A large international study led by Curtin University and published in Diabetes Care tracked nearly 480,000 adults who were diabetes-free at the start for 14 years.
The researchers looked at sarcopenic obesity — having both excess body fat and low muscle mass/strength.
Key findings:
- Much higher risk: People with sarcopenic obesity were more than 3.5 times as likely to develop type 2 diabetes compared to people with healthy body composition.
- Worse than obesity alone: They were 19% more likely to develop type 2 diabetes than people with obesity alone, and 91% more likely than people with low muscle mass alone (sarcopenia).
- Absolute rates: Within 10 years, nearly 15% of people with sarcopenic obesity developed type 2 diabetes, compared to around 11% with obesity alone and just 3% without either condition.
- Who is most affected: The link was particularly strong among women and adults under 60.
The authors say the results challenge the idea that diabetes risk is driven mainly by weight on the scales. Because muscle uses a lot of glucose and helps regulate insulin resistance, preserving muscle mass and strength through regular physical activity may be just as important as managing weight for prevention.
Lead author was PhD candidate Zhongyang Guan, senior lead Professor Mario Siervo, with comment from Diabetes WA on how physical activity helps use blood glucose and reduce insulin resistance.