Fitness pros have a unique opportunity to take a leadership role by guiding their female clients toward a healthier, movement-oriented lifestyle. This excerpt of the article “Research Update: Explore the Value of Exercise for Women’s Health” focuses on type 2 diabetes and discusses contemporary scientific findings you can use to educate your clients and plan up-to-date programs. For more information on cardiovascular disease, osteoporosis, anxiety disorders and menopause, see ideafit.com/fitness-library/explore-the-value-of-exercise-for-womenrsquos-health.
Diabetes and Exercise
Diabetes is a disease that limits the body’s ability to either produce (type 1) or respond to (type 2) the hormone insulin. This leads to an undesirably altered metabolism of carbohydrates and elevated levels of glucose in the blood. Of the estimated 30.3 million adult cases of diabetes in the United States, 90%–95% are type 2 diabetes (CDC 2017).
Approximately 14.9 million U.S. women aged 18 and older have diabetes. Of that number, 11.7 million have diagnosed diabetes, and the other 3.2 million have undiagnosed diabetes. A woman’s risk of diabetes increases if she smokes, has overweight or obesity, has high blood pressure, is physically inactive, and/or has high cholesterol and high blood sugar (CDC 2017).
An American Diabetes Association (ADA) position stand states that, in people with type 2 diabetes, regular exercise improves blood glucose, helps promote weight loss, reduces cardiovascular risk factors (which are associated with type 2 diabetes) and boosts well-being (Colberg et al. 2016). The position stand further states that since blood glucose management varies with the type of diabetes and the presence of diabetes-related complications, exercise recommendations should be tailored to meet the specific needs of each individual.
The ADA exercise guidelines for people with diabetes include the following two overarching recommendations (Colberg et al. 2016):
Exercise every day or at least every 2 days. This recommendation is aimed at increasing insulin sensitivity. One goal is that a person who is insulin-sensitive will require smaller amounts of insulin to lower blood glucose levels.
Perform both aerobic exercise and resistance training. Women with type 2 diabetes should do both aerobic exercise and resistance training for optimal blood glucose control and health. For clients with type 1 diabetes, the recommendation is to engage in aerobic exercise. Because the effects of resistance training on type 1 diabetes are currently unclear, resistance training for persons with type 1 is encouraged but not specifically recommended.
Training tip: When aerobic and resistance training take place in the same session, the ADA advises doing resistance training first, as this sequencing results in more stable blood glucose control.
Primary aerobic exercise guidelines. Women with diabetes should engage in at least 150 minutes of moderate-to-high volumes of aerobic activity 3–7 days per week. This amount is associated with a substantially lower risk of cardiovascular disease and early mortality. In addition, high-intensity interval training has been shown to improve insulin sensitivity and cardiorespiratory fitness in people with diabetes.
Training tip: The ADA suggests progressing clients to vigorous-intensity aerobic exercise as long as there are no complications (Colberg et al. 2016).
Primary resistance training guidelines. ADA recommendations call for a minimum of 2 nonconsecutive days of resistance training each week, eventually progressing to 3 days each week. Exercise programs should include 8–10 exercises to target the major muscle groups of the body. Fitness pros are advised to start clients with single-set training, progressing to 3 sets per exercise. Intensity should begin at a moderate load, 10–15 reps per set, progressing to 8–10 reps per set (heavier load), then 6–8 reps per set (heavier again). All sets are performed to near fatigue.
Balance and flexibility exercise guidelines. The ADA recommends flexibility and balance training 2–3 days per week. Clients should stretch to the point of mild discomfort and hold the stretch for 10–30 seconds, repeating stretches 2–4 times. Balance training, which can reduce fall risk, may be of any length and should focus primarily on clients’ specific balance goals and needs (Colberg et al. 2016).
To learn more about research for women who have conditions such as cardiovascular disease, osteoporosis, anxiety disorders and menopause, please see “Explore the Value of Exercise for Women’s Health” in the online IDEA Library or in the July 2018 print edition of IDEA Fitness Journal. If you cannot access the full article and would like to, please contact the IDEA Inspired Service Team at 800-999-4332, ext. 7.