Sarcopenic Obesity Triples Risk of Type 2 Diabetes: Study

A major new international study led by Curtin University, has found diabetes risk is about more than just body weight or obesity, revealing muscle health also likely plays a big role in whether people will develop the condition.

Published in one of the world’s leading diabetes journals, Diabetes Care, the study saw researchers from the Curtin School of Population Health and Dementia Centre of Excellence at the Curtin enAble Institute analyse health data from nearly 480,000 adults over 14 years - all of whom were diabetes-free at the beginning of the study.

The team found people with both excess body fat and poor muscle health – a condition known as sarcopenic obesity - were more than three-and-a-half times as likely to develop type 2 diabetes than people with healthy body composition.

It also found people with sarcopenic obesity were 19 per cent more likely to develop type 2 diabetes than people with obesity alone and 91 per cent more likely to develop type 2 diabetes than people with low muscle mass and strength (sarcopenia) alone.

Lead author and PhD candidate Zhongyang Guan said the findings challenge the common perception diabetes risk is primarily driven by body weight.

"Most people know carrying excess weight can increase the risk of type 2 diabetes, but our findings show muscle health is also an important piece of the puzzle," Mr Guan said.

"People with both excess body fat and low muscle mass had a substantially higher risk of developing type 2 diabetes than those with obesity alone.

"This suggests we need to look beyond the number on the scales when assessing diabetes risk, as maintaining muscle strength and muscle mass may be just as important as managing body weight."

The study found nearly 15 per cent of people with sarcopenic obesity developed type 2 diabetes within 10 years, compared with around 11 per cent of people with obesity alone and just 3 per cent of people without sarcopenia or obesity.

The link was particularly strong among women and adults under the age of 60.

Project senior lead Professor Mario Siervo said the results supported a broader approach to diabetes prevention.

"Healthcare professionals routinely monitor body weight and obesity, but our findings suggest assessing muscle health could help identify people at high risk earlier," Professor Siervo said.

"As populations age and rates of obesity continue to rise, preserving muscle health through regular physical activity and healthy lifestyle habits could play an important role in reducing the burden of type 2 diabetes."

Diabetes WA Clinical Services Manager Jessica Weiss said the findings highlighted the important role muscle plays in controlling blood sugar levels and reflected what health practitioners were seeing firsthand.

"We know our muscles use a lot of our glucose for fuel and working them during physical activity is a great way to help use up glucose from our blood and regulate glucose levels,” Ms Weiss said.

“Physical activity also reduces our body's resistance to insulin, an important element to type 2 diabetes.

“The more muscle we have and the more regularly we use them, the better equipped our body is to prevent or manage type 2 diabetes.”

Reference:

Zhongyang Guan, Blossom C.M. Stephan, Mario Siervo; Sarcopenic Obesity and Risk of Incident Type 2 Diabetes: A Prospective Cohort Study and Landmark Analysis From the UK Biobank. Diabetes Care 2026; dc260797. https://doi.org/10.2337/dc26-0797