What amount of muscle mass is required to improve glycemic control?

From the Guidelines

To improve glycemic control, aim to increase muscle mass through progressive resistance training performed 2-3 times per week, as recommended by the most recent guidelines 1. The amount of muscle mass required to improve glycemic control is not explicitly stated in the provided evidence, but it is clear that resistance training is beneficial for glycemic control.

• The American Diabetes Association recommends 2-3 sessions of resistance exercise per week, with each session consisting of at least one set of five or more different resistance exercises involving the large muscle groups 1.
• Combining resistance training with aerobic exercise (150 minutes per week of moderate-intensity activity) provides optimal benefits for glycemic control 1.
• Muscle tissue is metabolically active and serves as the primary site for glucose disposal, with each pound of muscle using approximately 5-7 grams of glucose daily.
• When you build muscle mass, you increase insulin sensitivity and glucose uptake capacity, as skeletal muscle contains GLUT4 transporters that facilitate glucose movement from bloodstream into cells.
• Additionally, muscle contractions during exercise stimulate glucose uptake through insulin-independent pathways, providing both immediate and long-term benefits for blood glucose regulation.
• Adequate protein intake (1.2-1.7 g/kg of body weight daily) and proper recovery between training sessions are essential to support muscle growth while pursuing these glycemic benefits. The most recent guidelines from the American Diabetes Association 1 prioritize the importance of resistance training and aerobic exercise for improving glycemic control, and provide recommendations for the frequency and intensity of these exercises.
• Key points to consider when developing a resistance training program for glycemic control include:
  • Frequency: 2-3 sessions per week
  • Intensity: moderate to high intensity
  • Volume: at least one set of five or more different resistance exercises involving the large muscle groups
  • Progression: gradually increase intensity, frequency, and/or duration over time By following these guidelines and incorporating resistance training and aerobic exercise into your routine, you can improve your glycemic control and reduce your risk of diabetes-related complications.

From the Research

Amount of Muscle Mass Required for Glycemic Control

• The exact amount of muscle mass required to improve glycemic control is not explicitly stated in the provided studies 2, 3, 4, 5, 6.
• However, it is known that resistance training, which helps build muscle mass, can improve insulin sensitivity and glycemic control 3, 6.
• A study found that 10 weeks of resistance training can increase lean weight by 1.4 kg, which may contribute to improved glycemic control 3.
• Another study suggested that minimal-dose resistance training, which can be done with lower session volumes and higher training intensities, can also improve strength and functional ability, potentially leading to better glycemic control 6.

Benefits of Resistance Training for Glycemic Control

• Resistance training can decrease visceral fat, reduce HbA1c, increase the density of glucose transporter type 4, and improve insulin sensitivity, all of which can help with glycemic control 3.
• Regular physical exercise, including resistance training, can also reduce the risk of chronic diseases such as type 2 diabetes and cardiovascular disease 2.
• Pioglitazone, a medication used to improve glycemic control, has been shown to be effective in combination with metformin or sulfonylurea, but the role of muscle mass in this context is not explicitly stated 4, 5.

Practical Considerations for Resistance Training

• Minimal-dose resistance training approaches, such as low-volume, high-load RT or resistance "exercise snacking", may be effective for improving strength and functional ability while minimizing barriers to participation 6.
• Selecting exercises that target major muscle groups and challenge both balance and stabilizing musculature may influence the effectiveness of minimal-dose RT on outcomes such as improved independence and quality-of-life in older adults 6.