Muscle health may be an important piece of the diabetes puzzle, according to a growing body of research examining how muscle mass and strength relate to blood-sugar regulation. Skeletal muscle is one of the body’s major tissues responsible for taking up glucose from the bloodstream, particularly during physical activity. Research has found associations between lower muscle mass or strength and a higher likelihood of insulin resistance and type 2 diabetes, although the relationship is complex and influenced by factors such as body fat, age, sex and physical activity.
The findings add another dimension to the traditional focus on body weight and diet when discussing diabetes risk. Rather than looking only at how much a person weighs, researchers are increasingly examining body composition and physical function. A 2025 systematic review of 25 cohort studies involving hundreds of thousands of participants found that measures of muscle mass and strength were generally associated with type 2 diabetes incidence, while also emphasizing that obesity and other risk factors must be considered.
Why Muscle Matters for Blood Sugar
Skeletal muscle plays a central role in glucose metabolism. When muscles contract during physical activity, they can take up glucose from the bloodstream, helping reduce blood glucose levels. Exercise can also increase insulin sensitivity, meaning the body can use insulin more effectively. The American Diabetes Association notes that muscle contraction can promote glucose uptake even without insulin acting as the intermediary.
This helps explain why muscle health has attracted attention in diabetes research. A study published in the Journal of Clinical Endocrinology & Metabolism involving 13,644 participants found that higher skeletal-muscle mass relative to body size was associated with greater insulin sensitivity and a lower prevalence of prediabetes. The researchers reported that each 10% increase in skeletal muscle index was associated with an 11% relative reduction in insulin resistance and a 12% relative reduction in prediabetes prevalence after adjustments for several factors, including obesity.
However, these findings should not be interpreted as proof that simply having more muscle prevents diabetes. Studies have produced differing results depending on the population and the way muscle was measured. For example, research involving 2,166 older adults found no overall association between measured muscle mass or strength and the development of diabetes after adjustment for other factors. Some associations differed according to sex and BMI.
Muscle Strength May Matter, Too
Muscle quality and strength may be just as important as muscle quantity. A systematic review and meta-analysis examining muscular strength and type 2 diabetes found that, after accounting for adiposity, higher muscular strength was associated with a lower risk of developing type 2 diabetes.
A separate 2025 systematic review reached a similar broad conclusion. Researchers analyzed 25 cohort studies, covering more than 278,000 participants in studies of muscle mass and more than 400,000 in studies of muscle strength. Measures such as muscle mass relative to body weight and grip strength relative to BMI were generally inversely associated with type 2 diabetes incidence. The authors also stressed that diabetes has multiple risk factors and that additional research is needed.
What This Means for Diabetes Prevention
The research reinforces the value of including muscle-strengthening activity alongside aerobic exercise. The Mayo Clinic recommends strength training for all major muscle groups at least twice a week as part of diabetes prevention and management strategies.
The National Institute of Diabetes and Digestive and Kidney Diseases likewise recommends regular physical activity and suggests muscle-strengthening activities, such as wall push-ups or seated arm raises, on at least two days a week.
For people who already have diabetes, physical activity can help improve blood-glucose control, but exercise needs to be individualized. Certain diabetes medications can cause low blood sugar, and some people may need to monitor glucose levels around exercise. Healthcare professionals can help determine an appropriate and safe exercise program.
A Broader View of Diabetes Risk
Muscle health is only one factor among many. Family history, age, body weight, physical activity, diet and other metabolic factors can all influence the likelihood of developing type 2 diabetes. The NIDDK notes that maintaining a healthy weight and being physically active can help people address some modifiable risk factors.
The emerging evidence therefore points toward a broader understanding of metabolic health: maintaining muscle mass and strength may support healthy glucose metabolism, but it should not be viewed as a standalone safeguard against diabetes. Regular physical activity that combines aerobic and muscle-strengthening exercise, along with appropriate nutrition and medical care when needed, remains an important part of reducing diabetes risk and managing blood sugar.
Sources:
- Harvard Health Publishing — Add strength training to your fitness plan
- Mayo Clinic — Diabetes prevention: 5 tips for taking control
- Cleveland Clinic — What Is Strength Training and Its Benefits?
- Johns Hopkins Medicine — Managing Diabetes: Six Healthy Steps with the Most Benefit
- NIDDK — Managing Diabetes
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