Type 1 Diabetes & Muscle Strength: What Happens as We Age?

As we age, our bodies naturally lose muscle mass and strength—a condition known as sarcopenia. But if you’re living with Type 1 diabetes, this muscle loss may happen earlier and more noticeably. Why? Because T1D affects not just blood sugar, but also the systems that keep our muscles strong, flexible, and responsive.

Let’s dive into why muscle changes matter, what causes them, what the research says, and how you can take charge of your strength at any age.

What’s Going On in the Muscles?

For people with T1D, the combination of insulin deficiency, inflammation, and long-term blood sugar fluctuations can interfere with how our muscles grow, repair, and function.

Here are some of the main contributors:

• Insulin is an anabolic hormone—it helps build muscle. Without enough circulating insulin or with cells resistant to insulin’s action, muscle protein synthesis slows down (Causal Relationship Between Insulin Resistance and Sarcopenia, Overview of Oxidative Stress and Inflammation in Diabetes).
• Inflammation and oxidative stress, both of which are more prevalent in individuals with diabetes, may accelerate muscle degradation (Gao et al., 2022).
• Nerve damage (neuropathy), especially in the legs and feet, reduces physical activity levels and weakens muscles through disuse (Diabetic Muscular Atrophy: Molecular Mechanisms and Promising Therapies).
• Reduced activity levels over time, either due to fatigue, joint pain, or fear of lows, also play a role.

What the Research Tells Us

Recent studies have confirmed that individuals with T1D often have lower muscle mass and strength, even at a younger age.

• An extensive analysis of adults with type 1 diabetes (T1D) found that they had less lean muscle and lower handgrip strength compared to people without diabetes, despite similar levels of physical activity (Protective effects of physical activity against health risks associated with type 1 diabetes: “Health benefits outweigh the risks”).
• Women with type 1 diabetes (T1D) may be particularly vulnerable to early-onset muscle weakness and reduced physical performance by midlife (Muscular involvement in long-term type 1 diabetes: Does it represent an underestimated complication?).
• Sarcopenia and “dynapenia” (loss of muscle strength before muscle mass declines) are more common in people with long-standing T1D and poor glycemic control (Cunningham et al., 2020).

Solutions That Work

While these findings can sound discouraging, there’s good news: muscle loss is not inevitable, and there are real, doable ways to maintain and even build strength—at any age.

1. Resistance Training

Lifting weights (or using resistance bands, body weight, or machines) 2–3 times a week can:

• Boost muscle mass and strength
• Improve blood glucose control
• Enhance balance, coordination, and confidence

Even simple movements, such as chair squats or wall push-ups, count.

2. Prioritize Protein

As we age, we need more protein, not less. Aim for:

• 1.0–1.2 grams per kg of body weight per day (e.g., about 70–85g daily for someone weighing 150 pounds)
• Include high-quality sources like fish, poultry, eggs, tofu, lentils, and Greek yogurt
• Distribute protein evenly across meals to maximize muscle-building (Dietary Protein Distribution Positively Influences 24-h Muscle Protein Synthesis in Healthy Adults)

3. Stay Active Throughout the Day

Regular movement—such as walking, stretching, gardening, or even dancing—helps prevent muscle disuse. Avoid sitting for long periods without breaks.

4. Get Enough Vitamin D

Vitamin D supports muscle function. Ask your healthcare team to check your levels and consider supplementation if needed (Vitamin D and Type I Diabetes).

5. Monitor for Neuropathy

Nerve damage can reduce mobility. Catching it early and addressing it (with physical therapy, foot care, and pain management) can help preserve strength and stability.

Know the Warning Signs

You might be experiencing diabetes-related muscle loss if you notice:

• Trouble climbing stairs or standing from a chair
• Feeling unusually weak or slow
• Muscle cramps or longer recovery time
• Shrinking calves, arms, or thighs
• More frequent falls or balance issues

Don’t ignore these signs. They’re not “just aging”—they’re essential signals to take action.

Final Thought: Aging Strong with T1D Is Possible

If you live with Type 1 diabetes, muscle loss may be part of the aging puzzle—but it’s a puzzle with plenty of solutions. With the right mix of movement, nutrition, support, and self-awareness, you can maintain strength, independence, and confidence as the years go on.

You’ve already lived with diabetes longer than anyone ever expected. You’ve got the resilience—now let’s make sure your muscles do, too.

Last updated 09/14/2025.