Best Exercises for People with Diabetes on GLP-1 Medications to Avoid Muscle Loss
- Feb 2
- 7 min read
Updated: Mar 3
Preserve lean muscle while taking GLP-1 medications. Learn the best resistance exercises for diabetes and how to combine them with proper nutrition.
GLP-1 receptor agonist medications - including semaglutide (Ozempic, Wegovy), tirzepatide (Mounjaro, Zepbound), and others - are wonderful tools for people with Type 2 diabetes. They help improve blood sugar control, reduce cardiovascular risk, and prevent complications.
However, these medications come with a big challenge: muscle loss due to overall weight loss. Fortunately, you can control and prevent this through the right approach to exercise and nutrition. In this guide, Vigor hopes to help you understand what negative effects GLP-1 can have on your muscle mass and how to offset them.
How GLP-1 Medications Cause Muscle Loss
When GLP-1 medications reduce appetite, people naturally eat fewer calories. Whether or not weight loss is a goal of yours, your body responds by breaking down both muscle tissue and fat for energy.
Sadly, you cannot choose which one you lose more if you have no other action accompanying this weight loss. Research shows that 25-40% of weight loss during GLP-1 therapy comes from lean muscle mass. For someone losing 10 kilograms, this could mean 3-4 kilograms of muscle, along with strength, metabolic capacity, and independence lost.
This is especially problematic for people with diabetes, where preserving muscle is already critical. Muscle tissue is metabolically active; it burns calories at rest, helps regulate blood sugar, and supports independence in daily life.
Why Resistance Training Matters When You’re on GLP-1
Training is the only solution to prevent or slow down muscle loss from any cause, including from GLP-1. Resistance training, combined with adequate protein, stops this muscle loss in its tracks.
When you do resistance training, you tell your body that this muscle is needed and must be maintained. This signal overrides the body's tendency to break down muscle during reduced calorie intake.
Additionally, resistance training directly improves how your body handles glucose by increasing insulin sensitivity and glucose uptake independent of the GLP-1 medication. You're not just preserving muscles, but also your overall diabetes management. Research shows that people on GLP-1 who combine strength training, adequate protein (1.2-1.6g per kilogram of body weight daily), and medical supervision achieve the best outcomes.
Top 5 Convenient Resistance Exercises For Diabetes Management
These exercises target major muscle groups, using minimal to no equipment, so that you can perform them right at home. Aim for 2-3 sets of 8-12 repetitions for each exercise, 3 times per week.
And don’t worry, you do not have to be as strong as a bodybuilder, weightlifter, or callisthenics athlete. Modifications are legitimate resistance training. What matters is that you're building strength progressively. Some people stay with modified versions forever, and that's completely fine. The goal is consistency, not matching someone else's fitness level.
Squats (Bodyweight or with Light Weight)
Squats engage your legs, glutes, and core - the largest muscle groups in your body. Stand with feet hip-width apart (roughly shoulder-width). Keep your chest upright and your weight balanced on your whole foot. Lower your body as if sitting back into a chair, keeping your knees aligned with your toes. Go as deep as comfortable, ideally until your thighs are roughly parallel to the ground, then push through your feet to stand back up.
Start with bodyweight squats. Once comfortable, hold a light dumbbell at your chest, then add more weight for progression as your body gets stronger.
For beginners or those with balance issues, do wall squats by leaning your back against a wall and sliding down into a squat position, or hold onto a chair back for balance while performing a standard squat. You can also do partial squats, lowering only halfway down at first.
Push-ups (Full or Modified)
Push-ups strengthen your chest, shoulders, triceps, and core - muscles essential for pushing, lifting, and upper body function. Many people avoid push-ups because they assume they need to do full floor push-ups, but there are many effective variations.
In a full push-up, the key is maintaining a straight line from your head to your heels throughout the movement. Elbows should bend at roughly 45 degrees from your body (not flared straight out). Lower yourself until your chest nearly touches the surface, then push back up.
For those who cannot perform a full push-up, start with wall push-ups. Place your hands on a wall at shoulder height and push your body away, then slowly lower yourself back.
Once that becomes easy, progress to incline push-ups with your hands on a sturdy chair or bench (the higher the incline, the easier the movement, and vice versa). Eventually progress to floor push-ups on your knees, then to full push-ups with your toes on the ground.
Rows (Resistance Band or Light Dumbbell)
Rows strengthen your back, shoulders, and arms - muscles critical for posture and pulling movements.
For a row with resistance band: anchor the band at roughly chest height, hold the ends, step back to create tension, then pull the band toward your body by driving your elbows back. Squeeze your shoulder blades together at the end of the movement, then slowly return to the starting position.
With dumbbells: hold a light weight in each hand at your sides, bend slightly forward at the hips (roughly 45 degrees), then pull the weights up toward your hips, driving your elbows back. Keep your back relatively straight. This is a common mistake where people bend and put pressure on their lower back.
Start with light resistance (a band or 1-2 kg weights). As this becomes easier, increase the resistance or the number of repetitions.
If standing balance is an issue, perform rows while seated. Sit upright in a chair, anchor a resistance band in front of you at chest height, and perform the same pulling motion.
Lateral Raises (Light Dumbbells or Resistance Band)
Lateral raises target your shoulders and upper back - muscles that support daily activities like lifting items onto shelves, carrying groceries, and maintaining good posture.
Stand with feet hip-width apart, hold light dumbbells at your sides with a slight bend in your elbows. Raise both arms out to your sides until they reach shoulder height, making a "T" shape with your body, then slowly lower them back down. The movement is slow and controlled, not jerky or swinging. Remember that you should feel pressure in your shoulders or the back of your arm, not your elbows.
With a resistance band, stand on the band with both feet and hold the ends. Perform the same movement as with dumbbells.
Start with very light weight/resistance; this exercise is challenging even for professionals. Many people use 1-2 kg dumbbells to start. As it becomes easier, increase the weight/resistance or add more repetitions.
If holding weights or bands is difficult, perform the movement without any weight, just the resistance of moving your arms against gravity. You can also perform lateral raises while seated, which removes the balance challenge.
Leg Extensions or Step-ups (Bodyweight or Light Weight)
Leg extensions and step-ups specifically target your quadriceps (front thigh muscles), which are critical for walking, climbing stairs, and maintaining balance.
For leg extensions while seated: sit in a chair with your back against the chair. Extend one leg straight out in front of you until your knee is fully extended, hold for a second, then slowly lower it back down. Do all repetitions on one leg, then switch to the other.
For step-ups: find a low step or small bench (roughly 15-20 centimetres high). Step up onto the platform with one foot, then step back down with control. Alternate legs or complete all repetitions on one side, then switch.
Bodyweight leg extensions and step-ups are the starting point. Once these become easy, you can add light dumbbells in your hands, or hold onto a chair for balance while doing faster repetitions.
If standing balance is limited, perform seated leg extensions exclusively. For step-ups, use a very low step (even 5-10 centimetres) or hold onto a counter for support.
Protein is Critical for Muscle Preservation on GLP-1
GLP-1 medications reduce appetite and make it harder to eat enough protein, but adequate protein intake is non-negotiable for muscle preservation. Aim for 1.2-1.6 grams per kilogram of body weight daily. For a 70kg person, that's roughly 84-112g daily; for someone at 90kg, it's 108-144g.
The timing matters when you are on medication. Try to consume 20-30g of protein within a few hours after strength training. This is when your muscles are most responsive to protein. A simple post-workout meal can be grilled chicken breast with rice and vegetables, or Greek yoghurt with berries and nuts.
Importantly, spread protein throughout the day (roughly 20-30g per meal) rather than loading it all at once. This distributes the muscle-building stimulus evenly.
Vigor's Medically-Directed Approach: Why It Matters for People with Diabetes on GLP-1 Medications
Exercising on GLP-1 medications requires careful attention. Blood sugar can behave unpredictably during or after workouts. Your medication timing, food intake, and exercise intensity all interact in complex ways. Without proper guidance, you risk hypoglycemia, frustration, or injury.
Vigor is Singapore's first medically-directed fitness centre, run by qualified physiotherapists and healthcare professionals who understand both exercise and diabetes management.
Our POWER programme - a physiotherapist-led strength training class - helps people build strength and muscle while managing chronic conditions like diabetes. We ensure you receive individualised attention within a supportive group setting:
Initial assessment: We conduct a comprehensive health assessment measuring your current muscle mass (InBODY), cardiovascular fitness, blood sugar patterns, and medication interactions
Personalised modifications: Our physiotherapists adapt exercises to your current fitness level and any diabetes-related complications (neuropathy, balance issues, etc.)
Medical supervision: You're exercising under the guidance of healthcare professionals who understand how GLP-1 medications affect blood sugar during exercise
Progress tracking: We measure your muscle preservation progress objectively over time, adjusting your program as needed
Ready to Preserve Your Muscle While Managing Diabetes?
Contact Vigor today to schedule your health assessment and start our POWER strength programme. Our physiotherapists will create a personalised resistance training plan adapted to your GLP-1 therapy, ensuring you preserve muscle, improve diabetes control, and maintain the strength you need for an independent life.