mmol/L (about 72 mg/dL), eat or drink something sugary that works fast, such as a small glass of fruit juice or 5 glucose tablets, and check again after 10 to 15 minutes.[8] Stop the session. With severe non-proliferative or unstable proliferative diabetic retinopathy, ADA says to avoid vigorous aerobic or resistance exercise, jumping, jarring, head-down moves and holding your breath.[2] Ask your eye doctor where you stand. Nerve damage in the feet? ADA advises keeping feet dry, wearing suitable shoes and checking your feet every day for blisters or sores.[2] Stop if you get chest pain, dizziness or sharp pain. Don't change insulin or other diabetes medicine doses because of a blog. That is for your doctor or diabetes educator.

ASCA Level 1 (strength and conditioning) and ACE (anatomy and biomechanics). These are credentials held by the coach. Neither body endorses this business or this article.

Sources

  1. [1] World Health Organization. WHO guidelines on physical activity and sedentary behaviour. Geneva: WHO; 2020. https://www.who.int/publications/i/item/9789240015128 (opens in a new tab)
  2. [2] Colberg SR, Sigal RJ, Yardley JE, et al. Physical activity/exercise and diabetes: a position statement of the American Diabetes Association. Diabetes Care. 2016;39(11):2065–2079. https://doi.org/10.2337/dc16-1728 (opens in a new tab)
  3. [3] Umpierre D, Ribeiro PA, Kramer CK, et al. Physical activity advice only or structured exercise training and association with HbA1c levels in type 2 diabetes: a systematic review and meta-analysis. JAMA. 2011;305(17):1790–1799. https://doi.org/10.1001/jama.2011.576 (opens in a new tab)
  4. [4] Sigal RJ, Kenny GP, Boulé NG, et al. Effects of aerobic training, resistance training, or both on glycemic control in type 2 diabetes: a randomized trial. Ann Intern Med. 2007;147(6):357–369. https://doi.org/10.7326/0003-4819-147-6-200709180-00005 (opens in a new tab)
  5. [5] Church TS, Blair SN, Cocreham S, et al. Effects of aerobic and resistance training on hemoglobin A1c levels in patients with type 2 diabetes: a randomized controlled trial. JAMA. 2010;304(20):2253–2262. https://doi.org/10.1001/jama.2010.1710 (opens in a new tab)
  6. [6] Dempsey PC, Larsen RN, Sethi P, et al. Benefits for type 2 diabetes of interrupting prolonged sitting with brief bouts of light walking or simple resistance activities. Diabetes Care. 2016;39(6):964–972. https://doi.org/10.2337/dc15-2336 (opens in a new tab)
  7. [7] Anjana RM, Unnikrishnan R, Deepa M, et al. Metabolic non-communicable disease health report of India: the ICMR-INDIAB national cross-sectional study (ICMR-INDIAB-17). Lancet Diabetes Endocrinol. 2023;11(7):474–489. https://doi.org/10.1016/S2213-8587(23)00119-5 (opens in a new tab)
  8. [8] NHS. Low blood sugar (hypoglycaemia). nhs.uk. https://www.nhs.uk/conditions/low-blood-sugar-hypoglycaemia/ (opens in a new tab)
  9. [9] American College of Sports Medicine. Position stand: Progression models in resistance training for healthy adults. Med Sci Sports Exerc. 2009;41(3):687–708. https://doi.org/10.1249/MSS.0b013e3181915670 (opens in a new tab)
  10. [10] Riebe D, Franklin BA, Thompson PD, et al. Updating ACSM's recommendations for exercise preparticipation health screening. Med Sci Sports Exerc. 2015;47(11):2473–2479. https://doi.org/10.1249/MSS.0000000000000664 (opens in a new tab)