Sarcopenia

The natural and continual loss of muscle, known as sarcopenia, is thought to begin as early as age 30. However, most people don’t tend to notice any difference until they are much older. It’s estimated that muscle mass decreases by approximately 3-8% per decade after the age of 30 and this rate of decline is even higher after the age of 60. While age is one of the main causes of muscle wastage, it is also most likely to occur in people who lead an inactive lifestyle. That is, lots of sitting time and not enough regular movement. The combination of both age and an inactive lifestyle will increase the rate at which someone loses muscle mass. A decrease in muscle mass is also accompanied by a progressive increase in fat mass and changes in body composition over time. This is associated with an increased incidence of insulin resistance. Other risk factors and the impact of muscles wastage will be further explored below. 

Muscle loss and blood glucose levels

For people living with diabetes, muscle loss also reduces the capacity of your muscles to draw glucose from the blood into the muscle to be used as energy. As a result, blood glucose levels can be higher and increase your risk of diabetes-related complications. It is for this reason, that is important to avoid muscle loss where possible.

As we age, our muscle mass tends to decrease. Mostly because we don’t engage in the same amount of physical activities that use muscle power. When blood glucose levels are persistently higher than the target ranges, circulation and nerve endings can be affected that supply the muscles. Muscles that lose their nerve supply can decrease in size and simply waste away.  

Muscle matters

As your muscles become smaller, they become weaker. When your muscles don’t contract, your body thinks you don’t need them anymore so the body starts breaking them down. As a result, you may find activities of daily living become more difficult and this can impact on overall function and mobility. To maintain a high level of independence, it’s important to stay physically active and have a nutritionally balanced diet. 

Aerobic and resistance exercise

Research tells us that people living with diabetes who participate in both aerobic activity and resistance exercise have better management of their blood glucose levels than those who just do aerobic, or just do resistance exercise. Therefore, try to aim for 30 minutes of aerobic exercise on most days of the week plus two bouts of resistance exercise per week. This will help maintain and/or increase your muscle mass and keep your glucose levels and HbA1c at an optimal level. 

Resistance training in particular helps build muscle mass, maintains flexibility and balance, assists with weight management and improves posture. A resistance training program that targets all the major muscle groups is a great way to maintain and/or increase your muscle mass. This may include exercises for your chest, shoulders, back, glutes, thighs and core muscles for example. Not only does resistance training help to build muscles, but it also improves your bone density, which reduces your risk of falls and broken bones. This is very important as we age!  

If you are wanting to get involved in resistance training, you can be very creative with equipment at home. A gym membership is not necessary, and you will find that there are many items you can use around the home as resistance, including your own body weight. Consider using cans of food from the pantry, water bottles filled with water or sand, or a stretchy theraband. Remember to start small if you haven’t exercised for a while and use smooth controlled movements when lifting weights. Ideally, a resistance or strength program should include 8-10 different exercises. Aim to complete 10 repetitions of each exercise and 2-3 sets of the whole program. 

If you are looking for individual support and guidance with resistance training, please see your doctor for a referral to an accredited exercise physiologist. They can tailor a specific program for you with consideration of your capabilities, limitations and goals. 

By Hayley Nicholson, Exercise Physiologist, Credentialled Diabetes Educator