What amount of muscle gain improves glycemic control?

From the Guidelines

Gaining approximately 1-3 pounds of muscle mass per month through regular resistance training can significantly improve glycemic control in most individuals. For optimal glycemic benefits, aim to engage in resistance training 2-3 times per week, focusing on major muscle groups with exercises like squats, deadlifts, bench press, and rows. Each session should include 8-10 exercises with 2-3 sets of 8-12 repetitions at moderate intensity. The improvement in glycemic control occurs because muscle tissue serves as the primary site for glucose disposal, with larger muscle mass increasing insulin sensitivity and glucose uptake from the bloodstream [ 1 ].

Key Points to Consider

• Resistance training has been shown to induce a hypertrophic response and a muscle-fiber type shift in exercising muscles, which allows for a potential increase in whole-body glucose utilization [ 1 ].
• The use of resistance training to improve glycemic control in T2DM is supported by the American College of Sports Medicine and ADA position statements [ 1 ].
• A combination of aerobic and resistance exercise training may be more effective in improving BG control than either alone [ 1 ].
• Combining resistance training with adequate protein intake (1.6-2.2g/kg of body weight daily) will optimize muscle protein synthesis and enhance these metabolic benefits.
• For individuals with diabetes or insulin resistance, even modest muscle gains of 3-5 pounds over several months can produce measurable improvements in fasting blood glucose levels and HbA1c.

Recommendations for Resistance Training

• Engage in resistance training 2-3 times per week
• Focus on major muscle groups with exercises like squats, deadlifts, bench press, and rows
• Each session should include 8-10 exercises with 2-3 sets of 8-12 repetitions at moderate intensity
• Combine resistance training with adequate protein intake (1.6-2.2g/kg of body weight daily) to optimize muscle protein synthesis and enhance metabolic benefits.

From the Research

Muscle Gain and Glycemic Control

• The relationship between muscle gain and glycemic control is complex, and research suggests that increased muscle mass can have a positive impact on glucose metabolism 2.
• A study published in 2020 found that increasing protein intake can lead to an increase in lean body mass, which is essential for health 3.
• The dose-response relationship between protein intake and muscle mass increase was evaluated in a systematic review and meta-analysis, which found that a increase in protein intake of 0.1 g/kg of body weight per day was associated with a mean increase in lean body mass of 0.39 kg 3.

Mechanisms of Muscle Gain and Glycemic Control

• Resistance exercise and nutrition are potent anabolic stimuli that can increase muscle protein synthesis and attenuate muscle protein breakdown, leading to an increase in muscle mass 2.
• The use of glucagon-like peptide 1 (GLP-1) receptor agonists has been shown to improve glycemic parameters and reduce body weight, and may be a useful tool in combination with other therapies to enhance glucose control 4, 5.
• High-intensity interval training (HIIT) may also be an effective way to promote gains in muscle mass, particularly in populations who are susceptible to muscle loss 6.

Clinical Implications

• The combination of premixed insulin, metformin, and a GLP-1 receptor agonist may be an effective therapeutic approach for uncontrolled type 2 diabetes, with improved glycemic control and reduced insulin dose 5.
• Increasing muscle mass through resistance exercise and nutrition may be an important strategy for improving glycemic control, particularly in individuals with type 2 diabetes 2, 3.