My hubby is a Type II diabetic and is looking to become healthier this year. While this forum has many recommendations, I am never certain what is safe & healthy for a Type II diabetic. I have heard it is difficult for diabetics to gain muscle because of insulin resistance. Additionally, talking to doctors is nearly useless. They know very little about muscle building & physical health maintenance beyond suggesting more medication.
Specifically, he is looking to build muscle and become healthier with a regular exercise regimen and helpful supplements along with a healthy diet.
He is 36 with a height of 5'9" and weighs 155 lbs.
Any advice is greatly appreciated! Happy New Year!
I certainly sympathize and agree with your assessment of doctors. They are great at diagnosing disease and illness (most times), but they are USELESS when it comes to getting anything done without medication, or with giving specific well-informed parameters for accomplishing things.
Here are some general guidelines. Everything can be modified, but these are general guidelines that should be adhered to most of the time, no matter what exercise plan you work on. Everything you do needs to have 2 goals : fitness goals and health goals (muscle building and keeping diabetes controlled).
1) Keep carbs low or tightly controlled. Only you and your husband know his carbohydrate tolerance, therefore unless someone is coaching your husband in person you two are the only ones who can watch it.
Obviously, as you know diabetics have seriously impaired insulin sensitivity and therefore handle carbs very poorly and require very careful handling with them. Exercise improves carbohydrate handling and insulin sensitivity around the workout window, therefore the workout window is the best period of time to have carbohydrates in the diet, both for muscle gaining and for health. (aside from Breakfast, which is usually the best "normal" time of the day to have carbs). Therefore while keeping overall carbs in the day low, put most of the ones you do have 1) at breakfast and 2) around the workout period.
1a) Protein is good. More protein in your diet provides an improved insulin sensitivity profile and also more muscle growth stimulus. So is fiber (though not around your workout period)
2) Quick movements improve insulin sensitivity and carb handling more than slow ones---This is reason #1 in favor of explosive lifting being the primary method of exercise, both in cardio (like sprints or bounding/jumping) and weightlifting. Of course, you need to get very used to general training form/technique and coordination FIRST--quick and/or explosive movements are only safe if done with coordination and focus, and a properly prepared body. But this should be a mid-longterm goal of exercise.
3) Whole body workouts or Upper/Lower split workouts achieve better insulin sensitivity and carb handling than body part splits (traditional bodybuilding splits). I know this will be a contentious issue for some people here on this forum, but for your husband's purpose it is very true. Whether it holds true in highly trained bodybuilders/powerlifters/athletes is something different altogether, and not relevant to this thread.
For newbies to weight training whole body each workout or alternating upper body/lower body splits work best. The rule of thumb is the more muscles you work at the same time, the more positive effect you obtain both in insulin sensitivity and growth stimulus for muscle gaining. This is ALSO the reason why compound exercises such as lunges, deadlifts, squats, step ups, overhead presses, barbell and dumbbell rows, and chin-ups are best muscle builders overall--they work many muscles in coordination and provide a bigger growth stimulus and fat loss stimulus.
The rule: the more of your body you use when performing 1 exercise, the better that exercise is for you in terms of health, strength, and muscle building.
4) Supplements---the most important supplements, aside from protein powder for your workouts, are health benefit supplements. Omega 3 fish oil does EVERYTHING. It's like the duct tape of supplements. Improves insulin sensitivity, cholesterol ratios, fat loss, digestion, is an anti-inflammatory, everything. Get the Flameout from Biotest, it's the best, period. Better than everything I've ever seen including the doctor recommended ones. If there were one supplement to splurge on, it's this one!
Big ones are omega 3 fish oils, multivitamin, vitamin D, Fenuplex and Insulinomics (both from Charles Poliquins website), and leucine. The big three for insulin sensitivity are the Fish oil, Fenuplex and Insulinomics.
5) Remember--as far as muscle gaining goes, while carbs can help they are not REQUIRED. Muscle gain has to do with training very hard to make your body adapt and grow, and eating over maintenance level to give your body the fuel required to grow more muscle during your rest days. You can do that with protein and healthy fats, no carbs required (although they can help a lot). The big thing is to watch the scale to see if you need to increase calories, and then keep a food log to monitor your calories so you know how much you are actually eating vs. what you think you are eating.
I would also add that eccentric-less exercise will play a huge role in muscle gaining for a diabetic, since any way you can drive nutrients into the muscles you want WITHOUT using insulin is great for people who are insulin resistant.
"Eccentric-less" means with no lowering portion. Like, when you squat down and stand up to pick something off the ground, the squat down is the eccentric portion and the standing up is the concentric portion. Eccentric motions with only your bodyweight are generally fine, what we are talking about is not adding any extra weight on top of your body weight. In other words, the weight you lower needs to drastically less than the weight you lift up. Throwing something like a shotput or heavy medicine ball is an example of eccentric-less exercise--there's no lowering portion, and you lift or project some kind of weight away from you.
Eccentric-less exercises are pretty much any dragging or pushing--like pushing a car, dragging a sled, flipping a big tire over. Flipping is eccentric-less because even though you do have to lower your body, all the resistance/weight is on the lifting up portion not the lowering portion (if that makes sense). Push-ups do NOT count because you are lowering the same weight you are pushing up.
Eccentric-less exercise can pump more blood into the target muscles, and deliver more nutrients (especially when combined with a protein shake) without being really hard to recover from. It is therefore a way to speed up muscle growth and recovery, without relying on insulin to do the nutrient delivery. Therefore it is much much more important for a diabetic than for a non-diabetic, although it is still super useful to both people.
My suggestion would be to get a sled to drag (check eBay). If you do that, I would suggest to start with 2-3 sessions a week ON your workout days to get used to it. Try to do it at a different time than your workout (eg: do the workout before work, sled dragging after work. Or workout after work, sled drag a few hours later). You can do it on off days as well.
Guideline is that eccentric-less work should strenuous (pushing or dragging a 10 lb weight would be useless but pushing or dragging an 80-200 lb weight would work great) , but you should never approach failure. Stop while you're ahead in other words. Stop just the other side of "fresh". Get the blood flowing for 10-20 minutes , then go home.
Protein is (like Carbohydrates) insulinogenic (but not hyperglycemic). Despite what certain people tell you, there is zero scientific evidence that anything above 1g per lb of Bodyweight per day has any additional positive effect
Keep protein at or under 20% of daily caloric intake
So your advice is, by implication, then to go on a high carb diet? especially when there's significant scientific evidence that a low carb diet improves insulin sensitivity in diabetics? And on top of that when carbs are the single most disease aggravating dietary macro in a diabetics life?
OP, I am a Type 2 Diabetic since around 2005. My father has Type 2 and my later maternal grandmother had Type 2 as well.
The doctor started me on Metformin 5 years ago, then slowly upped the dose because my sugar kept rising (my diet was not under control and I wasn't exercising consistently). They added Glucophage last year - I am told this is the one that helps produce more insulin (but I can't remember). We stopped Glucophage in September and sugar levels (fasted) have been normal.
My diet is principally consisting of meat, eggs, fish, nuts, berries, apples, green vegetables, macadamia oil, full cream, cheese. My last HbA1c tested 6.2 mmol/L, it's been higher than 9 before and the 6.2 is on reduced medication. My carbs can be between 50g to 100g a day sourced mainly from the green vegetables, apple and berries.
I train approximately 4 times a week (depending on what program I'm on, sometimes it's 5), work on building muscle (I only do resistance training), eat mostly protein and fat (been reading a lot of Paleo diets and recipes lately) and supplement properly (I'm taking zinc, magnesium, multi vitamin, 10 to 15g of fish oil daily). I've been taking something similar to Superfoods lately also once/twice a day.
What? how did you get from what i wrote to "[...]So your advice is, by implication, then to go on a high carb diet?" Did you maybe quote the wrong person or something?
how does "[...]Keep protein at or under 20% of daily caloric intake" mean 'by implication' "[...]to go on a high carb diet?"
I know its the internet but your statement makes no sense from either a logical or a semantical point of view.
Carb-restrictec diets are the quasi standart for every Type II Diabetic, some people even go on quasi-zero ketogenic diets (think Atkins).
What most people seem to overlook is the reason they restrict Carbohydrates in the first place is to keep total insulin secretion low, sbut a diet high in Protein can have close to no carbs in it but still generate quite a heavy insulin load. I have seen people in this forum throwing figures around from 2g protein per lbs of BW and even higher, when you do that you will suffer from both hypoglycemia and insulin resistance, and basically feel like shit even though you think you're doing everything (which conventional wisdom tells you is to restrict carbs) right.