If you live with type 2 diabetes, you may want to mind your muscles.
Your muscles play a vital role in your metabolism. The muscles are the largest organ in the body, and they remove more sugar from your bloodstream than the rest of your organs combined. The health of the muscles significantly impacts the development and progression of diabetes.
Unfortunately, many people with type 2 diabetes experience muscle atrophy (loss), which shares risk factors with diabetes itself. Muscle loss is associated with a slew of concerns: insulin resistance, impaired heart health, a lower quality of life, and an overall increased risk of death.
“Muscle mass can impact everything from your mobility and energy to your immune system and organ function,” says Ricardo Rueda, MD, a microbiologist and researcher with Abbott. “The good news is that our muscles are resilient. Aging adults can take small steps to improve their muscle health through a balanced, nutritious diet and exercise.”
Why Muscle Tissue Is So Important in Diabetes
To put it lightly, muscles do the body good, especially if you live with diabetes. The muscle tissue throughout your entire body plays a critical role in your body’s use of glucose and overall insensitivity.
When you eat a meal, your body breaks down and converts the food’s energy, especially carbohydrates, into glucose. Some of it will be used immediately. Your brain, for example, needs a constant supply of glucose to function. But when you don’t need it all immediately, your body can store extra glucose in multiple ways:
- Glucose can be stored in your muscle tissue, ready to fuel your muscles when needed during exercise.
- If your muscles don’t need more glucose, remaining glucose is stored as body fat.
The more you exercise, the more your muscles use glucose from the food you eat. When you eat again, more of the energy goes to replenishing muscle glucose stores, and less glucose is stored as fat.
Muscle Loss and Insulin Resistance: A Vicious Cycle
Insulin resistance, a signature feature of type 2 diabetes, prevents the muscles from taking in as much glucose as they should.
“In people with type 2 diabetes, elevated blood glucose levels over time cause cells to be more resistant to insulin, so cells aren’t getting the glucose — or nutrients — they need,” says Dr. Rueda. “Insulin resistance occurs when cells in the body don’t respond properly to insulin,” reminds Rueda. “Insulin unlocks cells to allow glucose in.”
If your muscles can’t get the glucose they need because of insulin resistance, this can lead to significant muscle loss. As described in a Nutrients review that Rueda helped write, the dynamic is a vicious cycle. Not only does insulin resistance cause muscle loss, but muscle loss can also cause further insulin resistance.
“Muscle loss can lead to increased risk of falls and fractures, increased risk of insulin resistance, or have a negative impact on cardiovascular health,” says Rueda.
Factors That Increase Your Risk of Muscle Loss
Rueda says that the factors that increase your risk of muscle loss include:
- Insulin resistance
- Prolonged high blood glucose levels
- Age
- A diet lacking high-quality nutrients, whole foods, etc.
- A diet high in heavily processed food
- Limited physical activity and a sedentary lifestyle
- Acute or chronic diseases
These are largely the same factors that characterize the progression of type 2 diabetes. The overlap between T2D and muscle loss risk is clear.
“People with type 2 diabetes have additional factors at play that further increase their risk for muscle loss,” adds Rueda. “For example, older individuals with type 2 diabetes often have greater nutrient needs — like protein — than individuals without the condition. This can make it even more difficult for them to meet their nutrient needs, which can exacerbate muscle loss.”
How People With Type 2 Diabetes Can Prevent Muscle Loss
It may be possible to limit muscle loss with healthy lifestyle habits.
Regular Exercise Is a Must
This isn’t new advice, but you might need to hear it again: Get moving every day to prevent muscle loss and boost insulin sensitivity.
You don’t need to start a new bodybuilding workout! A simple exercise is better than nothing, and even gentler types of exercise, like walking and yoga, can make a big difference. Regular exercise can have a dramatic impact on your body’s insulin sensitivity, which means it will be easier to manage blood sugar levels, too.
Eat Your Protein
Protein is essential to build and preserve muscle.
Rueda says that older adults with type 2 diabetes probably need extra protein in their diets: “While the protein recommendation for most adults is 0.8 grams of protein per kilogram of bodyweight, aging adults or people with chronic diseases like type 2 diabetes may need 20 percent more protein to preserve muscle.”
Focus on wholesome lean protein sources, including:
- Chicken or turkey
- Low-fat dairy (cottage cheese, yogurt)
- Fish
- Seitan
- Tempeh
- Tofu
- Nuts and seeds
- Beans
Prioritize the Right Nutrients
While regular exercise, eating more whole foods, and getting more lean protein are probably the most important ways to protect your muscle mass, a few specific nutrients might help, too.
“Vitamin D, hydroxymethylbutyrate (HMB), omega-3 fatty acids, and a few specific amino acids can also help promote muscle health and prevent muscle breakdown,” says Rueda.
“HMB is naturally produced in the body in small amounts,” says Rueda. “It is produced when your body breaks down the amino acid leucine found in protein. … HMB supplementation has been shown to help increase muscle mass and strength and has been shown to decrease muscle breakdown.”
Abbott’s research determined that lower levels of HMB were a common feature in people with T2D and general frailty.
“This emphasizes the importance of supplementing with muscle-building ingredients such as HMB in older adults with type 2 diabetes,” stresses Rueda. “HMB can be found in small amounts in foods such as avocados, grapefruit, and catfish, but it’s hard to get enough HMB from food sources alone. That’s why it’s important to look for a nutritional supplement that contains HMB.”
Rueda says oral sources of vitamin D, omega fatty acids, and protein could all be ideal for a person with T2D striving to prevent muscle loss.
The Takeaway
- Muscle tissue is truly important for people with type 2 diabetes. Muscle plays a critical role in your overall health, strength, energy, and blood sugar metabolism.
- Type 2 diabetes often causes muscle loss, which starts a vicious cycle, leading to diabetes progression and poor long-term outcomes.
- It’s possible to help limit muscle loss with the right nutrients, exercise, and a wholesome diet.