One in four with type 2 diabetes faces muscle loss and worse outcomes

In a new paper published in Clinical Nutrition, “Sarcopenic Diabetes Is an Under-Recognized and Unmet Clinical Priority,” nutrition and diabetes experts are calling attention to a little-known but serious complication of diabetes, the progressive loss of muscle mass and strength, a condition known as sarcopenic diabetes. Moreover, authors warn that the new class of weight loss drugs, like semaglutide, complicates this condition as weight loss with these drugs is caused, in part, by a decrease in muscle mass.

The new position paper, endorsed by the European Society for Clinical Nutrition and Metabolism (ESPEN) and the Diabetes Nutrition Study Group (DNSG), warns that this problem is widespread, underdiagnosed, and linked to significantly worse health outcomes for people living with diabetes.

“Sarcopenic diabetes occurs when diabetes is combined with meaningful muscle loss, which goes far beyond normal aging,” says paper co-author Hana Kahleova, MD, Ph.D., director of clinical research for the Physicians Committee for Responsible Medicine.

The paper says that studies suggest that roughly 1 in 4 people with type 2 diabetes also have sarcopenia. Compared with people without diabetes, those with the condition have a much higher risk of frailty, disability, longer hospital stays, and increased risk of death, as well as poorer outcomes in conditions like heart failure and chronic kidney disease.

The paper explains that muscle loss in diabetes is driven by multiple factors, including physical inactivity, poor diet, chronic inflammation, insulin resistance, high blood sugar, and diabetes-related complications such as nerve damage. It also highlights a new concern that weight loss from modern diabetes medications such as semaglutide and tirzepatide comes, in part, from muscle loss, making it even more important to monitor and protect muscle health during treatment.

The authors stress that sarcopenic diabetes is not inevitable and can be addressed. They recommend routine screening in people with diabetes, especially older adults and those experiencing weight loss. Simple measures such as testing muscle strength, along with body composition scans, can help identify people at risk. The authors also emphasize the importance of adequate protein intake, regular strength or resistance exercise, and reduced sedentary time as practical, evidence-based ways to preserve and improve muscle health.

The paper calls on clinicians, health systems, and researchers to recognize sarcopenic diabetes as a serious complication of diabetes and to integrate muscle health into routine care, alongside blood sugar and cardiovascular risk management.

“Sarcopenic diabetes is an under-recognized complication that significantly worsens outcomes for people with diabetes,” Kahleova said. “Protecting muscle through proper nutrition, strength training, and routine screening should be part of standard diabetes care.”

Provided by
Physicians Committee for Responsible Medicine