Life Without Limits Podcast, Episode 16: What to Know About Strength Training with a Chronic Health Condition

Life Without Limits Podcast, Episode 16: What to Know About Strength Training with a Chronic Health Condition

When it comes to strength training, sometimes people imagine loud grunting, heavy barbells, or chalk-covered hands.

But did you know that effective strength training is much simpler and far less intimidating than that?

According to Boston-based personal trainer and strength coach, Tony Gentilcore, that’s because the human body doesn’t recognize the amount of weight you’re lifting or the number of reps you’re doing. It only knows “time under tension,” or the amount of time your muscles are being worked.

That means there are many different ways—beyond barbells and chalk—to incorporate strength training into your health regimen regardless of the equipment available, what the weather is, or what health condition(s) you might have.

Gentilcore, who operates CORE and is often featured in Men’s Health and Women’s Health, joined the Life Without Limits podcast. He talks about strength training with a chronic condition, and how it can improve insulin resistance, increase metabolic flexibility, and transform your health as much as your appearance.

Whether working with professional athletes, movie stars, or people who have hypertension, Gentilcore believes that training with resistance is the “fountain of youth” and the core of good health.

Listen below and find Gentilcore on Facebook, Instagram, and Twitter for more great insight.




Host: This is Life Without Limits, the One Drop Podcast that gives you the tools, inspiration and support to challenge your limits. We talk with experts across all areas of health to open up more possibilities for you. Lean on us, as you step outside your comfort zone, to work your way toward better overall health and a Life Without Limits.

Kim Constantinesco: Welcome back to the Life Without Limits Podcast, where we talk with health experts to give you tips and support that help you reach your health goals. I’m your host Kim Constantinesco, and on today’s show we have Tony Gentilcore, a personal trainer and strength coach based on Massachusetts. He has worked with professional athletes, movie stars and people from all walks of life throughout his career. He owns and operates a personal training studio called Core in Brookline, Massachusetts and is often featured in Men’s Health, Women’s Health and many other worldwide health and wellness publications. Tony, thanks so much for joining the One Drop community today.

Tony Gentilcore: Well, thank you Kim. It’s my pleasure to come on. I love talking about strength training and getting people jazzed up on that topic. So I’m happy to do it.

Kim Constantinesco: Well, we have a lot to get into today. But first, tell us a little bit more about yourself and how you got into strength training, both in your personal life and in your professional life.

Tony Gentilcore: This is a funny story to me because I’m the only one in my immediate family is remotely interested in strength training. And for some reason as a kid growing up in the ‘80s it’s something I gravitated towards. I often attribute it to watching a lot of Rambo and Commando, Sylvester Stallone and Arnold Schwarzenegger movies. I watched those and was, like, oh man, those guys look pretty big and strong. That looks kind of cool.

And at that, obviously gravitated to sports. I was a baseball player all through high school, all through college, and I realized pretty quickly that resistance training and strength training could help me perform well on the baseball field. Unfortunately when I was still in my playing career there weren’t many professional teams looking for a right-handed pitcher who threw 87 miles an hour. And I finished my degree in health education and realized that I really liked strength training. I really liked this idea of helping people get healthy. So why not become a personal trainer?

And then fast forward 20 years, I own my own personal training studio in Boston and get the opportunity to work with a wide swath of people with different ability levels and injury histories and goals, which is a very rewarding career.

Kim Constantinesco: That’s incredible, and you mentioned yourself that you’re a former athlete. And I think a lot of people kind of associate strength training for athletes or for younger people or, quote, unquote, healthy people. But it’s actually a great health habit for people with chronic health conditions, and I want to ask you, what is it about strength training that helps people with diabetes?

Tony Gentilcore: You bring up a very valid and important point, in that strength training can be very intimidating to many people because they might get on social media and on YouTube or they might watch a show and they see these big, ginormous people with really heavy weight. And they attribute that to strength training, and it absolutely is when we talk about power lifting. However, anything could be strength training. It could be dumbbells. It could be a kettle bell. It can be a band. And really all we’re asking here is that we’re trying to implement an external load that the body has to adapt to in order to get stronger and perform better.

So it does not have to be placing a heavy barbell on the ground and lifting it off the ground. There’s a myriad of ways of implementing strength training. And if it’s any consolation, the vast majority of my clients currently are just regular, general population people who are interested in moving better. They might have a cranky back or a cranky knee that needs a little bit of attention. And we can use strength training to help them feel a little bit better, increase their range of motion, make things less painful. And really I often say, what I’m trying to do here is prepare you for everyday life events. Picking up your kids off the ground, carrying groceries from the store to the car, stuff like that. Strength training can absolutely benefit anyone who’s looking just to improve everyday life.

With regards to stuff like diabetes, really all we’re trying to say is that the more muscle somebody has or the more lean mass somebody has, that’s going to help the body insulin and improve insulin sensitivity and also just improve their storage capacity for stored sugar. So strength training can help with diabetes in that regard.

Kim Constantinesco: Well, and not just diabetes, right. So it helps with all kinds of health conditions, from hypertension to high cholesterol. Can you talk about some of the other benefits that it brings?

Tony Gentilcore: Yeah, with hypertension, any sort of physical activity is going to help there. Whether we’re talking about cardiovascular exercise, strength training. And strength training can be considered cardiovascular exercise because really in that context all we’re saying is really anything that elevates your heart rate can be considered cardio. And strength training can absolutely hit the nail on the button there.

And when we talk about elevating our heart rate, this helps strengthen your heart and helps improve its ability to pump more blood with less effort. And then it also forces the arteries, decrease the work that the arteries have to do. So yeah, strength training has many, many benefits with hypertension, diabetes, cholesterol. A lot of research suggests that strength training helps increase HDL, which is the, quote, unquote, good cholesterol. So there’s a lot of real world and research-based evidence that backs that up.

Kim Constantinesco: So let’s talk about, quote, unquote, dose of strength training, that makes the biggest impact to our health. How often do people need to incorporate this into their lives in order for it to start having those positive effects?

Tony Gentilcore: And I think this is an important question too because it’s that time of year where people are making many resolutions, particularly with their health and fitness. And I think they get it programmed in their head that more is better. I always try to people, listen, the dose is really going to be depending on what you’re willing to do and what fits your lifestyle, what fits your schedule, what fits your family obligations, your work obligations.

However, that being said, one mantra that I like to instill with new clients of mine is this three by fifty-two attitude or three by fifty-two mantra. And what I mean by that is, people often ask me, okay, well, how many days per week should I be working out? Or how many exercises should I be doing? I was, like, let’s not worry about the Xs and Os of all these exercises and stuff like that. So let’s worry about consistency and three by fifty-two. And what I mean by that is, if you focus on three per week, fifty-two weeks out of the year, do something, anything, whatever fills your (inaudible) with regards to physical activity. If you follow the three by fifty-two mantra, I find that it’s a very non-intimidating number for people.

So rather than me saying, hey, you have to do something every single day. That’s just not realistic for a lot of people. And I want to focus on consistency, but more importantly, realistic consistency. I find that saying three days per week is a number that people can wrap their mind around, and just seems pretty accessible. And I think that’s an important starting point for people to understand and realize.

Kim Constantinesco: I want to transition a little bit. You said strength training, it doesn’t have to be just hoisting the barbells over your head or even entering a gym. A lot of different things make up strength training. Can you talk a little bit about what counts as strength training?

Tony Gentilcore: Well, anything that forces you to adapt to a stress can be considered strength training. So we could make the case that if you gain weight, which I know not many people are interested in doing, but if you’re doing body weight exercises and you gain weight, you are technically lifting more load. And that can be considered strength training. Not to mention the number of reps you’re doing and number of sets you’re doing.

However, yes, barbells count as strength training. I think that’s pretty common knowledge. But also dumbbells, kettle bells, bands, really all the body is interested in is feeling tension and feeling stress. And there are many ways to implement that that fits people lifestyles and fits their preferences. So many times people come in with me and I’ll point to a barbell on the ground and they’re, like, “Oh, I don’t know if I want to do that.” But if I reframe it and say, “Okay, let’s lift this kettle bell or dimple off the ground,” it seems a little less intimidating to them. It’s a nice starting point for them.

And then eventually we can progress to barbell-based strength training. But there are many things that we can utilize that challenge the body to adapt and get stronger and many things that people can do at home. So like I said, bands, I think bands are a very underrated form of strength training. They’re very versatile. They don’t take up a lot of space, and a lot of people can get on board with that because it’s, again, a very non-intimidating thing to implement, rather than looking at a heavy barbell.

Kim Constantinesco: Well, and from what I understand, the body doesn’t necessarily know the amount of weight that you’re lifting or reps. Really what counts here is the time under tension that your muscles are under.

Tony Gentilcore: That’s a very valid point and kind of what I’m trying to relay here. Is that the body doesn’t recognize if you’re lifting a barbell or a dumbbell or if it’s a band or if it’s a machine. There are many, many exercise machines that people can use where you just put in the pin, put the weight on and it takes you – you’ve just got apply the force and it takes you through the range of motion.

So yes, all the body really needs in order to adapt is stress and time under tension. So whether that time under tension is ten reps, fifteen reps, five reps or if you literally just go for time. Like, you perform a certain exercise for 30 seconds, for 40 seconds, maybe up to a minute. As long as you’re focusing on stuff like that, and then you’re making a cognizant effort to do more work, meaning you’re not just using the same load, the same rep scheme, the same set scheme over and over and over again. That will work for a week, two weeks, three weeks. But eventually the body is going to adapt. You need to gradually increase resistance, increase total time under tension in order to make continued progress.

Kim Constantinesco: Right, and that’s true for all people. Doesn’t matter if you’re a man or a woman, and I do want to jump into something that is still kind of kicking around in our environment. And a lot of people tend to think that of women who strength train, they could become big or bulky. What can you tell us about how women’s bodies actually respond to it?

Tony Gentilcore: So there is a hormonal conversation to have here. So the snarky side of me, the snarky strength and conditioning coach side of me, whenever this comes up, and it’s gotten better. It’s becoming less pandemic, excuse the verbiage (inaudible). But this whole big and bulky notion that women – if they look at a barbell they’re immediately going to put on a bunch of muscle mass. It’s becoming less prevalent. It still exists.

But whenever that comes up, I often say, well, you need to remind all the men who are working their butts off and going to the gym three, four, five times a week and lifting massive amounts of weight, and yet still having a hard time putting on muscle mass. Despite having a more robust hormonal milieu to put on muscle mass because they have more testosterone. You need to remind them that it’s super hard. Because it is very, very hard to put on muscle mass.

Unfortunately, yes, there’s this kind of notion that some women have where, oh well, I don’t want to touch a barbell because I don’t want to get big and bulky. And they’re looking at the end point. They don’t realize that it takes years to put on that much muscle mass. If they’re looking on Instagram or a muscle and fitness magazine or some of these women who have very muscular fatigues that have spent 15, 20, 25, 30 years lifting weights. So it is definitely not something that happens overnight, and it’s not something that happens in a matter of weeks or months.

So we have to understand that it is a process and that you have to work pretty darn hard to get to that point. And most people aren’t going to work that hard to look this certain way that they see in magazines and on popular social media accounts. So yeah, it’s just not going to happen. I wish it were that easy because that would make my life a lot easier as a coach.

But what’s the cool thing is, is I just recently rejoined a commercial gym. I’ve been kind of living in the strength and conditioning bubble for the past 15, 20 years of my career, working in strength and conditioning facilities where I’m working with athletes. I’m working with a vast majority of people who want to put on muscle. So I haven’t been working out in commercial gyms for the past two decades.

Years ago, back in the day, we’ll say 2005, 2006, 2007, it was very uncommon to see women out on the weight room floor doing squats, doing dead lifts, lifting appreciable weight. Fast forward to now, like I joined a commercial gym here in Boston three, four months ago, and it’s been quite cool to see there are many women out on the gym floor now doing squats and dead lifts and lifting appreciable weight and it’s awesome. And none of them are walking around with manly figures. This is not to say that it doesn’t happen. Certainly there are some outliers out there who have – they picked the right parents where, yeah, they just look at a weight and they put on muscle. But it’s very, very rare.

Kim Constantinesco: Well, and I think one of the reasons why it has become more popular for women, and I’m someone who strength trains at least a couple of days a week, because I find incredible benefits with having some extra muscle on my body in terms of, it creates a buffer. So it allows me more flexibility to eat some of the things I really enjoy, to take a break from working out a little bit and I don’t have to worry about putting on extra weight or anything like that.

Tony Gentilcore: Okay, you bring up a – what you’re saying there about strength training allowing you a little bit of flexibility, especially with the foods you eat reminds me of a colleague of mine, (sounds like: Dan John), who brought up a story about – a couple of years ago about a woman client of his who fretted over this idea of eating cake or pie at parties. She was, like, “Oh, I can’t eat that. I can’t afford that many calories.” And she wasn’t somebody who did any strength training, and she was somebody who was kind of timid and felt that lifting a 20 pound dumbbell was pretty heavy.

And 20 pound dumbbells, yes, can be heavy for some people. But there are backpacks and purses that weigh more than 20 pounds that someone may carry around. So if you’re someone where 20 pounds is a challenging weight, strength training will obviously help you do that. And he made the point where he had another female client who was able to bang out five chin-ups, could squat her body weight for X amount of reps. And she again, like you, had the flexibility. She could show up to a casual dinner party or hang out with friends and not really worry about the extra slice of pizza or drinking soda, because she strength trained. And that helped her not only with her body composition and aesthetics.

But allowed her, like you noted, a bit of flexibility with her caloric intake. Which is a nice little side benefit. You don’t kind of sweat the details. Strength training I often say is the fountain of youth. I often tell people my age and sometimes they’re dumbfounded. Like, oh my god, you’re 45? My personality is a bit young, but physically speaking, I can’t say I look my age, and I always say that strength training is the secret sauce in terms of looking a younger age. And don’t forget, strength training provides shape and contour to the body. I’ve seen many times male and female clients who after several weeks or several months or up to a year of strength training, they don’t see a massive shift in their overall body weight. They might only have a net loss of say five pounds, which isn’t anything to write home for a lot of people over, a year of working your butt off.

But they look like they’ve lost 15, 20, 30 pounds because they’ve changed the shape of their body. They’ve changed their body composition. So what I mean by that is, a pound of fat and a pound of muscle weight exactly the same, a pound. However, a pound of muscle takes up less space. So when we talk about body composition, that’s also an important benefit of strength training.

Kim Constantinesco: Well, and you and I have brought up just some incredible benefits to strength training. So if someone is wanting to come in fresh to it, so if someone is trying it for the first time or kind of getting back into a routine again, where they want to make strength workouts a part of their life, what tips can you give to help people, first of all, begin? But also stay consistent over time. So doing that three days a week for fifty-two weeks a year.

Tony Gentilcore: That mantra I think is step one. Understanding that consistency is the key here. So I want people to marry themselves and tether themselves to an activity that they actually enjoy doing. Certainly I’m a little bit biased, and I think you might be a little bit biased too in understanding the profound effects and benefits of strength training. However, I want people to just be physically active.

So whatever is going to allow them to do that and be consistent, that’s going to be step number one. Step number two, and I can’t really emphasize this enough is to think about hiring a professional to kind of take you through those steps. To have somebody take you through a proper physical assessment or movement assessment to figure out, okay, here’s some things that we should probably work on. Knowing your injury history. Maybe we have these certain workarounds that we have to consider. Like, you might have had knee surgery a few years ago that we have to work around. Maybe you have chronic lower back pain that we have to be cognizant of.

But with that I also say, when you do hire a fitness professional, the idea there is we need to find your trainable menu. We have to figure out what you – or focus on what you can do rather than what you can’t do. So even if you are somebody who has mobility deficits or are deconditioned or have a musculoskeletal issue that we have to deal with, whether it’s a shoulder injury or a knee injury, there’s always ways to work around that. The body is a pretty resilient piece of machinery, and we got to find that trainable menu.

There’s rarely an injury that I’ve come across where we can’t train around that. Like, two summers ago in 2020 I ruptured my Achilles, my right Achilles. And I made it a point throughout that journey that summer on my social media, showcasing here’s stuff I can still do. I can still get accurate in the weight room and still make progress with my strength despite not having a right leg to walk on. I have a left leg I can train. I have an upper body I can train. So let’s focus on the trainable menu and focus on what you can do rather than what you can’t.

Kim Constantinesco: Well, and I think that trainable menu concept applies to people with chronic health conditions as well. So things like diabetes, hypertension, high cholesterol and finding what works for your condition. So, for example, if you’re someone with diabetes and you don’t necessarily feel your best in the morning, well, maybe there’s an opportunity where you can make time to incorporate a strength-based workout later on in the day, when it does work more for your body.

Tony Gentilcore: Of course. Yeah, same thing goes with hypertension. Certainly we have to be aware of not increasing blood pressure too much. We don’t do a lot of really high intense interval training or really super, duper heavy, heavy weights, where you’re increasing your blood pressure too quickly. So it is about finding that Goldilocks area of what’s going to be appropriate for the individual.

But yeah, time of day, I mean, my wife is up at 5:00 in the morning and she’s at the gym. I’m, like, I’m not touching that with a ten foot pole. I’m someone, later in the morning, 10:00 a.m., 11:00 a.m., early afternoon is more my home base, when I feel ready and most energized to train. And I have some clients that I’ve trained who come to at 7:00 p.m., 8:00 p.m. So everyone’s a little bit different, and it’s about finding what feels best for you and also what fits your schedule. I think that’s an important point. We can’t pressure ourselves into thinking that we have to work out in the morning or in the afternoon.

I want you to work out when you’re actually going to do it. And again, it just plays into that whole consistency and how that should be kind of the umbrella theme here. It’s, like, what’s going to help you be the most consistent?

Kim Constantinesco: And also you don’t have to carve out hours out of your day to incorporate a workout either. So let’s say you have 20 minutes to fit in a strength workout. So for you Tony, let’s say you have limited equipment available. Maybe you’re traveling. Maybe you’re snowed in. What are you doing with your 20 minutes for a workout?

Tony Gentilcore: I think that’s an important point because I think we’re also (inaudible) again, more is better. So if 20 minutes is good, then 40 minutes is better, or 60 minutes is better or 2 hours is better. And most grownups don’t have two hours in the day to exercise. Really at the end of the day it comes down to effort. So I’d rather have somebody have an effort full 20 minute workout than a meandering 60 minute workout where they’re kind of looking at their social media, looking at their watch, going for water breaks. Twenty minutes, if you’re getting after it in 20 minutes, you can get a lot done.

And to that point, I think if somebody does have a limited amount of time, it behooves them to focus on more of movements that are full body, multi joint, compound exercises, where they are working multiple muscle groups, multiple parts of the body. Because in that fashion we can make the case that you’re going to be burning more calories and stuff like that.

So what I mean by that is, like, squats, single leg lunges, push-ups, any kind of role variation. To me I’m more inclined – if time is limited, to have people, for example, pair a lower body movement, say a squat, a body weight squat, a goblet squat or some kind of squat variation. Whatever fits their needs and ability level. Pair that with an upper body exercise, say a push-up or a row or anything of that nature and pairing them back-to-back. So for three to four rounds.

And then I’ll have a B list, where now we’re going to work on, okay, another lower body exercise, but a single leg motion. So maybe a body weight reverse lunge or maybe a body weight step up, and pair that with more of a pulling action. So a row, a dumbbell row, a band row. So that way we’re working the entire body within that amount of time. And to me you’re just going to get a little bit more benefit out of that in the sense that you’re working multiple muscle groups. Not just a bicep or a glut, if that makes sense.

Kim Constantinesco: Yep, that makes sense. So you’re working in more volume for your overall body.

Tony Gentilcore: It’s about more bang for your training buck. To me it doesn’t make much sense for me to say, hey, we’re just going to work your biceps for 20 minutes. Or, we’re just going to work your calves. Or, we’re just going to work your abdominals for 20 minutes. Is it better than nothing? One hundred percent, absolutely. However, again, I’m more inclined to encourage people to think more big picture and think what’s going to work best for their training buck. And to me, you’re just going to be way better off focusing on compound, multi joint movements that involve the whole body. You’re going to get a bunch of benefit out of that.

Kim Constantinesco: That makes a lot of sense. Now I want to transition a little bit, and I know we could have an entirely different show on this, and maybe we will down the road. But how do you fuel your body for strength training in a way that it gives you the energy for your workout, but also allows you to recover from that strength workout?

Tony Gentilcore: Yes, you are 100% correct. This is an entire dissertation here that we’re going to start to discuss. I’ll make a caveat that I’m a strength coach not a nutritionist. But of course as a strength coach and a personal trainer, nutrition will inevitably come up. And fueling your workout and what people should eat after a workout always comes up, and I’m perfectly comfortable talking about that.

And the main point I try to instill in my clients is that carbohydrates are not evil. They’re an important macro nutrient that your body does utilize and use and can very much complement your strength workouts and your goals in the long run. Because to me there’s still this connotation out there that people have where if I train on an empty stomach in the morning or whatever, then I’m going to burn more calories. I’m going to burn more fat. And I would make the case, like, no. You’re going to be exercising on fumes. So your exercise intensity is going to be much lower.

Whereas if you did fuel your workout with say maybe a protein smoothie or a banana and a little bit of oatmeal, something light beforehand where you fuel your workout with carbohydrates that your body will use for short bursts of energy and use that glucose for short bursts of energy. Now your intensity is going to be a little bit higher. Inevitably you will burn more calories, if that is your goal. Not to mention you are going to complement your strength.

It’s hard to do an aggressive strength training workout early in the morning or even late in the day on an empty stomach if you’re not fueling that workout. So part of that fuel, yes, we could fuel that with protein as well. But carbohydrates are going to be that preferred, easily accessible source of fuel, pre and post workout. So even post workout I think it is important that when you deplete all your muscles of their stored sugar after a hard workout, it’s important to replenish them so we can begin that process of healing the muscles after we work them. Replenishing them with glycogen stores and stored sugar. So then we’re ready to go for the next workout.

So that would be kind of my short Cliff Notes version of how I would approach that pre and post workout nutrition conversation. But I always try – unfortunately there’s this idea that carbohydrates are bad or evil. I know there’s a small fraction of the population that think that. But it does exist, and I would make the case that we want to use those to our advantage. They can be very, very helpful with our strength training workouts.

Kim Constantinesco: Can you give us a few examples of some healthy carbs that people might have before or after a session?

Tony Gentilcore: Of course. My family – in this household, in the Gentilcore household, we love our oatmeal. So eating a quarter cup or half cup of oatmeal, maybe 45 minutes to an hour before a workout, toss in some cold blueberries, maybe a little bit of protein powder. To me that’s a wonderful way of kick starting the process of getting ready for your workout.

And I think too I mentioned smoothies. So there are a myriad of protein smoothies out there that are quick and easy to make. We can add nut butters in there. We can add flax seeds. It isn’t just carbohydrates. I think it still is important to include a little protein and fat in the conversation as well. But yeah, yogurt is another one that I’ve used in the past with clients. And honestly, even something as simple as eating an apple, Gala, Braeburn, Red Delicious, whatever your choice is. But maybe even an apple with a slight tint of peanut butter. We got to be careful how much peanut butter we use there. But those would all be nice simple, easy suggestions for most people that I’ve used with clients with high success.

Kim Constantinesco: That’s great Tony. Now before we close out the show, can you tell us where the One Drop community can learn more about your work?

Tony Gentilcore: Home base for me is my website, which is And that’s the site where I have all my blog articles and podcasts and social media outlets. Maybe more pictures of my cat than need to be on there, but she’s on there as well. That is home base. So that would be everything that you need to gain access to me, it would be on that website.

Kim Constantinesco: Well, thank you so much for coming on Tony. We really were treated today with a lot of helpful information from physical activity to nutrition, and hopefully we can have you on again real soon.

Tony Gentilcore: My pleasure. This was great. Thank you for having me.

Kim Constantinesco: Keep it here for more episodes of the Life Without Limits Podcast, as we help you take charge of your health. We’re in this together.

Host: Thank you for listening to Life Without Limits. If you liked this episode, tell a friend. We’re here to help you take back your time, power in life so you can life to your fullest potential.



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Kim Constantinesco
Jan 18, 2022

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