Washington, D.C.— In a new paper published in Clinical Nutrition, “Sarcopenic Diabetes Is an Under-Recognized and Unmet Clinical Priority,” nutrition and diabetes experts are calling attention to a little-known but serious complication of diabetes, the progressive loss of muscle mass and strength, a condition known as sarcopenic diabetes. Moreover, authors warn that the new class of weight loss drugs, like semaglutide, complicates this condition as weight loss with these drugs is caused, in part, by a decrease in muscle mass.
The new position paper, endorsed by the European Society for Clinical Nutrition and Metabolism (ESPEN) and the Diabetes Nutrition Study Group (DNSG), warns that this problem is widespread, underdiagnosed, and linked to significantly worse health outcomes for people living with diabetes.
“Sarcopenic diabetes occurs when diabetes is combined with meaningful muscle loss, which goes far beyond normal aging,” says paper co-author Hana Kahleova, MD, PhD, director of clinical research for the Physicians Committee for Responsible Medicine.
The paper says that studies suggest that roughly 1 in 4 people with type 2 diabetes also have sarcopenia. Compared with people without diabetes, those with the condition have a much higher risk of frailty, disability, longer hospital stays, and increased risk of death, as well as poorer outcomes in conditions like heart failure and chronic kidney disease.
The paper explains that muscle loss in diabetes is driven by multiple factors, including physical inactivity, poor diet, chronic inflammation, insulin resistance, high blood sugar, and diabetes-related complications such as nerve damage. It also highlights a new concern that weight loss from modern diabetes medications such as semaglutide and tirzepatide comes, in part, from muscle loss, making it even more important to monitor and protect muscle health during treatment.
The authors stress that sarcopenic diabetes is not inevitable and can be addressed. They recommend routine screening in people with diabetes, especially older adults and those experiencing weight loss. Simple measures such as testing muscle strength, along with body composition scans, can help identify people at risk. The authors also emphasize the importance of adequate protein intake, regular strength or resistance exercise, and reduced sedentary time as practical, evidence-based ways to preserve and improve muscle health.
The paper calls on clinicians, health systems, and researchers to recognize sarcopenic diabetes as a serious complication of diabetes and to integrate muscle health into routine care, alongside blood sugar and cardiovascular risk management.
“Sarcopenic diabetes is an under-recognized complication that significantly worsens outcomes for people with diabetes,” Kahleova said. “Protecting muscle through proper nutrition, strength training, and routine screening should be part of standard diabetes care.”
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Journal
Clinical Nutrition
Method of Research
Commentary/editorial
Subject of Research
Not applicable
Article Title
Sarcopenic diabetes is an under-recognized and unmet clinical priority. A call for action from the European Society for Clinical Nutrition and Metabolism and the Diabetes Nutrition Study Group
Article Publication Date
19-Nov-2025
COI Statement
Conflict of Interest RB received speaker fees from Novo-Nordisk and Ely-Lilly; JLS received consulting fees from Perkins Coie LLP, Tate & Lyle, Brightseed, Ingredion, Almond Board of California; and speaker fees from Dairy Farmers of Canada, FoodMinds LLC, Nestlé, Abbott, General Mills, Nutrition Communications, International Food Information Council (IFIC), Calorie Control Council, International Sweeteners Association (ISA), Arab Beverages Association, Collaborative CME and Research Network (CCRN), Phynova; and other support from California Walnut Commission, Peanut Institute, Nutrartis, Dairy Farmers of Canada, Danone; LG received grant funding from Nestle Health Science, Foundation Nutrition2000Plus; and speaker fees from Fresenius Kabi and Lilly; CWCK received grant funding from Advanced Food Materials Network, Agriculture and Agri-Foods Canada (AAFC); consulting fees from Lantmannen; travel support from International Nut and Dried Fruit Council, McCormick Science Institute; MDB-P received consulting fees from Abbott Nutrition, Fresenius Kabi, Danone Nutricia; and speaker fees from Abbott Nutrition, Fresenius Kabi, Nestle Healthcare, Danone Nutricia; YB received grant support from Novo Nordisk, Ely-Lilly, Nestlé Health Science; LC received grant support from Protein Industries Canada, United Soybean Board, Alberta Pulse Growers; speaker fees from Arkansas Children's Hospital, Plant-Based Health Professionals UK; and travel support from World Sugar Research Organization; TC received speaker fees from Fresenius-Kabi, Danone-Nutricia; expert testimony fees from Nestle; travel support from Fresenius Kabi; A-MA received consluting fees from Novo-Nordisk Foundation; CD received travel support from Numil Hellas, Mavrogenis Empowering Health; NED received grant support from Abbott Nutrition; speaker fees from Abbott Nutrition; SMS received grant support from VectivBio, Nestlé Health Science, Dr. Falk, Sanofi; consulting fees from Baxter, Nestlé Health Science, Pfizer, Takeda; speaker fees from Amgen, Fresenius-Kabi, MSD, Nestlé Health Science, Nutricia, Thermo Fisher, Ely-Lilly, EverPharma; SK received speaker fees from Baxter, B-Braun, Nestle, Nutricia, Fresenius-Kabi; JS-S received grant support from International Nut and Dried Fruit Foundation; consulting fees from Spain Institute Danone Advisory Board; travel support from Nut and Dried Fruit Foundation; advisory board memberships in Scientific Committee of Danone Institute International; MLS received travel support from Nutricia and Abbott; JIM received speaker fees from Abbott Nutrition, Merck; advisory board fees from Abbott Nutrition, Twin Health; stock ownership for Twin Health; AG, CC, HK, LMD, US, GR have no conflicts of interest to declare.