It has been established that aerobic exercises, such as brisk walking, jogging, cycling and swimming, just to name a few, are beneficial in diabetes-management. The role of resistance or weight training, however is still novel. Resistance training is often perceived as more suited to the young, usually males and body builders. That is far from true. Weight training can be carried out safely and effectively even by the elderly when assessed and supervised initially by a professional.

Different equipment can be used for weight or resistance training. The most expensive are the weight or resistance machines that can either be made up of various weight stacks or elastic bands or pneumatic pumps. These machines require some adjustments to fit one's height and the position of the limb. Most of these machines came with attachments that stabilise certain parts of the body - usually one's back or posture - before one moves through the range against resistance.

It is advisable to get a fitness instructor or gym assistant to demonstrate the correct usage of the machine to ensure safety, as well as target the right muscle or muscles.

How much weight stacks to use?

An easy way is to determine your 10 repetitive maximum or 10-RM. Here's an example. If you do a leg press to target the thigh muscles or mainly the quadriceps, you can begin by first testing if you can push the plate non-stop at a speed of one repetition per two to three seconds. Repeat this 10 times. You should be doing this without feeling breathless, but it must not be too easy. However, it should not be so resistant that you have to take a rest before the 10 repetitions are done. That will indicate your I0-RM and you can do about two to five sets of eight to 12 repetitions depending on your level of fitness.

As a beginner, you should start off at two to three sets of eight to 12 repetitions. Then, every two weeks increase the number of sets. Once you are able to do five sets of 10 to 12 repetitions comfortably and the weights become too light to tackle, you can increase by hall or one weight stack or the next level of resistance.

During the weight training, you must remember not to hold your breath but to breathe throughout the exercises as naturally as possible. Quite often, you will hear the instructors telling clients to breathe out with exertion. That is to prevent Valsalva manouver (or forcefully holding one's breath) during weight training.

Other forms of resistance training involve using free weights such as ankle weights and elastic bands such as Theraband. These forms of exercises require proper positioning before you start exercising. There is also a need to assess the right free weights or resistance to be used. Theraband has a free web site where you can download exercise sheets with instructions and pictures to help guide you in exercising the various muscle groups and joints. However, whenever in doubt, it is always advisable to consult a physiotherapist or a specialist to guide you.

It is important to conduct every contraction against a load slowly and in a controlled manner. Resistance exercises can be conducted using 'home-made' weights. Some examples include filling a 500mI bottle with water, sand and beans: placing beads, grains or sand in a plastic bag with a zip, and using stockings or garters as 'elastic bands'

Resistance exercises are safe, effective and even inexpensive to do.

Reference:
1. American College of Sports Medicine. (2002). Position Stand: Progression models in resistance training for healthy adults.
Medicine and Science in Sports and Exercise. 34(2). 364-380.
 

2. American Diabetes Association. (2003) Physical activity / exercise and diabetes mellitus. Diabetes Care. 26 (supplement I ). S73-S77.
 

3. American Diabetes Association. (2002). Position Statement: Diabetes mellitus and exercise. Diabetes Care, 25(supplement I ), S64-S68.
 

4. http://www.thera-bandacademy.com

While insulin-dependent diabetic patients are more predisposed to these cutaneous lesions, patients with type 2 are at an increased risk to develop skin infections, which one may see in 50 percent of these patients.

Fungal infection such a candidial intertrigo, vaginitis and paronychia may be an early marker for undiagnosed diabetes, and is more common in poorly controlled elderly diabetics.