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Can weak muscles and a poor hand grip increase your diabetes risk two-fold?

When you have a low muscle mass, you tend to have more insulin resistance. So, people with or without diabetes should throw in resistance training in their workout schedule in order to improve muscle strength and mass, says Dr Ambrish Mithal, Chairman and Head, Endocrinology and Diabetes, Max Healthcare

A study from Singapore shows that women with weaker upper and lower body muscles were more than two-fold likely to have diabetes as compared to those with normal strength. The study found that upper body strength, as measured by hand grip strength, was independently linked to 1.59-fold higher cases of diabetes. What this means, says diabetologist Dr Ambrish Mithal, is that people with or without diabetes should throw in resistance training in their workout schedule in order to improve muscle strength and mass.

What is the link between diabetes and muscle mass?

Muscles are one of the key targets of insulin. And it is now known that when you have low muscle mass, you tend to have more insulin resistance. This is actually one of the reasons why prevalence of diabetes is high in India – not only do we have central fat; it is accompanied by a low muscle mass. People who have a higher fat percentage and lower muscle mass are the ones who have the worst outcomes.

But it is also a loop. If you have diabetes, your muscle mass and hand grip strength go down. Meaning, low muscle mass and strength predispose you to diabetes and diabetes leads to low muscle mass and strength. Diabetes affects the nerves and muscles, especially if it is uncontrolled.

Another interesting thing – and there is a lot of work from Korea on this, we have also done studies that have found similar results – is that hand grip strength was also associated with poor control of diabetes.

The current study was based on muscle strength in middle-aged women. Are the findings likely to be the same among men?

Yes. The impact will be the same for men. Those with low muscle mass and strength are more likely to have diabetes or poorly controlled diabetes. And those with diabetes are likely to have reduced muscle mass and strength.

Why this study focusses on women may be to emphasise the fact that women usually have lower muscle mass and strength than men.

So, what needs to be done?

The most important thing is to improve muscle mass through resistance training. There is more and more evidence now to suggest that aerobic exercises alone may not be enough.

While walking and running are good forms of aerobic exercises, resistance training – where the muscles have to work against a resistance – helps in building muscle mass and strength.

People must include resistance training in their workout schedule ideally twice a week. Not only will it help in improving blood glucose control in those with diabetes, but it also improves bone health.

What are the exercises that one should do?

Well, resistance training is essentially any exercise where your muscles work against a force – exercises with dumbbells, resistance bands or even calisthenics (body-weight exercises) work. There is no need to go to a gym and work with machines, lifting even small dumbbells at home can help. Or, if you are able to, exercises like sit-ups, squats and push-ups also work.

Can changing your diet help in building muscle mass?

Certainly. There is a need to increase protein intake to build better muscles. For non-vegetarians, it is easier. All meats contain a good amount of protein. And, if they need to avoid red meat due to other health conditions, there is always poultry and fish that are also rich in protein. For vegetarians, a good source of protein is soya. Other than that, all beans, legumes and dal have a good protein content.

Everyone can have dairy products that also have good protein and calcium content. People may choose to have skimmed milk if they are worried about fat intake. However, now evidence is emerging that suggests that even full cream milk is not so bad – long-term consumption of full fat milk hasn’t been associated with higher risk of heart disease.

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