Dominic Stone
Diabetes is a disease caused by insufficient action of the hormone insulin, which lowers blood sugar levels and promotes the growth and proliferation of cells. Insufficient action of insulin results in the suppression of the growth and proliferation of muscle cells, which in turn contributes to a decline in skeletal muscle mass. This is known as muscle atrophy, which is caused by an imbalance in contractile protein synthesis and degradation. This reduction in muscle mass and strength can affect a patient's mobility and independence, as well as their capacity to perform daily activities.
| Characteristics | Values |
|---|---|
| Type | Type 2 Diabetes |
| Muscle Impact | Loss of muscle mass, particularly in the legs |
| Muscle Function | Reduced muscle recovery and strength |
| Muscle Fatigue | Increased rate of muscle fatigue |
| Muscle Atrophy | Caused by an imbalance in contractile protein synthesis and degradation |
| Muscle Protein Degradation | Caused by the ubiquitin-proteasome, autophagy-lysosome and caspase-3-mediated proteolytic pathways |
| Muscle Protein Synthesis | Decreased due to systemic inflammation initiated by obesity and prolonged overnutrition |
| Muscle Genes | VPS39 gene is less active, preventing production of VPS39 protein |
| Muscle Risk Factors | Inactivity, ageing, high blood sugar levels |
| Muscle Prevention | Exercise, resistance training, improving body composition |
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What You'll Learn
Diabetes and muscle atrophy
Diabetes mellitus is a disease caused by the insufficient action of the hormone insulin, which lowers blood sugar levels and promotes the growth and proliferation of cells. Insufficient insulin activity can result in the suppression of the growth and proliferation of muscle cells, contributing to a decline in skeletal muscle mass. This condition is known as muscle atrophy and is characterised by an imbalance in contractile protein synthesis and degradation.
Recent research has found a strong link between diabetes and sarcopenia, or accelerated age-related muscle loss. People with diabetes have three times the risk of sarcopenia, which is associated with an increased risk of falls, frailty, and mortality. Sarcopenia can also make diabetes harder to manage, leading to negative effects like joint stiffness and decreased bone density.
The relationship between diabetes and muscle atrophy appears to be a two-way street. Not only does diabetes lead to muscle atrophy, but muscle loss itself can also contribute to the development of diabetes. This vicious cycle is likely driven by muscle insulin resistance, which impairs insulin signalling and disturbs glucose uptake in skeletal muscle, resulting in hyperglycemia. Additionally, increased inflammation caused by diabetes may play a role in muscle atrophy, as it contributes to insulin resistance and decreases the body's ability to build muscle.
Elevated blood sugar levels have been found to trigger muscle atrophy, with two proteins, WWP1 and KLF15, playing key roles. When blood sugar levels rise, the amount of WWP1 decreases, leading to an increase in KLF15. This results in a decline in skeletal muscle mass. Furthermore, the longer an individual has diabetes, the more muscle mass they tend to lose, especially in the legs.
To mitigate the risk of muscle atrophy associated with diabetes, individuals can focus on improving their body composition by reducing body fat and building muscle mass. Exercise, specifically resistance training, can be beneficial in this regard, as it increases glucose delivery to muscle cells and improves the diabetic state. Additionally, nutritional therapy and increased physical activity can help maintain euglycemia and improve muscle status in patients with diabetes and muscle atrophy.
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Diabetes and muscle strength
Diabetes is associated with various health problems, including a decline in skeletal muscle mass. Research has shown that Type 2 diabetes (T2D) negatively affects muscle strength and muscle mass. T2D patients experience reduced muscle recovery and strength, and they also start to lose muscle mass, especially in the legs. This loss of muscle mass is due to muscle atrophy, which is caused by an imbalance in contractile protein synthesis and degradation.
In addition to T2D, other conditions such as physical inactivity or ageing can also result in muscle mass loss. However, it is important to note that having low muscle mass alone does not increase the risk of diabetes. Rather, it is the combination of high body fat and low muscle mass that increases the risk of developing diabetes.
To reduce the risk of diabetes or improve diabetic state, it is crucial to focus on improving body composition. This can be achieved by reducing body fat and building muscle mass. Strength training is an excellent way to build muscle and manage diabetes. It helps to lower blood sugar levels, improve insulin efficiency, and increase the rate of calorie burn. Resistance exercises, such as using stretchy elastic bands or free weights, are particularly beneficial for individuals with T2D.
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Diabetes and muscle recovery
Diabetes mellitus is a disease caused by insufficient action of the hormone insulin. Insulin not only lowers blood sugar levels but also promotes the growth and proliferation of cells. Insufficient action of insulin results in the suppression of the growth and proliferation of muscle cells, which in turn contributes to a decline in skeletal muscle mass.
Diabetes-induced muscle loss is attributable to increased amounts of the protein KLF15. When blood sugar levels rise, the amount of WWP1 decreases, which in turn decelerates the degradation of KLF15 and thus increases its cellular abundance. Research has also shown that increasing muscle mass can reduce the risk of Type 2 diabetes.
Diabetes provides an unfavourable environment for muscle mass and function after muscle injury. In diabetic mice, regenerating fast muscles are weaker, lighter, and slower compared to nondiabetic mice. Diabetes decreases skeletal muscle contractility and induces atrophy.
Exercise is important for controlling hemoglobin A1c and maintaining proper glycemic control in people with diabetes. Exercise also increases overall insulin sensitivity and decreases dependency on diabetes medication. However, people with diabetes may experience delayed-onset muscle soreness (DOMS) and metabolic and endothelial impairment, which could result in a prolonged sensation of muscle soreness following exercise. This makes it difficult for those with diabetes to sustain exercise regimes.
Interestingly, a diabetes drug that regulates blood sugar can also prevent muscle atrophy and muscular fibrosis, which could help the elderly bounce back faster from injury or illness. Metformin, a drug used to treat type 2 diabetes, can target senescent cells, which affect muscle function. Metformin also reduces muscle atrophy.
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Diabetes and muscle mass
Diabetes is a disease caused by insufficient action of the hormone insulin, which lowers blood sugar levels and promotes the growth and proliferation of cells. Insufficient action of insulin results in the suppression of the growth and proliferation of muscle cells, which in turn contributes to a decline in skeletal muscle mass. This is known as muscle atrophy, which is caused by an imbalance in contractile protein synthesis and degradation.
Diabetes is associated with various health problems, including a decline in skeletal muscle mass. Research has shown that elevation of blood sugar levels leads to muscle atrophy and that two proteins, WWP1 and KLF15, play key roles in this phenomenon. When blood sugar levels rise, the amount of WWP1 decreases, which in turn decelerates the degradation of KLF15 and thus the increase in the cellular abundance of KLF15.
In addition, people with Type 2 Diabetes (T2D) experience reduced muscle recovery and strength and tend to lose muscle mass over time, especially in the legs. T2D reduces overall muscle strength, and those with the condition experience muscle fatigability, which refers to the rate at which muscles become weaker after exercise or movement and the time it takes for them to recover.
However, increasing muscle mass and improving body composition can help reduce the risk of T2D. Resistance training has been shown to be particularly beneficial for T2D, as it increases the delivery of glucose to muscle cells. Larger muscles require more energy, so the leg muscles are especially important for glucose uptake and regulation. Therefore, targeting the legs with resistance exercises may improve diabetes risk factors and promote physical function.
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Diabetes and muscle protein synthesis
Diabetes is a chronic inflammatory disease that affects nearly all biological processes, including protein metabolism. It is associated with disturbances in muscle protein metabolism, resulting in decreased muscle mass and, in some cases, a loss of daily functioning, decreased productivity, and a reduced quality of life.
Insulin resistance has been suggested to result in a reduced muscle protein synthetic response to food intake. However, studies have shown that the muscle protein synthetic response to carbohydrate and protein ingestion is not impaired in men with longstanding type 2 diabetes. In these studies, muscle protein synthesis rates were higher following a carbohydrate and protein hydrolysate (CHO+PRO) treatment than a carbohydrate-only (CHO) treatment, with no difference between diabetes patients and normoglycemic controls.
Insulin treatments in subjects with type 2 diabetes have no effect on muscle mitochondrial protein synthesis and cytochrome C oxidase, a key enzyme for ATP production. However, insulin treatment reduced leucine nitrogen flux and transamination rates in subjects with type 2 diabetes. Furthermore, muscle strength was found to be unaffected by diabetes or glycemic status, although diabetic patients showed an increased tendency for muscle fatigability.
Recent research has shown a link between diabetes risk and low muscle mass. Type 2 diabetes patients have reduced muscle recovery and strength and tend to lose muscle mass, especially in the legs. Muscle atrophy is caused by an imbalance in contractile protein synthesis and degradation, which can be triggered by various conditions, including type 2 diabetes. Type 1 diabetes muscle wasting results from insulin deficiency, while type 2 diabetes muscle atrophy is caused by decreased insulin responsiveness in the muscle.
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Frequently asked questions
Yes, diabetes is associated with muscle loss or atrophy. This is caused by an imbalance in contractile protein synthesis and degradation.
Research has shown that a rise in blood sugar levels triggers muscle mass decline. Two proteins, WWP1 and KLF15, play a key role in this process.
Muscle loss can reduce the muscles' capacity to absorb sugar or glucose from the blood via insulin. This can result in higher blood glucose levels and an increased risk of diabetes-related complications such as insulin resistance, cardiovascular disease, amputations, and vision loss.
Muscle loss can affect a person's ability to perform daily activities, resulting in a decreased quality of life and an increased risk of premature mortality.
Building muscle mass through resistance exercises can help prevent and even reverse muscle loss. Additionally, consuming fish oil supplements may protect against muscle loss by improving the way mitochondria use oxygen.
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