Muscle is often discussed in the context of strength, mobility and physical fitness, but it also plays an important role in how the body handles glucose. Skeletal muscle is one of the major tissues involved in taking up glucose from the bloodstream, particularly after eating. This raises an important question: could having very little muscle change the way a person’s blood sugar is regulated?

Low muscle mass can occur for different reasons, including ageing, prolonged inactivity, inadequate nutrition and certain health conditions. It is also possible for someone to have a body weight that appears normal while having relatively little muscle. Since glucose regulation depends on several organs and metabolic processes, the relationship between muscle mass and blood sugar may be more complicated than simply having “more muscle is better”.

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Understanding this connection could be particularly relevant for people who are older, physically inactive or losing muscle over time. An expert can help explain how reduced muscle mass may influence glucose disposal and insulin sensitivity, whether people with low muscle mass face a greater risk of blood sugar problems, and what can realistically be done to support metabolic health.

Skeletal muscle and blood sugar

Kanikka Malhotra, Consultant Dietician & Diabetes Educator, tells indianexpress.com, “Skeletal muscle is the body’s largest storage site for glucose. After eating a meal, nearly 70% of the sugar entering the bloodstream is absorbed and stored by muscle tissue, where it is converted into glycogen for later use as energy. This makes muscle a key player in keeping post-meal blood sugar levels stable. When a person has very low muscle mass, this storage capacity shrinks significantly. There is simply less tissue available to absorb glucose, so more of it remains circulating in the blood for longer periods.”

Over time, she adds, the body compensates by producing higher amounts of insulin to push glucose into cells, and the muscle that remains often becomes less responsive to insulin’s signals. This combination of reduced storage space and blunted insulin response is one reason low muscle mass is increasingly recognised as a hidden but significant contributor to poor blood sugar control, even in people who are not overweight.

Low muscle mass and diabetes risk

“Yes, low muscle mass can raise the risk of insulin resistance and type 2 diabetes independent of body weight or BMI,” states Malhotra, adding that this also explains why some slim, normal-weight individuals still develop blood sugar problems, a pattern often described as metabolically unhealthy despite looking lean. With less muscle to absorb glucose, the pancreas works harder to compensate, and this strain builds up over years.

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“That said, muscle mass is one piece of a larger picture. Overall risk also depends on visceral fat around the abdomen and organs, family history of diabetes, age-related muscle loss, physical activity levels, sleep quality, and diet composition, especially intake of refined carbohydrates and protein. Two people with identical BMI can have very different metabolic risk depending on how much muscle versus fat makes up that weight. This is why body composition, not just the number on the scale, matters for assessing true metabolic health,” shares Malhotra.

Rebuilding muscle to improve glucose regulation

Quick Quiz

See if you can answer this:

Which approach is most effective for rebuilding muscle and improving glucose regulation?

A. Do intense strength training immediately to build muscle faster.

B. Focus only on eating large amounts of protein.

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C. Combine gradual resistance training with adequate protein, while prioritising sleep and recovery.

D. Consume most of the day’s protein in one large meal after exercising.

Reveal the answer

✅ Correct answer: C

Malhotra explains that resistance training combined with adequate protein can improve glucose regulation in people with low muscle mass. Strength training helps muscle cells take up glucose more efficiently, while protein supplies the building blocks needed for muscle repair and growth. Training should progress gradually, particularly in older or deconditioned individuals, and protein is best distributed across meals. Adequate sleep and recovery are also essential because muscle repair occurs between training sessions.