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Physical training is an important part of type 2 diabetes therapy. A new study by the German Diabetes Center (DDZ) shows that blood flow restriction training (BFRT) offers particular advantages. Despite significantly lower weight loads, BFRT improves muscle strength just as effectively as classic strength training. In addition, BFRT reduces abdominal fat (visceral adipose tissue), improves cellular energy production and increases blood flow. This reduces the risk of diabetes-related comorbidities. BFRT can therefore be an alternative to classic strength training for people with type 2 diabetes. The results of the study were recently published in the renowned journal Cell Metabolism.
Strength training strengthens muscles, improves blood glucose control, and is said to reduce the risk of cardiovascular disease. However, people with lower physical fitness, age-related muscle weakness, lower muscle mass, or obesity may find training with heavy weights difficult. In addition, many people underestimate how much weight they actually need to build muscle (about 70 percent of their individual maximum strength). This is where BFRT comes in. This training method, which is already used in rehabilitation and competitive sports, physiotherapy, and a few gyms, involves placing inflatable cuffs on the thighs. This completely blocks venous blood flow and reduces arterial blood flow by up to 80 percent. Training is carried out with weights of only around 30 percent of the individual's maximum strength. Despite the low weights, an intense training stimulus is created because adaptation processes are activated that would otherwise only occur at significantly higher loads. However, little was known about how BFRT works in people with type 2 diabetes.
BFRT tackles the root causes of type 2 diabetes and reduces visceral fat tissue
In the study, 20 people with type 2 diabetes, divided into two groups, completed training three times a week over a period of twelve weeks at the German Diabetes Center – either with BFRT or classic strength training. Both groups increased their muscle strength to a similar extent. In addition, their resting heart rate and blood pressure improved, and their fat tissue decreased; the participants lost weight. The decisive difference was in the distribution of body fat: classic strength training mainly reduced subcutaneous fat, while BFRT reduced visceral fat tissue surrounding the internal organs in the abdominal cavity. “Visceral fat releases not only fatty acids but also pro-inflammatory messenger substances into the blood,” explains Professor Michael Roden, Scientific Director and Spokesperson of the Board of the DDZ as well as Director of the Department of Endocrinology and Diabetology at Düsseldorf University Hospital. “This promotes insulin resistance, for example a deterioration in insulin action, and increases the risk of cardiovascular disease. If this fatty tissue is specifically reduced, particularly beneficial effects on prevention and therapy can be expected. The fact that this occurs with BFRT, a low-impact form of exercise, is a particular advantage for people with type 2 diabetes.”
Mitochondria become more efficient, blood circulation improves
BFRT also affects the mitochondria, the powerhouses of the cells. Training increased their number and efficiency in the muscles. “Mitochondria determine how well muscle and fat cells can metabolize glucose and fats. The more efficient they are, the better the metabolism,” explains Professor Dominik Pesta from the German Aerospace Center (DLR). In addition, the analysis showed that BFRT promotes processes that support the formation of new small blood vessels in the muscle (angiogenesis). Better blood circulation increases the supply of oxygen and nutrients to the muscles, thereby facilitating both glucose uptake and energy production in the cells.
Dr. Nina Trinks, research associate at the Institute of Clinical Diabetology at the DDZ, emphasizes the practical benefits of the study: “Many participants reported that they felt stronger and more resilient in their everyday lives. More than half signed up for a gym membership after the study ended in order to continue with regular strength training, if their fitness level allowed.”
Info box: Blood flow restriction training – better than classic strength training with heavy weights?
Advantages of classic strength training: Strength training with heavier weights is widely accessible and generally easy to integrate into everyday life. When training with sufficiently heavy weights, it increases muscle strength and mass, promotes cardiovascular health, and helps with weight loss.
Limitations of BFRT: By specifically reducing blood flow, BFRT with low loads activates metabolic processes that otherwise only occur during strength training with heavy weights. However, BFRT is currently only available to a limited extent and requires special equipment and professional supervision. Before starting BFRT training, you should always consult your doctor.
Conclusion: Due to the low mechanical stress, BFRT is an alternative for people with type 2 diabetes who are less physically fit. Both BFRT and classic strength training have specific strengths and can be combined effectively.
Dr. Nina Trinks
Research Associate at the Institute of Clinical Diabetology at the DDZ
Titel: Blood-flow restriction resistance training improves skeletal muscle mitochondrial capacity and cardiovascular risk factors in type 2 diabetes
Journal: Cell Metabolism
Authors: Trinks, N., Gancheva, S., Pützer-Furmanczak, J. et al.
Doi: https://doi.org/10.1016/j.cmet.2025.12.016
During BFRT, venous blood flow is completely blocked and arterial blood flow is reduced by up to 80 ...
Copyright: DDZ
To prevent the cuff from slipping during training, it must be securely fastened – similar to when me ...
Copyright: DDZ
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