Living with diabetes means facing challenges, including the risk of muscle loss. Research shows a strong diabetes-sarcopenia link, with diabetics having three times higher risk. Sarcopenia in older adults raises fall and frailty risks. As diabetes prevalence grows, clinicians and patients must be vigilant.
What is sarcopenia?
Everyone experiences some loss of muscle mass and function with age. Beginning in your 30s, muscle mass naturally decreases roughly 3-8% per decade. By age 60, the rate of loss is even higher.
While some muscle loss is expected, sarcopenia is an unusually fast rate of loss. Sarcopenia involves a loss of muscle mass, as well as reduced function and strength of the muscles.
As muscle mass decreases, fat mass increases, which increases the risk of insulin resistance. Diabetes and muscle loss seem to be a two-way street; not only does the condition seem to lead to muscle loss, but muscle loss itself can also lead to diabetes.
Sarcopenia can make diabetes harder to manage, in addition to other negative effects like joint stiffness and decreased bone density. This can lead to a snowball effect where sarcopenia combined with diabetes speeds up overall health decline as you age.
Of course, you don’t need diabetes to experience overall health decline. Obesity plus sarcopenia can also contribute to negative impacts on health as you age.
The link between diabetes and sarcopenia
While the relationship between diabetes and muscle loss is well documented, there are still some open questions about the mechanism behind it.
“We know that for any insulin deficiency, such as type 1 diabetes or advanced type 2, the body cannot use sugar for energy and starts using fat and protein as alternative sources. Muscle loss occurs due to muscle being consumed as a source of energy,” Hatipoglu said.
“However, muscle loss is now also acknowledged even in people with type 2 diabetes without total insulin deficiency, and the explanation of why is not clear in those cases.”
There are theories, however. Many things related to diabetes likely increase the rate of muscle loss. For example, increased inflammation caused by diabetes may play a role.
Decreased insulin activity may also decrease the ability for your body to build muscle. One of the key things insulin does is help move proteins from your blood into skeletal muscle. With decreased insulin sensitivity, the process of protein synthesis is less effective. That means over time, your body can’t build muscle faster than it’s being lost.
Sarcopenia is also tied to metabolic syndrome, which the majority of people with type 2 diabetes have. Other diabetes complications, such as painful neuropathy, may make it harder to participate in physical activities (like weight lifting, for example) that protect against muscle loss.
Maintaining Strong Muscles with Diabetes
Managing your blood sugar effectively is crucial for maintaining muscle strength if you have diabetes, says Hatipoglu. While direct studies are limited, better glucose control likely aids in keeping muscles robust.
Strength or resistance training is also vital due to the increased risk of muscle loss in diabetes. This type of exercise improves blood glucose control and muscle functionality, breaking a vicious cycle.
You don't have to be an extreme athlete or bodybuilder. Depending on your age, mobility, and muscle condition, you might need a physical therapist or certified trainer's guidance. They can collaborate with your doctor to create a suitable plan.
Hatipoglu recommends supervised weight training for motivation.
According to diaTribe Diabetes, Aging, and Muscle Loss: What You Need To Know