Did you know strength training can do more for type 2 diabetes than medication ever could?

Amy Hudson and Dr. James Fisher continue their series on the benefits of strength training and reveal how powerful it can be for managing—and even reversing—type 2 diabetes.

They break down why excess sugar builds up in the bloodstream, how your muscles play a critical role in blood sugar control, and what kind of training yields real, measurable results—without needing extreme diets. If you—or someone you know—is dealing with type 2 diabetes, this is an episode you won’t want to miss.

• Dr. Fisher defines type 2 diabetes: it’s a condition where the body becomes unresponsive to insulin, leaving glucose floating in the bloodstream instead of being stored and used properly.
• Dr. Fisher breaks down how insulin resistance begins. When your body stops reacting to insulin’s signal to store sugar, it starts a cascade of health issues that lead to type 2 diabetes.
• According to Dr. Fisher, over 422 million people worldwide have diabetes, and the disease causes at least 1.5 million deaths every year.
• Dr. Fisher highlights how diabetes is largely lifestyle-driven. That means many cases are preventable or reversible with the right habits—especially consistent exercise and dietary awareness.
• Amy poses the big question: Is sugar intake or lack of exercise the real issue? Dr. Fisher explains that both matter—but without regular movement, even a modest diet can lead to sugar overload and poor glucose control.
• If you’re not actively burning glucose through movement, even a “normal” Western diet is likely giving you far more sugar than your body can handle.
• Strength training is a powerful tool against diabetes. Studies show it reduces waist size, body fat, blood pressure, cholesterol, and most importantly, HbA1C—the key marker of blood sugar control.
• Amy reminds us that it’s easy to believe you need drugs or extreme diets, but strength training alone can help manage your blood sugar levels.
• Dr. Fisher outlines the most effective approach to strength training. The best results came from lifting moderate to heavy weights (over 60% of one-rep max) with high effort, two to three times per week.
• Why intensity matters more than duration. You don’t need long workouts—you need focused, high-effort sessions that push your muscles to adapt and grow stronger.
• Amy makes an encouraging observation about habit stacking. When people begin exercising, they often naturally start eating better, sleeping more, and making other healthy choices.
• Dr. Fisher shares results from a large meta-analysis covering 1,100 people. The most impactful programs were progressive—meaning the weight and difficulty increased over time, keeping the body challenged.
• Why working with a personal trainer or a supervisor can accelerate your progress. Supervised sessions ensure your workouts are safe, structured, and progressively harder.
• The academic consensus is crystal clear. Strength training helps regulate blood sugar, reduce HbA1C, improve insulin sensitivity, and may even reverse type 2 diabetes in certain cases.
• Amy offers a compelling reason to start now. Even if you’re healthy, strength training provides peace of mind that you’re protecting yourself against future metabolic diseases.
• Dr. Fisher shares his 80/20 approach to eating. He focuses on clean, whole foods 80% of the time and gives himself the freedom to enjoy things like cookies and chips without guilt the other 20%.
• Amy reminds us that healthy living isn’t about being flawless—it’s about staying consistent and doing your best most of the time, even if you stumble occasionally.

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It can be a truly horrible disease, but it is almost completely reversible for all intents and purposes.

But it’s so exciting because strength training can help you with this. I know we’ve seen clients who have done just that. They feel so empowered when that happens. It’s like, I did that. Welcome to the Strength Changes Everything podcast, where we introduce you to the information, latest research, and tools that will enable you to live a strong, healthy life. On this podcast, we will also answer your questions about strength, health, and well -being.

I’m Amy Hudson. I own and operate three exercise coach studios. My co -hosts are Brian Sagan, co -founder and CEO of The Exercise Coach, and Dr. James Fisher, leading researcher in evidence -based strength training. And now for today’s episode. Welcome back to our podcast, and I am so excited that you are with us today. We’ve been in a series taking a little bit of a deep dive into various health benefits of strength training.

Today’s topic is diabetes. If you have family members that are dealing with type 2 diabetes or you have sort of a genetic predisposition, this is going to be an episode you’re going to want to listen to. I still remember when I learned about the connection between type 2 diabetes, managing it, or sometimes even reversing it with strength training and how exciting that was. This episode, we’re going to talk about the prevalence of diabetes, what it is, and how strength training can help us manage or even sometimes reverse this condition. So if you have somebody in your life or you personally are at risk for this, this is going to be a really great episode for you. Dr. Fisher, I’m super excited for you to walk us through this topic and kind of getting started with the backstory.

But first, how are you?

I’m doing great today, Amy. Thank you. How are you?

Good, good.

And I can’t wait to dive into this topic. So why don’t you start us off by describing sort of the backstory of diabetes? What is it and what is the prevalence of it?

Yeah, absolutely. So, first of all, many people listening might have diabetes or they might have family members who have diabetes and they’ll have an awareness that what they’re testing, what they’ll often test is their blood sugar levels and they might then inject insulin or they might then control their diabetes with certain dietary habits as well as exercise, of course. So, diabetes is essentially a condition where our body now doesn’t, or type 2 diabetes I should say, is a condition now where our body doesn’t respond to the glucose that we’re taking in through our dietary habits, through the carbohydrates in our meals, and our body is not responding to the insulin that’s being released from our pancreas. So effectively, when we take in sugar in a dietary form, we can store it in our muscles and we can store it in our liver. And then when we need it, we can kind of call upon it to be used. And we’ve previously talked about the idea of a glycogen dump or we’ve talked about concentrated cardio in one of our previous podcasts.

And we’ve said that concentrated cardio at the end of a high -intensity strength training workout can be great because it’s that last bit of glycogen that’s in the muscles and it’s even retrieving that glycogen from the liver to be used for energy production. And then when we need it, go and have a meal, our pancreas can release insulin and it can direct that sugar to where it needs to be stored ready to be used again. So oftentimes the analogy with sort of blood sugar levels with diabetes is that there’s already the muscles in the liver are already filled with sugar and now we’re taking more sugar and so our pancreas releases insulin but there’s no way to and store that insulin. So now we just have extra sugar kind of floating around in our blood system. And this is called HbA1c.

It’s a measure of hemoglobin A1c. That’s effectively how much sugar we have in our blood. And so we’re kind of overfilling. The slurry pool is often the analogy here. And so two things happen. First of all, it’s not great to have too much sugar in the blood.

But second of all, our body stops reacting to this insulin signal. So it becomes something called insulin resistance. It just effectively stops reacting to it. And this can cause major problems with our circuitry and our nervous system and our immune system. When we talk about our circuitry system, many people and some people that I’ve worked with in the past, some great colleagues through basketball, have actually had toes or lower limbs amputated as a result of not controlling their diabetes very well, and they’ve even kind of had visual impairment and lost eyesight and things like that. So it can be a truly, truly horrible medical condition to live with.

The estimates, the statistics around it is that there’s maybe 422 million people worldwide have diabetes, and it’s directly attributable to 1 .5 million deaths per year. In the US alone, 11 % of females and 14 % of males are diagnosed with diabetes. And of course there’ll be many who are pre -diabetic or have gone undiagnosed. So diabetes truly is a terrible, terrible condition. And interestingly, the World Health Organization and medical professionals class it as what’s called a non -communicable disease. And what that means is that you can’t catch diabetes from the person next to you.

It’s not a communicable disease in that form. but it actually means it’s more of a lifestyle disease or even a behavioral disease. And that means that it’s for all its purposes quite avoidable by making the right changes to our lifestyle. Now, the reason I say this is not to embarrass people that might have diabetes, but to highlight to them that the decisions that they make in their future can really kind of impact their medical well -being. And there is certainly academic resources that have shown evidence of people reversing diabetes, effectively coming off diabetic medication altogether. So it can be a truly, a truly horrible disease, but it is almost completely reversible for all intents and purposes.

Which is super, super encouraging. And actually, you know, that begs the question, you know, lifestyle, how much sugar I’m consuming and how often I’m depleting my muscles of that stored energy, you know, which is more important. What if somebody is going to identify a major contributor to somebody developing type 2 diabetes, you know, is it more about their consumption of sugar or is it more about their lack of exercise to the extent that they’re depleting that glycogen or is there a way to even quantify that?

Well, that’s a really difficult question to answer, but there’s a couple of examples that we can give. First of all, if somebody isn’t doing much exercise or isn’t doing any exercise, they’re already taking in too much sugar. If they’re having a normal Western diet, they’re already taking in too much sugar in the form of refined carbohydrates. If they’re simply not burning that sugar off through exercise, then effectively they’re taking in too much. They need to increase their exercise. and they need to start to do the right type of exercise, which I would advocate is higher effort exercise or strength training specifically, which is the topic we’ll get into, to use that stored sugar and to kind of empty the swimming pool and allow our body to then refuel. Now, the other end of the spectrum is, of course, our world -class rowers, swimmers, and cyclists that are truly Um, you know, maybe our Olympic endurance athletes. Now they’ve often talked about having things like a 10 ,000 kilocalorie per day diet and having a huge, huge amount of carbohydrates. And the reason that they can do this, first of all, I would say that that might not be completely essential. I think that that’s quite a historic approach. But with the volume and the intensity of exercise that they’re doing and the regularity of their training, which may be twice per day with different modalities of training, multiple days per week, they’re able to burn through that amount of stored sugar.

So that when they then take in more through their diet, their body can still react to the insulin and they can still store it and so forth. So it’s almost not a case of saying Do I need to do more exercise or do I need to eat less refined sugar? Well, you kind of need to do both, but you can find a balance between the two. If you’re doing enough exercise and the right type of exercise, then you can afford to have a little bit higher kind of refined sugar intake if you so choose. There might be other implications of that, but certainly from a blood sugar perspective, it’s quite manageable in that way.

Perfect.

Thanks for clarifying that.

Okay. The first study that I want to get into, and we talked previously about meta -analyses, and just to recap in case anybody hasn’t listened to the previous podcast, a meta -analysis is essentially a collection of the body of literature that’s looked at a topic. So for example, there are a number of studies, there’s a plethora of studies that have looked at the impact of strength training on diabetes or prediabetes. blood sugar levels and so forth. And a meta -analysis effectively creates specific criteria and then groups all those studies together and looks at the data from all of those studies in one single analysis and comes up with a kind of a clearer solution of is it impactful or is it not impactful or how impactful is it. So the first study that I’m going to talk through, and for those of you watching on YouTube, you can obviously see the title.

For those of you listening on the podcast, I have got some slides that we’re sharing on YouTube. So if you want to go ahead and switch to YouTube, you can do, or if you want to do it at a later date, you can see the studies themselves. So the first study here is the effectiveness of resistance training. and program characteristics in patients at risk for type 2 diabetes. So these are pre -diabetics. So they’re high blood sugar, but they’re not quite into diabetic criteria yet.

So this meta -analytic review is 14 studies and it’s nearly 700 participants, all with pre -diabetes. And I’ve jumped straight ahead to the results because I don’t want to get into too much detail of each of these studies. But for those of you on YouTube, you can see the figure. The figure has a vertical line at the zero and you’ll see all the markers are reduced. So if I just describe this for those of you listening to the podcast, we can see waist comfort was significantly reduced. Body fat percentage significantly reduced.

HbA1c, which is our hemoglobin A1c level, which is basically our marker of blood glucose. is significantly reduced as a result of strength training. And then previously on the podcast, we’ve talked about cholesterol. So we’ve got our LDL, which is our low -density lipoprotein, and our triglycerides, they’re both significantly reduced. And then we’ve also talked about hypertension, and this shows our systolic blood pressure and our diastolic blood pressure. Again, also significantly reduced. So in this combination of all of these studies, we can see that unequivocally, strength training serves to reduce all of these factors. So a big win, probably the primary one we’re looking at in this instance is HbA1c and insulin, our fasting blood glucose and our insulin levels.

But the fact that we’re seeing that pattern across other variables is also noteworthy.

Wow. So if you’re if you’re a person out there whose doctor is telling you that you’re too high in some of these areas and you’re testing high for these, you know, it’s very easy and tempting to believe, well, then I just have to get on a medication to get me back into the normal range or I have no other way to, you know, to fix this really, unless I go super extreme with my diet and I’m not willing to do that. But it’s so exciting because strength training can help you with this. There’s actually changes to your tests that you may be able to experience through strength training.

That’s super, super exciting. Yeah, absolutely. And in fact, one of the criteria within this study is they wanted to look at some of the program characteristics. So we’ll get into that a little bit. So they talked about the idea of using loads that were greater than 60 percent of one repetition max. So that means they’re using a moderate to heavy weight, not a super duper heavy weight, but they’re still using a light weight.

Now I would say this is probably most people engaging in strength training, and certainly everybody engaging in strength training through the exercise coach. What we obviously use at the exercise coach is isokinetic equipment, so it doesn’t detail a one repetition max, which is the maximum weight that you can lift for a single repetition. but it works on effort level and it works on a previously measured isometric force and you are almost certainly lifting more than 60 % of your one rep max when you exercise on the exerbotics devices. It also talked about effort and the this context they put it as effort of one to three repetitions shy of failure. So failure, if you consider a normal weight stack that goes up and down when you lift weights, so failure is now your inability to kind of complete the concentric phase, the lifting phase, of that exercise for that repetition.

So one to three repetitions is a relatively high effort level. And again, on exerbotics devices, you never truly reach failure because as your fatigue kicks in, your effort can remain high, but so the machine effectively matches your effort with its, you know, technologically enabled programming. So, um, but you know, it’s all about how hard you’re willing to work or you’re prepared to work. And then they talk about a frequency of two to three times per week. And that’s exactly as prescribed at the exercise coach. Uh, if you, if you go to an exercise coach studio, you’re training twice per week, you’re hopefully training twice per week.

And then they also talked briefly about the benefits of multi joint exercises. And they specifically mentioned leg press, chest press, overhead press. pull down and seated row which again are what I would consider to be sort of the big five main exercises in strength training and of course a big part of the programming in the exercise coach studios.

So Dr. Fisher, do you know in these studies Was there anything that these participants did in terms of nutrition or were they simply not even including that as a variable? Yes, well, they didn’t control that or they didn’t include that as a variable. And if we get into the crux of it, some of the studies may have controlled it and said that participants were encouraged not to make dietary changes. That’s almost certainly going to be the case. That’s typically what we would have done in previous studies like this, because we want to simply see the impact of strength training and strength training alone. Now, what’s quite interesting is when people start to dip their foot in the water with one health modality, it tends to be that other health modalities follow. We, in a previous study many years back, we found that people when they engage in strength training also increase their step count. We’ve previously talked about a step count on this, this podcast, but this was without any kind of guidance to do that. And what we simply found was that they were engaging in exercise. And so they were also thinking about the other benefits of other things that they could do for their health and wellbeing. So many people will obviously just engage in strength training and that’s it.

They won’t change anything else. And that was the aim of that study. But some people who do engage in strength training will also make other small changes to their lifestyle. They might start to look at their sleep habits, particularly because they’ll be more fatigued in the evening.

So their sleep habits might improve, their nutrition habits might improve as well, and so forth.

It just goes to remind you of those cascading effects that trickle in, even if we’re not trying to, to other areas of our health. Absolutely. So the next study that we’re going to look at is another meta -analysis, and this time it’s with participants who are diabetic, they’re diagnosed with type 2 diabetes. So just for absolute clarity, when we measure HbA1c, anything above, I think it’s about 5 .6%, up to 6 .4 % is pre -diabetic, and anything over 6 .5 % is considered diabetic. So these participants all typically into that boundary of diabetes. They were diagnosed, they were recognized, they were on some form of medication.

So there’s 20 studies here with a combined total of 1 ,100 participants, or just over 1 ,100 participants. And the authors concluded that resistance training significantly reduced HbA1c, so obviously that was the bug glucose marker that we talked about. And the interventions that had the largest training effect were interventions that had where strength progressed and where the workout itself progressed. So one of the key things that we’ll often talk about in strength training is that somebody is given a program, they may, you know, we’ve talked about big box gyms, you may go to a big box gym and you’re given a program and the program says to do three sets of ten repetitions with a certain weight. And by experience, if you go back to that person six months later and you say, how are you getting on?

If they’re still going to the gym, they say, yep, I’m still doing my three sets of 10 with the same weight. So there’s been almost no progression in their workout at all. And of course, this is one of the benefits of supervised workouts. And the key part of the exercise coach and the supervision that you get is that the workouts are progressive. There’s that constant strive to improve on the previous workout. Now, we have also talked about the fact that The graph can’t always move up and to the right.

You can’t always be stronger than the previous workout. But the emphasis here is on that intent to improve that effort level.

But they found that people who improved their strength to a greater degree also made more notable reductions in their HbA1c level.

Okay, cool.

Yeah, yeah.

So it’s even better results when they’re strength training and then also adding and improving in their strength and working a little bit harder over time. Absolutely. And so there’s one final study here that I’m really briefly going to touch on. This is another study, oh sorry, another meta -analysis with 24 studies. The title of this one is resistance exercise intensity is correlated with attenuation of HbA1c and insulin in patients with type 2 diabetes. So again, it’s a combination of 24 studies, a combined total of nearly 1 ,000 participants in the intervention group, in the strength training group, compared to nearly 500 in a control group, all diagnosed with type 2 diabetes and within the age of 45 and 71 years. And what did they find? Well, exactly the same as the previous meta -analyses that we’ve looked at. Resistance exercise substantially decreases HbA1c levels in diabetic patients. And again, they reported that the reduction in HbA1c was greater with heavier loads. And in this case, they talked about heavier loads being greater than 50 % of one repetition max and compared to very light load exercise.

So again, there’s all this research now that’s showing the benefits of strength training in reducing our HbA1c level, our insulin, also reducing triglycerides and LDL cholesterol and so forth. But the key here is that we’re starting to take control of diabetes if you’re pre -diabetic or even take control of it if you’re already diagnosed with diabetes. Now, I talked at the start of a couple of studies that I’ve worked with colleagues, one in Germany and one in Brazil, where they actually had some patients on these studies who completely came off their diabetes medication and effectively were re -diagnosed as not being diabetic or shifted down the spectrum from diabetic to pre -diabetic and changed their medication as a result. So, you know, we saw at the start about this condition and it really wasn’t to shame or embarrass anybody, but it was really to say that the benefits are there for anybody who is, is diagnosed with diabetes. And obviously we talked about the, um, the significance of this medical condition. So if you know somebody who has diabetes, then a key question is, are they engaging in strength training?

Cause the academic research is a very clear strength training. is very good in helping people with diabetes control their blood sugar levels, reduce their HbA1c and start to reverse that. That is so amazing. I know we’ve seen clients who have done just that exactly what you’re talking about to get back into the normal range and wow, they feel so empowered when that happens. It’s like, I did that.

I was able to do that and even if you are not a risk for type 2 diabetes, if you’re participating in strength training, it’s great peace of mind knowing that you’re basically warding that off, you know, and it’s not something you’re going to be have to be as concerned with, even if that’s not your primary goal, which is really cool to think about. Yeah, I mean, it can be, you know, we can take a number of perspectives on this. I tend to have quite a pretty good diet, I would say. I tend to have what I call an 80 -20 principle on my diet, 80 % of the time. I’m very focused on eating good things, on eating healthy things, you know, less processed, uh, food and things like that. But 20 % of the time, my halo slips.

Uh, you know, I’m, I like cookies. I like potato chips. I like fries, all that kind of stuff that we all know tastes great, but we know isn’t good for us. And, and I’ve been asked by people, you know, you’re, you’re a health nut or a health freak, you know, surely you don’t eat that kind of thing. And I sort of say, well, actually, because I’m a health freak now and then I can that kind of thing.

And that’s my outlook on things, that I’m not sacrificing some of those small pleasures in my life that I can still enjoy, but I know that I’m countering those small pleasures by my engagement in strength training. I love that. I love that. If you’re an exercise coach client too, you may have participated in the Metabolic Comeback, and that’s another thing that we do at our studios with our clients. They will combine their weekly workouts to strength training workouts a week. So that strength training piece with a whole food approach to nutrition, a lot of intentionality.

We’ve talked in other episodes about that. that is, but basically choosing anti -inflammatory, lower sugar, less processed foods in a focused way for 30 days. And one thing we explain to people is that once you sort of get off of that blood sugar roller coaster and learn how to make better choices most of the time, because we learn how to enjoy eating a whole food diet, 80 % of the time, like you said, our body will be better able to handle those treats on the occasions that those choices are made because we’ve set ourselves up for way better success in choosing those than we would be if we were not participating in strength training and not making those healthy choices the rest of the time. And I think that’s a healthy way to look at it versus the all or nothing, perfection or nothing at all approach. That’s not going to serve you long term. Nobody can be perfect all the time.

But it’s also pointless to just give up as well in terms of that area because there’s so much good you can do for yourself. So thank you for breaking all this down for us. So what would you like to leave listeners with today in terms of their understanding of type 2 diabetes and strength training.

What’s your sort of call to action or encouragement for listeners? So just to recap, we talked at the start about this is a non -communicable disease. So this really is considered a behavioral or a lifestyle condition. And we know that engagement in strength training, we’re very clear, engagement in strength training can really help. people with this condition to reduce and control their blood sugars and even go so far as to reduce diabetes and help bring people off medication. So there is no doubt that anybody, if you have diabetes or if anybody you know has diabetes or struggles with their blood sugar or even just struggles with their nutrition or even just wants to improve their quality of life and their overall health, then they should be engaging in strength training. Absolutely. And maybe you’re missing peace. Well, Dr. Fisher, thank you for breaking this down for us. It’s super, super exciting. I’m so thankful that you did this for us today.

And I hope it encouraged you as a listener. We will see you next time back on this podcast. I hope you remember strength changes everything. Thanks for listening. If you enjoyed today’s episode, please share it with a friend.

You can submit a question or connect with the show at strengthchangeseverything.com. Join us next week for another episode and be sure to follow the show on Apple Podcasts, YouTube, or wherever you get your podcasts so that you never miss another episode. Here’s to you and your best health.