In the U.S. alone, one in 10 people were suffering from diabetes in the year 2015, whereas prediabetics constituted roughly one quarter of the nation’s entire population aged 18 and older.1 Such worrisome statistics reveal to us that certain illnesses, like diabetes or cardiovascular problems, are not only the result of diet choices, but a variety of lifestyle choices. Genetics also play a role and, in certain instances, may even be the sole cause of a diabetes diagnosis. But most importantly, over 90% of cases are due to environmental, rather than hereditary, factors. This is good news for the majority of the population and means diabetes triggers can be controlled and eliminated, thereby avoiding the onset of the disease, preventing further complications related to it, or greatly improving one’s health as a diabetic.
Some go as far as to claim that they have “cured” themselves of diabetes through proper lifestyle management, mostly by eating right and exercising often. While this is theoretically possible for the majority of metabolic disorders commonly referred to as diabetes mellitus, completely treating this ailment is a bit more complicated, and may not even be a possibility for some type 1 cases (T1D). For this reason, it is important that you verify the claims I’m about to make against your own particular case, with the help of at least one physician. This guide is intended to use as general advice for those dealing with insulin deficiency or insulin-receptor insensitivity. Even if you have not been diagnosed with this condition, low-levels of activity combined with high levels of fat, stress, and high waist/hip ratios may be indicators that you are already prediabetic, that is, likely to develop diabetes.
Testing for Knowledge
You may feel miles away from such medical issues, but screening yourself by means of a simple HbA1c test can potentially save you from a lot of heartache, not to mention from having to spend anywhere between two and three times more on your medication.2 The HbA1c is considered a more reliable indicator of diabetes-related problems than oral tolerance tests, since it reveals how your body has been dealing with blood sugar in the past two months. It’s also quite cheap and, if you’re fortunate to benefit from one, ofte completely covered by medical insurance. Given the substantial number of adults, both in the U.S. and in Europe, who are undiagnosed or prediabetic already, pre-emptive testing should become a common-sense practice. Putting it another way, it’s very little blood for a lot of knowledge.
The Role of Nutrition
There are many myths about diabetics and gaining muscle. Some are conjectures, others may simply be individual cases. The reasonable, verified facts are as follows: gaining muscle as a diabetic is more difficult. You will need to closely monitor your blood-sugar levels while training and make important adjustments to your lifestyle.3
Eating right is a decisive aspect of any attempt to tone, gain muscle, or even trim down a little. However, when you are also dealing with diabetes, it becomes a more delicate matter. A slight caloric surplus will actually be needed while you are active, since you are aiming at creating new tissue, which requires additional calories and nutrients. It’s important not to bank on this too much, however. Anywhere between 5% and 10% excess of your daily calorie requirements should be your target when doing three or more sessions of resistance training per week.
The best dietary options for controlling your blood sugar while gaining muscle actually embody the staple, correct diet. Your carbohydrates must come from high-fiber, slow-release sources, so as to not peak your blood glucose too much, too fast. You want to completely eliminate any white flour products, particularly since their consumption is directly linked to increased risk of cardiovascular diseases and diabetes4, and replace them with whole wheat flour like buckwheat, rye, amaranth, quinoa, chickpea, or brown rice alternatives (all of which are also gluten-free).
Protein is the most important aspect of your diet and where you get it matters even more when you are a diabetic. Fish, poultry, and any lean meat cuts should be your go-to options. According to the University of California’s Diabetes Teaching Center, low-calorie, low-fat sources are preferred.5 This means that any dairy products should be low-fat or non-fat, which also goes for any cheeses. It’s actually advised that you eliminate cheeses as much as possible. Plant-based sources of protein come highly recommended for diabetics. This means beans (pinto, lima, black, kidney), chickpeas, tofu, soy, seitan, lentils, quinoa, nuts, and seeds. Substituting some of your animal protein with plant-based protein will also reduce your risk of dying because of cardiovascular disease, according to a 2016 Harvard study.6 If you also want to supplement, there are plenty of soy, hemp, rice, or pea protein isolate products out there that will spare you the headache of having to find a whey product with low contents of fat and/or sugar.
Last, but not least, you need to keep a very close eye on your fats. There are good ones (mono and polyunsaturated) that actually help your cardiovascular system maintain itself, and bad ones (saturated, hydrogenated, or trans fats), that clog it beyond anything imaginable. The latter, usually found in meats, cheese, butter, cream, chicken skin, lard, margarine and most processed food items are to be avoided at all costs. Great choices of dietary fat are nuts and avocados, sunflower, soy, peanut, olive, canola, flaxseed, or safflower oil.
Generally, you want to follow a 40% carb, 40% protein, 20% fat ratio while being active. Nonetheless, the amount of carbohydrates should always be dictated by your blood sugar levels. If you find that you’re spiking most of the time, lower it accordingly. Don’t force yourself to eat, especially if you’re a T1D. Blood sugar management comes first, then the food you’ve planned for the day.
How to Train
Why would you want to gain muscle as a diabetic? Because it’s literally the best thing to do for your body to help it manage insulin. Increases in muscle mass have been shown to prevent the on-set of insulin resistance, as well as glucose tolerance.7 Partial or even full remission was attained for T2D in significant percentages following an overall increase in physical activity, as well as dietary changes, to the point where the two became a habit.8 The mechanics behind muscle activation, muscle growth and diabetes are simple: if you have too much glucose in your blood, physical activity will help you lower it naturally, since your muscles will be screaming for glucose in order to keep going. There’s also good news for those who are insulin resistant, since exercise makes muscle fibers more sensitive to the pancreatic hormone, which means that your body will need less insulin to stabilize itself.
Perhaps the most important aspect about physical activity is that it will help you strengthen your cardiovascular system, which is a sensitive spot for those suffering from diabetes. Regular training will lower your blood pressure, help build stronger muscles and bones, improve your mood, and offer one of the best natural discharge of stress. This is important since stress is all too well-known for its blood-sugar bullying. Perhaps more vital is the fact that exercise tolerance, i.e. your levels of fitness and percentage of muscle mass, are actually the strongest scientific predictor of your risk of dying.9
As a diabetic, it is key for your health that you monitor your blood-sugar levels before, after, and even during your training. This is a major reason why diabetics are deterred from or even medically advised to avoid gyms. If, at any point, you are below 100 md/dl, you should stop and eat a couple of glucose tablets, followed by a light protein bar around 8 minutes later. Always keep a snack handy in case you feel some of the symptoms of low blood sugar, such as light-headedness, irritability, hunger, or shakiness. After your snack, it’s advised you rest for around 15 minutes—browse some catalogs or check out some routines online and then re-test to see if you’re between 100 and 120. Hypoglicemia will ruin your training experience. If there’s just no way to bring it into a safe 115, it’s best to find something else to do.
Staying hydrated is extremely important, as this will help your system manage your body temperature. Too high of a temperature will result in glucose fluctuations. And speaking of degrees, you should not be exercising under any extreme environmental temperature, as this is another way to destabilize your system.
Post-workout meals or consistent protein shakes are a must. The glycogen stores that have been tapped to keep you going need to be replenished, and your muscles require it for repair, recovery, and growth. Diabetes basically makes this post-workout snack mandatory, so as to balance the low-blood sugar caused by exercising. There’s no point in fearing carbs or purposefully restricting them in order to get the body you want, especially since they play such a big role in our health.
Wearing a bracelet or letting your trainers know about your condition is also advised, as they will be prepared to help out in case something goes south. Better to be safe than sorry. Other than this, a healthy mix of cardio, flexibility, and strength should be your mantra. Obviously, gaining muscle can be your priority, but there’s only so much powerlifting that your body will respond to in a week. Instead of pushing yourself beyond what you can handle, variation is highly recommended. Sores and injuries will take longer to heal and might bring about unwanted complications. After all, the ultimate goal is to increase muscle mass while lowering percentages of fat.
Necessary Lifestyle Changes
Absolutely no smoking. This goes even if you are not a diabetic. There are so many reasons smoking is bad for you that we’d need another op-ed to properly list them all. Blood sugar management is the best way you will ensure that your life and training are as enjoyable as possible. Incorporate monitoring into your habits and it will become so automatic that you won’t even remember doing it. Check your blood sugars before and after exercising. If you feel it to be necessary, check it during, too.
Sleep is monumental. I cannot overstate the importance of rest for your well-being. Your muscles are regenerating and growing while you slumber, which is why sleep is an intrinsic part of improving your health. For diabetics especially, deprivation can be exponentially more harmful. The previously quoted study by the Endocrine Society showed that healthy, young adults subjected to just one week of sleep deprivation were brought into prediabetes numbers. For T1Ds, insulin will be incredibly more effective at lower doses up to seven hours after your routine. Despite this, there is a staggering gap in medical research in terms of how T1Ds should administer insulin to manage post-exercise hypoglycaemia.
It may be tempting to think that the bigger the drop in blood sugar, the better it is, but exercising in a hypoglycemic state will trigger a series of unwanted effects, the first of which is actually burning protein and muscle tissue for energy, not to mention fatigue, dehydration, or worse. If you haven’t been too active, it’s important to take it slow to begin with and understand how your body reacts to physical activity. Obviously, big muscle groups such as your quadriceps, deltoids, pectorals, and shoulders should give you the best results to begin with.
You Can Do This
Bodybuilding with diabetes is medically recommended. The benefits of exercise and muscle growth in terms of dealing with T2D and greatly improving T1D are proven beyond any doubt. With this in mind, there are numerous variations of diabetes and they all impact each body in a slightly different way, even though there are some rules that generally apply to everyone.
Training while also dealing with this ailment won’t be easy, but it’s far from impossible. Ben Tzeel is just one T1D diagnosed individual who would not let his illness define who he is.10 The portal where his article is published is a major source of information for a healthy, active lifestyle with diabetes. There are many like him who succeeded despite having adverse conditions by means of diet and overall lifestyle improvements. Cardio routines are amazing for losing weight right away, whereas resistance training is meant to help you manage your weight and insulin sensitivity long-term by creating lean muscle tissue. This new tissue will burn more calories in the future, helping you maintain your weight and blood sugar. If you’re afraid of getting bulky, know that this requires many hours and really heavy weights, so there’s no need to fear it.
While there’s no telling what the next medical study will say about diabetes, the fact that we must be active and fit to increase our well-being, fight off diseases, and improve our odds of surviving longer is incontestable.
1. American Diabetes Association, “Statistics About Diabetes”, Diabetes.org, 19 July 2017, accessed February 24, 2018.
2. American Diabetes Association, “Economic Costs of Diabetes in the U.S. in 2012“, Diabetes.org, 23 April 2013, accessed February 24, 2018.
3. Diabetes.co.uk, “Building Muscle with Diabetes”, January 2018, accessed February 24, 2018.
4. Lindsay Oberst, “Make Better Choices: Healthy Alternatives to White Flour”, OneGreenPlanet.org, 14 July 2017, accessed February 24, 2018.
5. Diabetes Teaching Center at the University of California, “Understanding Protein”, dtc.ucsf.edu, accessed February 24, 2018.
6. Mingyang Song, Teresa Fung, Frank Hu et al, “Association of Animal and Plant Protein Intake With All-Cause and Cause-Specific Mortality”, JAMA International Medicine, no. 176 (10):1453-1463, accessed February 24, 2018.
7. P. Srikanthan, A. S. Karlamangla, “Relative Muscle Mass Is Inversely Associated with Insulin Resistance and Prediabetes. Findings from The Third National Health and Nutrition Examination Survey”, Journal of Clinical Endocrinology & Metabolism, no. 96 (9):2898-2903, accessed February 24, 2018.
8. John Buse, Sonia Caprio, William Cefalu et al, “How Do We Define Cure of Diabetes?” Diabetes Care, no. 32(11):2133-2135, accessed February 24, 2018.
9. Miho Nishitani, Kazunori Shimada, Santoshi Sunayama et al, “Impact of diabetes on muscle mass, muscle strength, and exercise tolerance in patients after coronary artery bypass grafting”, Journal of Cardiology, no. 58(2):173-180, accessed February 24, 2018.
10. Ben Tzeel, “Gaining Muscle with Type 1 Diabetes: An Intro Guide”, DiabetesStrong.com, 9 September 2017, accessed February 24, 2018.