Diabetes and Weight Loss: Muscle Matters!

I have been a Registered Dietitian/Nutritionist and Diabetes Care and Education Specialist for over four decades, and a major focus of my work has been on supporting my patients to optimize their health through nutritious food choices. I also help them learn to view nutrition and lifestyle as essential parts of managing blood glucose levels, preserving functional status, and maintaining mobility so they can do the things they want to do with reduced risks of frailty and malnutrition (which can happen at any body size).

The Overlooked Importance of Muscle Preservation with Weight Loss

There is an element of nutrition that is often overlooked when it comes to weight loss and weight management strategies, and that is the importance of preventing muscle loss and optimizing muscle strength. Muscle loss related to the aging process (known as sarcopenia) accelerates as time goes on, but it can be further hastened by rapid weight loss, elevated glucose levels, certain medications and medical conditions, a sedentary lifestyle, and lack of adequate nutrition.

A lot of attention and focus is placed on weight loss and weight management as part of a diabetes regimen, and the question of what really “works” in terms of diet is continuously on many people’s minds. For the past several decades, we have seen a variety of fad diets come and go, with weight cycling (losing/regaining weight) often occurring as a result. Many of these diet approaches are geared toward people with diabetes, and oftentimes they are more marketing than science.

Personalized Nutrition Is Important for Sustainable Health

The American Diabetes Association does not actually recommend a specific “diet” for people with diabetes. In order to support one’s nutritional health, an individualized approach that considers one’s lifestyle, budget, culture, food preferences, time constraints, medical conditions, and goals is essential for sustainable outcomes. This is where a Registered Dietitian/Nutritionist can help. For beginner meal planning tips, check out Meal Planning 101 or visit the nutrition section of our video vault.

Different Types of Weight Loss Affect Muscle Loss

Getting back to the importance of muscle preservation, causes of muscle loss as mentioned above can vary. When muscle loss is a result of weight loss, the degree of the muscle loss is often connected to the weight loss approach. Bariatric surgery, for example, causes significant and rapid weight loss early on which may increase risk to higher muscle loss during this time, so high protein intake such as 1-1.2 grams/kilogram as part of overall balanced nutrition is essential.

A slower rate of weight loss (such as calorie reduction with exercise) along with adequate nutrition that includes protein distributed throughout the day and a higher amount of protein during active weight loss periods, can attenuate the estimated average 25% loss of muscle that accompanies more extreme weight loss approaches like bariatric surgery. During weight loss, both fat and muscle are lost and as much as 25% of weight loss can be attributed to muscle loss. This is why a diet higher in protein in this period can help preserve important muscle tissue.

The Role of Exercise and Resistance Training in Diabetes

Along with consistent, sufficient protein, resistance exercises are an essential part of maintaining muscle and strength. Keeping a routine of supportive nutrition and physical activity is essential to good health and lowering health risks. Learn more about the significance of exercise for diabetes management from Harvard Health here. If you’re looking for ways to stay active at home, consider these free online fitness resources.

Diabetes Medication Management for Muscle Preservation

Medications that help manage a chronic condition like diabetes, high blood pressure, high cholesterol, and obesity are meant to be taken consistently and maintained to control the condition. As time goes on, goals of care may certainly change and any discontinuation or change in dose of medication should be discussed with your physician. Using medications to maintain blood glucose control helps to preserve muscle mass, as we know that chronic high blood sugar above target ranges can accelerate muscle loss due to the metabolic stress on the body. When muscle is lost, it can take extra effort and time to rebuild for many people. A term often used for this is “anabolic resistance.”

In my practice as a Diabetes Care and Education Specialist, the importance of muscle is always at the top of my list for patient education. Muscle is much more than appearance and strength! Muscle is also highly involved in endocrine and metabolic function, including assisting with insulin sensitivity, storage of the fuel in muscle (glycogen), optimizing metabolic rate (muscle is more metabolically active than fat tissue), bone strength and fracture risk reduction (those with diabetes also have higher bone fracture risks). It’s an amazingly synchronized system that needs our support.

In Summary

Whether you’re managing diabetes, weight, another health condition, or wanting to maintain quality of life and resilience for recovery from medical issues, consistent, adequate nutrition with good sources of protein along with movement and strength exercises that match your needs and abilities can make a big difference over time. Some excellent high-quality protein sources include eggs, meat, chicken, fish, and dairy products such as Greek yogurt, milk, and lactose-free milk. For those with a busy lifestyle who want added convenience with great taste, a protein shake such as Glucerna Protein Smart can be included any time of the day.  Speak with your healthcare provider or ask to be referred to a registered dietitian to help you meet individual nutrition needs and goals.

Editor’s Note: Abbott Nutrition was a partner of Taking Control of Your Diabetes® at the time of publication, but TCOYD® maintains control over editorial content. Please consult your healthcare team before making any changes to your diabetes care regimen.