When I was 14 years old, I decided my goal in life was to get a 6-pack.
“Why?” you ask.
In gym class, as a part of our weightlifting unit, we were told to do 40 v-ups in as few sets as possible. Guess how many I did?
Four.
That was it. I thought I was going to die. My midsection burned like crazy.
More importantly, I was mortified as my classmates ripped off seemingly endless v-ups around me.
So, I vowed to obtain that 6 pack and do my v-ups religiously. Suddenly, 40 v-ups weren’t difficult. I moved to 50, then 60, and then 70 consecutively.
I accidentally stumbled upon what would become one of my life’s passions: gaining muscle.
I’m here to give you some of the Do’s and Don’ts for gaining muscle while staying lean and maintaining a great A1c at the same time.

Eat a caloric surplus
Contrary to what anyone may try to tell you, resistance training and type 1 diabetes mix, and they mix very well. You can find countless reasons in the archives on this site.
But for gaining weight, especially muscle mass? It’s about balance. Balance, patience, and consistency.
No matter how you slice it, weight gain of any type, muscle included, requires a caloric surplus. Why? Because you’re creating new tissue. You can’t create something out of nothing.
You need inputs (calories) to create outputs (lean muscle mass).
Let me repeat: you will NOT gain weight OR muscle if you are NOT in a caloric surplus.
However, don’t let this fool you: the “See Food” approach of “I see it, I eat it, with no regard to caloric content except for the insulin I take” is not the optimal way to gain weight. You’ll be chasing high and low blood sugars constantly with the massive amounts of insulin you’ll be taking, and the majority of the weight you gain will be fat.
I personally prefer a slower, more methodical approach to weight gain. Put simply, you determine your caloric maintenance – how many calories are required for maintaining body weight – and then add 200-300 calories or 5-10% of total calories on top of that number.
You can learn how to easily find your caloric maintenance level in this post!
Don’t rush the process
Why so conservative?
Muscle gain is not linear or fast
If your resistance-training program is doing its job, you should be making steady progress in the gym during this time in a caloric surplus, whether it is increases in your load (amount of weight you are using) or increases in your volume (sets and reps).
However, in ideal conditions, the maximum amount of muscle you can build in a week is ½ lb. That’s assuming everything is PERFECT. Women, cut that number in half. That rate is for new lifters: the more experienced you are, the slower that rate will be.
That being said, why overload your body with excess calories if only a moderate percentage will turn into the lean mass you desire?
Less fat gain
Raise your hand if you enjoy insulin resistance, decreased levels of testosterone (with corresponding increases in estrogen), and making life more difficult for yourself for no reason.
No one? That’s what I thought.
Too high a surplus leads to more fat gain, which activates the aforementioned mechanisms, which primes the body to lay down even MORE fat while making it tougher to add muscle.
Slow and steady wins this race.
Easier to manage blood sugar levels
In my experience, it is quite a bit simpler to factor in a modest increase in calories into my insulin-dosing regimen than a huge increase.
While the occasional day of a 1000+ caloric surplus is doable and manageable, it’s a lot more playing catch up of blood sugars on the back end – the spikes are higher, the crashes are lower, and insulin sensitivity changes through the day and even by the meal.
Throw in some meals where the macros are a mystery, and let the roller coaster ride begin!
Eat enough protein
Protein consumption aids in satiety, muscle protein synthesis, recovery from workouts, post-meal blood sugars, and a myriad of other benefits that could be a whole separate article.
To make a long story short: you need it to be at your best, and you need it in adequate amounts.
No, you won’t need to eat pounds of meat or drink six shakes a day. Without boring you with too much biochemistry and research, the American College for Sports Medicine recommends a daily intake of 0.5-0.8g/lb and multiple studies recommend 0.6-0.8g/lb, with no real benefit beyond 0.8g/lb.
Don’t worry about being perfect
Nothing feels worse than having your diet absolutely on point for the day, testing your blood sugar at 1130pm, being 54, and eating what seems like everything in the house.
We have type 1 diabetes. Life happens. Your blood sugars may run high one day and you may not hit your caloric goal, or you may have a low and overeat.
Do not stress, my friends. That solves nothing and actually may make your blood sugars worse.
Diabetes control comes before anything else. To perform at our best in the gym, on the field, or wherever we may be, blood sugar management is the key to success. If everything is haywire, forcing things will get us nowhere.
Remember: your calories are like a bank – if you withdraw too much one day, make up for it the next day by reducing calories a little. If you undereat one day, eat a little more the next day. This principle can be applied to both muscle gain and weight loss.
Suggested next post: How to lose weight when you live with diabetes
Kingdom
I’m a type 1 diabetic looking to gain muscle mass, what is your advice with use of mass gaining protein shakes?
Christel Oerum
Most of the mass gainers are just protein with a lot of added sugar which can be really tricky when it comes to blood sugar management. If you do go that route you might want to consider pre-bolusing or using Afrezza
Sara
Hi
I am a Type 1 Diabetic and have been active my whole life. But I recently started heavy weight training and a calorie surplus. But I have noticed I have gained a lot of extra fat instead of extra muscle like I want. Do you have any suggestions of what I can switch, and how I can lose the extra fat I gained but still gain muscle?
Christel Oerum
I’d focus on doing one thing at a time. If you’re gaining fat over muscle your diet is dialed up a bit too much for you. You could dial it back a bit and continue to lift heavy and build some good solid muscle
Natneal Yonas
I’m 17 years old and since having diabetes I’ve been skinny and weak. During this period my blood sugars were stable and very rarely go high or low. I’ve always wanted to change my current body into a body I feel confident and have a good physique so 2 weeks ago I began my journey. I bought protein mass gainer from myprotein and have increased my protein and calorie intake and perform heavy compound lifts 3x a week. So far I have seen decent progress with the weights I’m lifting however my blood sugars have been rising with an average of 10.5 since going gym and I’ve gained a lot of fat on my bottom and some on my stomach.
I know I’ve said a lot but I am in desperate need of advice so that I can bring my blood sugar down while pursuing my vision on having a physique so if you could help it would mean a lot.
Thank you
Christel Oerum
You need to learn how to manage your blood sugars while doing this type of (anaerobic training). This might be a good article to help you with that: https://diabetesstrong.com/how-resistance-training-affects-your-blood-sugar/
As for weight gain, it could mean that you’re in a bit too large of a calorie surplus. It’s easier to gain muscle with a decent calorie surplus but you do risk adding a bit of fat as well. I would play around with your calories or work with a knowledgeable RD and trainer like Ben Tzeel.
And remember significant muscle gain takes time, years
Andrew
Hi – I’m doing heaps of resistance training and am finding my glucose levels rising really late at night, often 8 hours after intense anaerobic exercise and 6 hours after a meal. Is this a thing?? I wake up at the night now to bolus myself and want to pinpoint why I get those night time rises.
Christel Oerum
Hm, usually people see a drop. A few things come to mind:
– If you lower your insulin during or after your workout you might have too little onboard later in the day
– If food doesn’t hit your bloodstream until 6 hours post-meal you might want to get tested for gastroparesis
– If you eat high fat that could be the reason why you see increases in your blood sugar later
Based on what you write that’s all I can think of. Your endo might have other explanations
Andria
I’m a type 1 diabetic and I usually do bodypump by Les Mills twice a week and cycle class 1-2 a week mixed in with a class called tone. I feel like this is a good mix and like the tone-ness it brings. I’m guessing if I wanted more buffness I could just always add more weights during body pump ? Although I dont want to lose my form so I have to be carful with that as well. One question I have is after having 3 big babies(2-3 years in between) each was a C-Section, is there any way to restore my abs/ loose skin? I’m also on a low carb (veggies) moderate proteins healthy fat way of eating . Any tips would be grateful!!
Christel Oerum
Sounds like a great routine!
If you decide you want to add more bulk, going heavier during your class is the way to go. But yes, don’t sacrifice form.
As for loose skin, depending on the amount there is only really to ways to deal with it. Accept and love it or get it surgical removed. Even the top fitness model mamas have loose skin
Rohan
Hi. I’m 26 years old. I’ve been working out for the past 1year, but I’ve hardly gained any muscles. To find out what is wrong, i did a full medical check-up, and discovered that i have type 1 diabetes. Please help me. Will I be able to persue my bodybuilding goals?
Christel Oerum
Yes, you will. You’ll need to eat enough to build muscle, lift enough for your muscles to grow and manage your diabetes tightly. And of course, read the whole article where Ben takes you through the basics
John
Do you think P90X is a good workout option for diabetics?
Alternately, 2 days cardio, 2 weights, and 1 yoga session as a weekly training regiment work better?
Christel Oerum
Yes, that can be an excellent routine. Most importantly it needs to continue to challenge you
Dwight
I am Type 1 diabetic and one thing I have noticed is that I gain muscle almost too fast, faster than I gain strength. I assume this is due to the insulin factor and I am a very conservative insulin taker and I do a lot of cardio in between sets.
But in the weight lifting world many have taken to taking insulin to gain more muscles, so it appears that this is part of the process, for better or for worse.
But then again this just might be my metabolism in general.
Another thing I have noticed is that after working out, it takes me longer to recover.
Any an all working out is great for the overall system, but it takes some diligence to not go to low or high due to muscles absorbing glucose store and releasing them.
If anything it makes the body more efficient in the use of the insulin that you take and allows your body to access the sugars in the system through the muscles.
And it also increases blood flow overall.
Just things to consider.
Andrew Reppel
I stumbled across this article and website, just to become more intrigued. I’m also a type 1 and have been for 23 years. I’ve alwyas been looking at becoming a personal trainer and needed this type of information on nutrition for a long time. I can’t express how much this site and your team is an inspiration for me. Is there any information on how I can pursue the same career path? I’d love to know how I can accomplish these goals.
Christel Oerum
Hi Andrew,
Thank you! Glad you like the site.
The first step would be to get a personal training education. There are different options so depends on your focus. And then you start to add on. Some of our writers have nutrition degrees, some have other physiology degrees and some are personal trainers who have worked with PWDs for a long time and have a significant amount of relevant continued education.
So if you’d like to be a strength coach like Ben, maybe a similar education as a Certified Strength and Conditioning Specialist (CSCS) is the way to start.
But most importantly, continue to be your genuine self
Julie
Love this article. This is exactly the formula to gain muscle if you have diabetes. Even though I don’t take insulin and meds anymore because I keep it under control, it was a learning process for me and what worked for me. The more reliable information you have, the better you are at managing your diabetes. From the time I was diagnosed over 5 years ago, I have lost 85 lbs. and lift weights 3 times a week with cardio 2 to 3 times a week. Weight lifting / resistance training and solid, reliable information like these priceless articles on Fit with Diabetes / Fit Blog saved my life. I am 53 years old and competing in my first Triathlon in 3 weeks… and I am so excited. Ms. Oerum’s information is priceless, as well as the experts she utilizes to educate people with diabetes. And ladies, if you want a wonderful body, follow these wonderful weight training / resistance exercises Ms. Oerum has on this website. It will be your fountain of youth. I love to wear tank tops and shorts and show all my muscles. I’m no Arnold but I always have people come up to me and tell me how good my arms, legs, back, etc. look. …..The hardest part is just starting, that initial beginning. And I stuck with it…..take all this priceless information and use it…..I started seeing better A1C in my first 6 months…. and I couldn’t believe how I looked. Once you see your body change and energy levels change, you are hooked, your life is better, everything is better. Just start ….
Christel Oerum
Oh my, you’re making me blush 🙂 Thank you so much for taking the time to write this very kind feedback. I’m thrilled for you, and very impressed with all you have achieved (and in such a limited timeframe I might add).
I hope you have fun with your Triathlon, and keep rocking those tanktops and shorts!!!
Andreea
Were you a type 1 or 2? You said you don’t take any medication ?
SaraBee
Most type 1 diabetics do not lose weight after they are diagnosed, they gain weight. The symptoms of untreated T1 are extreme thirst, fatigue, and weight loss due to the lack of insulin production. Insulin therapy is required for Type 1 diabetics because their bodies cannot produce any- according to the Mayo Clinic “Type 1 diabetes, once known as juvenile diabetes or insulin-dependent diabetes, is a chronic condition in which the pancreas produces little or no insulin” If you do not need to take insulin, you are not a Type 1 diabetic, but all types of diabetics can benefit from the advice on Christel’s site.
Jamie Rector
No meds? Are you Type 1 or 2?
Sue
Really truly appreciate all the articles and insights. Would it be possible to have some help for us well aged Type 1 diabetics that no longer have the stamina or endurance that many of these things take. At age 73 and after 41 years as a type 1 with hand, leg , foot problems as a result what would you suggest for building muscle other than long hours at the gym. Still working full time which I am convinced is keeping me alive so long hours exercising at the gym is not possible.
Christel Oerum
Hi Sue, great question! We have a post by Dr. Sheri Colberg that talks about resistance training for older adults and people with reduced mobility. Perhaps it can help you: https://diabetesstrong.com/resistance-training-guidelines-for-older-adults-or-anyone-with-reduced-mobility/
Please take a look and let me know if this is the kind of information you are looking for.