September 10, 2025 • 15 mins
Could muscle loss be more than just a complication of diabetes—could it actually be a cause? In this episode of The Health Pulse, we explore how skeletal muscle, the body’s primary glucose disposal system, plays a critical role in blood sugar control and why losing it may set the stage for type 2 diabetes.
We share unusual case observations where patients presented with muscle wasting, claw-hand deformities, and foot drop—symptoms resembling hereditary neuropathies rather than classic diabetic complications. These cases prompted a deeper look into how reduced muscle mass impairs glucose uptake, prolongs high blood sugar, and accelerates insulin resistance.
You’ll also hear a powerful case study: a patient with severe muscle loss normalized blood sugar and eliminated insulin use within a month by following a strict carb-elimination diet combined with continuous glucose monitoring. The result underscores how targeting the root metabolic dysfunction can achieve outcomes that traditional management often misses.
This episode reframes muscle as a metabolic powerhouse—and highlights strategies to preserve and strengthen it as a cornerstone of diabetes prevention and care.
📞 Need lab work done from the comfort of home? QLM offers fast, reliable mobile phlebotomy services—no clinic visit required.
📅 Book your appointment or learn more at:
👉 Quick Lab Mobile
📧 Contact us: info@quicklabmobile.com
💬 Enjoyed the episode? Leave us a review and let us know what topics you'd like us to cover next! Your feedback helps us bring you the content that matters most.
Disclaimer: The information provided in this podcast is for informational purposes only and should not be considered medical advice. The content discussed is based on research, expert insights, and reputable sources, but it does not replace professional medical consultation, diagnosis, or treatment. We strive to present accurate and up-to-date information, medical research is constantly evolving. Listeners should always verify details with trusted health organizations, before making any health-related decisions. If you are experiencing a medical emergency, such as severe pain, difficulty breathing, or other urgent symptoms, call your local emergency services immediately. By listening to this podcast, you acknowledge that The Health Pulse and its creators are not responsible for any actions taken based on the content of this episode. Your health and well-being should always be guided by the advice of qualified medical professionals.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:01):
Welcome to the Health Pulse, your go-to source for
quick, actionable insights onhealth, wellness and diagnostics
.
Whether you're looking tooptimize your well-being or stay
informed about the latest inmedical testing, we've got you
covered.
Join us as we break down keyhealth topics in just minutes.
Let's dive in.
Speaker 2 (00:26):
Welcome back to the Deep Dive.
We're here again to reallyunpack those sources you send us
, the ones with insights thatgenuinely make you stop and
think.
Speaker 3 (00:33):
Yeah, shift your perspective a bit.
Speaker 2 (00:34):
Exactly.
Speaker 3 (00:35):
Yeah.
Speaker 2 (00:36):
And today we're looking into something, well,
pretty critical.
It's this link betweenneuropathy, muscle loss and type
2 diabetes.
Speaker 3 (00:44):
It's often overlooked , honestly.
Speaker 2 (00:46):
Definitely overlooked .
Speaker 3 (00:47):
And it might just change how we all think about
diabetes risk, maybe evenmanagement.
Our goal here is to exploreyour sources and pull out this
surprising connection.
Speaker 2 (00:56):
It challenges the standard way of thinking, for
sure.
Speaker 3 (00:59):
It really does.
And it kicks off with thisreally interesting clinical
observation A doctor seespatients type 2 diabetes, yes,
but with some really oddphysical signs.
Speaker 2 (01:10):
Not the usual presentation.
Speaker 3 (01:12):
Right.
Picture this A physician, apatient diagnosed with type 2
diabetes.
Okay, standard enough, but thispatient has severe muscle
wasting.
Their hands are becoming thesource calls them claw-like
Right and they have foot drop.
You know where they can'teasily lift the source calls
them claw-like Right and theyhave foot drop.
You know where they can'teasily lift the front of their
foot.
Speaker 2 (01:28):
Yeah, Difficulty walking tripping hazard Exactly
Now.
Your first reaction maybe likemine might be okay.
That sounds like reallyadvanced diabetic neuropathy.
Speaker 3 (01:38):
That's the common assumption.
Speaker 2 (01:40):
But here's the twist from the sources, this specific
pattern, the really profoundmuscle loss, these deformities.
It's not typical of thediabetic neuropathy.
Most people know the kindthat's mainly about sensation.
Speaker 3 (01:54):
No, that's usually more tingling, numbness, maybe
pain sensory predominant, wecall it.
Speaker 2 (02:01):
So this wasn't just another case, it was a puzzle
really made them rethink things.
Speaker 3 (02:05):
That's precisely it.
That distinction is key.
When you see signs likeclaw-like hands, where the
fingers get stuck in that bentposition and foot drop, well,
that's a specific kind of redflag.
It points towards nerve damagethat's primarily motor.
It's affecting the nerves,telling muscles to work.
Speaker 2 (02:20):
Ah, so not just feeling, but movement.
Speaker 3 (02:22):
Right, leading to weakness, to wasting.
It looks a lot more likeconditions such as hereditary
motor and sensory neuropathy.
Chikungunya tooth disease, orCMT, is the classic example.
Cmt okay, yeah, diabeticneuropathy Usually it's those
sensory issues First burning,tingling, numbness, Not usually
this kind of severe specificmuscle atrophy that causes
(02:45):
deformities.
Speaker 2 (02:46):
That clarifies things and it led the source author to
ask this really big questionCould the muscle loss itself be
setting people up for diabetes?
Speaker 3 (02:56):
Rather than just being a late complication.
Speaker 2 (02:58):
Exactly.
What if losing muscle mass wasactually, you know, paving the
way for the metabolic problems?
So that's what we're digginginto today the yes to that
question, and what it all means.
Speaker 3 (03:10):
It's a fundamental shift in thinking.
Speaker 2 (03:11):
Okay, but let's really unpack this because
honestly, we tend to thinkmuscle is just for well lifting
stuff or maybe looking good.
Speaker 3 (03:19):
Right performance aesthetics.
Speaker 2 (03:20):
But it's clearly doing a lot more behind the
scenes, metabolically speaking.
Speaker 3 (03:23):
Oh, absolutely.
Skeletal muscle is, you couldsay, an unsung hero of
metabolism.
It's the body's number oneprimary site of glucose disposal
.
Just think about that.
Speaker 2 (03:33):
Primary site wow.
Speaker 3 (03:34):
Yeah, when you eat carbs your blood sugar goes up.
Insulin comes along to helpshuttle that glucose out of the
blood and into your cells andthe research cited it shows a
massive 70, 80 percent ofinsulin stimulated glucose
uptake happens right there inyour muscles 70 to 80 percent.
Speaker 2 (03:52):
That's huge.
Speaker 3 (03:53):
It's enormous.
Your muscles act like thesehuge sponges for glucose.
They soak it up, store it asglycogen, burn it for fuel.
So imagine what happensmetabolically when those big
glucose clearing systems startshrinking.
Speaker 2 (04:06):
Right.
So if muscles are doing most ofthat work, taking up the
glucose, what happens when welose that muscle mass, when
those glucose sponges getsmaller?
What are the knock-on effects?
Speaker 3 (04:16):
Well, the consequences, the sort of domino
effect, it's pretty significant.
Less muscle means fewer placesfor glucose to go, simple as
that.
Speaker 2 (04:24):
Okay.
Speaker 3 (04:24):
So blood sugar stays higher for longer.
This leads straight to insulinresistance.
Your cells just don't respondas well to insulin anymore.
Speaker 2 (04:31):
Even if the pancreas is making plenty.
Speaker 3 (04:33):
Even if it's working overtime.
Yeah, and that, of course,significantly boosts your risk
of type 2 diabetes.
We see this clearly in studies,especially with older adults.
Low muscle mass stronglycorrelates with diabetes and
metabolic syndrome.
Speaker 2 (04:46):
Makes sense.
Speaker 3 (04:46):
And if Losing muscle makes everything worse More
complications, less mobility,just poorer health long term.
Speaker 2 (04:57):
So it really forces you to see muscle differently,
not just strength, but as a keymetabolic organ.
Speaker 3 (05:02):
Exactly A vital regulator, protecting it is key.
Speaker 2 (05:05):
And this is where it gets.
I think really interesting,because we're not just talking
about losing muscle becauseyou're, say, less active or just
getting older, Right, losingmuscle because you're say less
active or just getting older,Right.
The sources point out thatcertain kinds of nerve damage,
certain neuropathies, directlycause muscle loss in a way that
throws another wrench into themetabolic works.
Speaker 3 (05:23):
That's a really crucial distinction to make.
Like we touched on diabeticneuropathy, the common kind,
mostly sensory, predominantburning, tingling, numbness,
feet usually first Sure, somemuscle weakness can occur in
really advanced stages but it'sgenerally not severe enough to
cause those dramatic things likeclaw hands or significant foot
(05:43):
drop.
Now contrast that withhereditary neuropathies like
Charcot-Marie tooth disease, cmt.
These are fundamentallydifferent.
They're motor and sensoryneuropathies.
Speaker 2 (05:51):
Motor and sensory.
Speaker 3 (05:53):
Yes, the nerve fibers carrying signals to the muscles
get damaged.
It's like cutting thecommunication lines and that
directly causes progressivemuscle atrophy, basically severe
muscle wasting, particularly inthose small fiddly muscles in
the feet and hands.
Speaker 2 (06:07):
Right the intrinsic muscles.
Speaker 3 (06:08):
Exactly and this leads to very specific signs.
You get foot drop because themuscles lifting the foot, the
ankle dorsiflexors, they getweak.
Speaker 2 (06:16):
Making walking difficult.
Speaker 3 (06:17):
Very difficult.
You see claw toes and clawhands because those intrinsic
muscles waste away.
Often you also see pescavus, avery high arched foot.
That's a classic sign oflong-term muscle imbalance and,
of course, just general handweakness.
That makes everyday things youknow, opening jars, buttoning
shirts really tough.
Speaker 2 (06:38):
So paint the picture.
Yeah, what happens when youhave that kind of muscle loss
driven by the neuropathy and youcombine it with the metabolic
stress that leads towardsdiabetes?
It sounds like a recipe fordisaster.
Speaker 3 (06:50):
You nailed it.
It's a perfect storm, acompounding effect.
You've got significantly lessmuscle mass, so naturally less
glucose disposal.
Plus, these conditions oftenmake physical activity harder,
which doesn't help metabolismeither.
It reduces overall energy use,Makes sense to worsening
(07:10):
diabetes.
But complications like footulcers infections, because
circulation and sensation canalso be impaired.
So, connecting the dots, itstrongly suggests that patients
with these underlying motorneuropathies could be at
increased risk of developingtype 2 diabetes and maybe their
diabetes will look different,perhaps be harder to treat with
(07:31):
standard approaches.
Speaker 2 (07:32):
And this isn't just hypothetical.
The source material reallybrings it home with these
patients' stories.
The doctor saw what twopatients in just one year.
Speaker 3 (07:40):
Yeah, two patients whose symptoms just didn't fit
the usual diabetic neuropathypicture.
Speaker 2 (07:45):
They had that severe muscle wasting in the hands and
feet the claw hand deformities.
The foot drop with gaitdifficulty.
And deformities.
The foot drop with gaitdifficulty.
Speaker 3 (07:52):
Exactly All signs pointing away from typical
diabetic nerve damage and moretowards something like CMT, a
hereditary motor insensorineuropathy.
And one patient's case wasparticularly complex.
They were following the dietadvice, doing what the
nutritionist recommended, butstill had poor glycemic control.
Blood sugars were just stayinghigh.
Speaker 2 (08:11):
Frustrating.
Speaker 3 (08:12):
Very.
The doctor realized the keyissue was likely profound
insulin resistance in skeletalmuscle, made much worse by the
muscle wasting itself.
Speaker 2 (08:21):
Ah, the core problem we discussed.
Speaker 3 (08:23):
Precisely so.
The intervention was well,quite bold.
An elimination approach, Astrict carnivore diet for one
month.
Speaker 2 (08:32):
Wow Okay, strict carnivore.
What was the thinking there?
Speaker 3 (08:36):
The idea, as the source explores, was to
drastically cut carbs, basicallygive the insulin system a
complete rest.
Let the body's cells,especially in the remaining
muscle, hopefully regain somesensitivity to insulin.
Speaker 2 (08:48):
Makes sense conceptually, but how do they
manage that safely, especiallywith insulin involved?
Speaker 3 (08:53):
Technology was key.
They used a Freestyle LibreContinuous Glucose Monitor, a
CGM.
Speaker 2 (08:58):
Ah, constant tracking .
Speaker 3 (08:59):
Yes, close tracking Vital for avoiding overshooting
insulin doses, giving too muchinsulin, which is a real risk
with such a big dietary shift.
Speaker 2 (09:07):
And the results Did it work.
Speaker 3 (09:09):
According to the source.
Yeah, the results were prettyremarkable.
The patient lost weight overthat month.
Their blood sugar levelsgradually normalized Normalized,
yes, and the most striking part, by the end of that one month
trial, they no longer requiredinsulin therapy.
Speaker 2 (09:25):
Went off insulin completely.
Speaker 3 (09:26):
Completely.
It's a powerful example reallyof how targeting the underlying
metabolic issue that profoundinsulin resistance linked to the
muscle loss can lead todramatic improvement.
Speaker 2 (09:40):
That's incredible, but you know, this isn't just
about these specific, perhapsrarer, neuropathies, is it?
The sources connect this tosomething much more common
age-related muscle loss.
Speaker 3 (09:51):
That's right.
It broadens the lensconsiderably.
It brings in sarcopenia.
Speaker 2 (09:55):
Sarcopenia, age-related loss of muscle.
Speaker 3 (09:57):
Exactly, and the link between sarcopenia and a higher
risk of type 2 diabetes isbecoming increasingly clear.
It's consistent.
Speaker 2 (10:04):
And the mechanism is basically the same.
Speaker 3 (10:05):
Pretty much the same principle Less muscle means less
metabolic flexibility.
With less muscle mass, there'sjust less glucose uptake after
you eat.
Speaker 2 (10:13):
Right, the sponge is smaller.
Speaker 3 (10:14):
Exactly, which leads to greater insulin resistance
and also a higher risk of fatbeing stored where you don't
want it in the liver, around theabdominal organs.
That just adds fuel to themetabolic fire, and large
studies now confirm this.
Sarcopenia is recognized as agenuine predictor of type 2
diabetes in older populations.
It's a big deal, often creepingup unnoticed.
Speaker 2 (10:37):
So even though those first patients had
neuropathy-driven muscle loss,the underlying metabolic
consequence is similar tosarcopenia.
Correct?
And then you throw modern dietsinto the mix.
What happens then?
Speaker 3 (10:49):
Well, that just amplifies the risk.
When you combine that reducedmuscle capacity whether from age
or neuropathy with modern dietshigh in refined carbohydrates,
you're putting an even biggerstrain on the insulin system.
Speaker 2 (11:01):
Creates that perfect storm again.
Speaker 3 (11:03):
Exactly.
It really highlights thatpeople with any condition
causing significant muscle loss,hereditary or required modern
neuropathies included, might bethis under-recognized risk group
for diabetes.
Speaker 2 (11:14):
So the muscle loss itself is a major risk factor.
Speaker 3 (11:17):
It seems so, it fundamentally impacts the body's
ability to handle glucose.
It just underscores how crucialmaintaining muscle mass is,
whatever the reason for itspotential decline.
Speaker 2 (11:28):
Okay.
So, given all this, what canpeople actually do?
How do we get ahead of this,especially since, as you said,
this muscle loss can quietlymess with insulin sensitivity
long before blood sugar goes wayup and causes symptoms?
Speaker 3 (11:41):
Yeah, early detection and monitoring are absolutely
key, because you're right, bythe time symptoms are obvious,
things might already be quiteadvanced.
Speaker 2 (11:49):
So what should we be looking at?
Speaker 3 (11:50):
The sources mention several key lab tests.
These are really important forboth detection and management.
First there's HbA1c.
Right, really important forboth detection and management.
First there's HbA1c.
Speaker 2 (11:57):
Right the average sugar over a few months.
Speaker 3 (11:59):
Exactly Then fasting glucose and fasting insulin
Together.
These give you a snapshot ofcurrent glucose handling and,
importantly, insulin resistance.
Okay, a full lipid panel isalso crucial LDL HDL
triglycerides and, importantly,ldl HDL triglycerides and,
importantly, apav.
Speaker 2 (12:15):
APAV.
Why that specifically?
Speaker 3 (12:17):
Well, APAV is a protein marker, and many experts
now consider it a perhaps moreaccurate predictor of
cardiovascular risks linked toinsulin resistance than just LDL
cholesterol alone.
Speaker 2 (12:30):
Interesting Okay, what else?
Speaker 3 (12:36):
Kidney function tests creatinine, EGFR, checking for
albumin in the urine.
Protecting the kidneys isabsolutely paramount.
In diabetes and liver enzymes,Elevated levels can be an early
sign of fatty liver disease,which is very closely tied to
insulin resistance as well.
Speaker 2 (12:49):
Got it, so a pretty comprehensive panel.
Speaker 3 (12:51):
It gives a much clearer picture of overall
metabolic health.
Speaker 2 (12:54):
And you mentioned CGMs earlier, continuous glucose
monitors.
They fit in here too.
Speaker 3 (12:59):
Oh, immensely valuable Used alongside those
lab tests.
Cgms provide that real-timefeedback.
You can see exactly howdifferent foods, activities,
stress affects your blood sugar.
It's incredibly empowering forfine-tuning diet, lifestyle,
even medication.
Speaker 2 (13:14):
Yeah, that real-time data seems like a game changer,
and I thought this practicalpoint was interesting too.
The source mentioned thingslike at-home blood draws
available in places like Miami,apparently making it easier for
people who maybe have mobilityissues from neuropathy or are
just juggling tons ofappointments already.
Accessibility matters.
Speaker 3 (13:32):
Absolutely Removing barriers to regular monitoring
is huge for effective management.
Speaker 2 (13:38):
So, wrapping this all up, the big message today, the
core insight, is this oftenoverlooked reality isn't it that
our muscle mass is central tometabolic health?
Speaker 3 (13:49):
Absolutely.
It's not secondary, it'sfundamental.
Speaker 2 (13:52):
It's not just about strength or looks.
It's about how metabolicallyresilient we are.
Speaker 3 (13:56):
Precisely Conditions that cause significant muscle
wasting, whether it'sage-related sarcopenia or
specific neuropathies likeCharcot-Marie tooth.
They directly impair the body'sability to clear glucose.
Speaker 2 (14:07):
They create, as the source put it, fertile ground
for type 2 diabetes.
Speaker 3 (14:10):
Exactly, and they make managing existing diabetes
much, much harder.
Speaker 2 (14:16):
It just shows how tightly woven our muscular and
metabolic systems really are,and this is important.
A patient's story gives hope.
It shows there's a path forwardeven when things seem really
complex.
Definitely.
Speaker 3 (14:26):
Once you understand the underlying mechanism, you
can use the right tools.
We saw it there Continuousglucose monitoring for that
precise feedback, thoughtfulnutritional strategies, like the
carbohydrate elimination usedin that case, and close,
consistent lab monitoring.
Yeah, with those things,patients can see remarkable
(14:46):
improvements, like normalizingblood sugar, sometimes even
reducing or eliminating theirneed for insulin.
Speaker 2 (14:53):
Which is incredible.
Speaker 3 (14:54):
It really is.
It moves beyond just managingsymptoms.
It's about empowering thebody's own metabolic processes
and helping people regain ameasure of control.
Speaker 2 (15:03):
So thinking about muscle not just for power, but
is this vital metabolic engine?
What really stands out to youlistening to this?
How does understanding thesequite nuanced connections
empower your own health journey?
Does it make you thinkdifferently about supporting
your own metabolic flexibility,maybe through movement or diet?
Speaker 3 (15:21):
It definitely makes you reconsider the role of
muscle in overall health.
Speaker 2 (15:24):
Yeah, it's a deep dive that kind of flips the
script on something you thoughtyou knew.
Thanks, as always, for joiningus.
Speaker 1 (15:34):
Thanks for tuning into the Health Pulse.
If you found this episodehelpful, don't forget to
subscribe and share it withsomeone who might benefit.
For more health insights anddiagnostics, visit us online at
wwwquicklabmobilecom.
Stay informed, stay healthy andwe'll catch you in the next
episode.
Welcome to the Health Pulse, your go-to source for
quick, actionable insights onhealth, wellness and diagnostics
.
Whether you're looking tooptimize your well-being or stay
informed about the latest inmedical testing, we've got you
covered.
Join us as we break down keyhealth topics in just minutes.
Let's dive in.
Speaker 2 (00:26):
Welcome back to the Deep Dive.
We're here again to reallyunpack those sources you send us
, the ones with insights thatgenuinely make you stop and
think.
Speaker 3 (00:33):
Yeah, shift your perspective a bit.
Speaker 2 (00:34):
Exactly.
Speaker 3 (00:35):
Yeah.
Speaker 2 (00:36):
And today we're looking into something, well,
pretty critical.
It's this link betweenneuropathy, muscle loss and type
2 diabetes.
Speaker 3 (00:44):
It's often overlooked , honestly.
Speaker 2 (00:46):
Definitely overlooked .
Speaker 3 (00:47):
And it might just change how we all think about
diabetes risk, maybe evenmanagement.
Our goal here is to exploreyour sources and pull out this
surprising connection.
Speaker 2 (00:56):
It challenges the standard way of thinking, for
sure.
Speaker 3 (00:59):
It really does.
And it kicks off with thisreally interesting clinical
observation A doctor seespatients type 2 diabetes, yes,
but with some really oddphysical signs.
Speaker 2 (01:10):
Not the usual presentation.
Speaker 3 (01:12):
Right.
Picture this A physician, apatient diagnosed with type 2
diabetes.
Okay, standard enough, but thispatient has severe muscle
wasting.
Their hands are becoming thesource calls them claw-like
Right and they have foot drop.
You know where they can'teasily lift the source calls
them claw-like Right and theyhave foot drop.
You know where they can'teasily lift the front of their
foot.
Speaker 2 (01:28):
Yeah, Difficulty walking tripping hazard Exactly
Now.
Your first reaction maybe likemine might be okay.
That sounds like reallyadvanced diabetic neuropathy.
Speaker 3 (01:38):
That's the common assumption.
Speaker 2 (01:40):
But here's the twist from the sources, this specific
pattern, the really profoundmuscle loss, these deformities.
It's not typical of thediabetic neuropathy.
Most people know the kindthat's mainly about sensation.
Speaker 3 (01:54):
No, that's usually more tingling, numbness, maybe
pain sensory predominant, wecall it.
Speaker 2 (02:01):
So this wasn't just another case, it was a puzzle
really made them rethink things.
Speaker 3 (02:05):
That's precisely it.
That distinction is key.
When you see signs likeclaw-like hands, where the
fingers get stuck in that bentposition and foot drop, well,
that's a specific kind of redflag.
It points towards nerve damagethat's primarily motor.
It's affecting the nerves,telling muscles to work.
Speaker 2 (02:20):
Ah, so not just feeling, but movement.
Speaker 3 (02:22):
Right, leading to weakness, to wasting.
It looks a lot more likeconditions such as hereditary
motor and sensory neuropathy.
Chikungunya tooth disease, orCMT, is the classic example.
Cmt okay, yeah, diabeticneuropathy Usually it's those
sensory issues First burning,tingling, numbness, Not usually
this kind of severe specificmuscle atrophy that causes
(02:45):
deformities.
Speaker 2 (02:46):
That clarifies things and it led the source author to
ask this really big questionCould the muscle loss itself be
setting people up for diabetes?
Speaker 3 (02:56):
Rather than just being a late complication.
Speaker 2 (02:58):
Exactly.
What if losing muscle mass wasactually, you know, paving the
way for the metabolic problems?
So that's what we're digginginto today the yes to that
question, and what it all means.
Speaker 3 (03:10):
It's a fundamental shift in thinking.
Speaker 2 (03:11):
Okay, but let's really unpack this because
honestly, we tend to thinkmuscle is just for well lifting
stuff or maybe looking good.
Speaker 3 (03:19):
Right performance aesthetics.
Speaker 2 (03:20):
But it's clearly doing a lot more behind the
scenes, metabolically speaking.
Speaker 3 (03:23):
Oh, absolutely.
Skeletal muscle is, you couldsay, an unsung hero of
metabolism.
It's the body's number oneprimary site of glucose disposal
.
Just think about that.
Speaker 2 (03:33):
Primary site wow.
Speaker 3 (03:34):
Yeah, when you eat carbs your blood sugar goes up.
Insulin comes along to helpshuttle that glucose out of the
blood and into your cells andthe research cited it shows a
massive 70, 80 percent ofinsulin stimulated glucose
uptake happens right there inyour muscles 70 to 80 percent.
Speaker 2 (03:52):
That's huge.
Speaker 3 (03:53):
It's enormous.
Your muscles act like thesehuge sponges for glucose.
They soak it up, store it asglycogen, burn it for fuel.
So imagine what happensmetabolically when those big
glucose clearing systems startshrinking.
Speaker 2 (04:06):
Right.
So if muscles are doing most ofthat work, taking up the
glucose, what happens when welose that muscle mass, when
those glucose sponges getsmaller?
What are the knock-on effects?
Speaker 3 (04:16):
Well, the consequences, the sort of domino
effect, it's pretty significant.
Less muscle means fewer placesfor glucose to go, simple as
that.
Speaker 2 (04:24):
Okay.
Speaker 3 (04:24):
So blood sugar stays higher for longer.
This leads straight to insulinresistance.
Your cells just don't respondas well to insulin anymore.
Speaker 2 (04:31):
Even if the pancreas is making plenty.
Speaker 3 (04:33):
Even if it's working overtime.
Yeah, and that, of course,significantly boosts your risk
of type 2 diabetes.
We see this clearly in studies,especially with older adults.
Low muscle mass stronglycorrelates with diabetes and
metabolic syndrome.
Speaker 2 (04:46):
Makes sense.
Speaker 3 (04:46):
And if Losing muscle makes everything worse More
complications, less mobility,just poorer health long term.
Speaker 2 (04:57):
So it really forces you to see muscle differently,
not just strength, but as a keymetabolic organ.
Speaker 3 (05:02):
Exactly A vital regulator, protecting it is key.
Speaker 2 (05:05):
And this is where it gets.
I think really interesting,because we're not just talking
about losing muscle becauseyou're, say, less active or just
getting older, Right, losingmuscle because you're say less
active or just getting older,Right.
The sources point out thatcertain kinds of nerve damage,
certain neuropathies, directlycause muscle loss in a way that
throws another wrench into themetabolic works.
Speaker 3 (05:23):
That's a really crucial distinction to make.
Like we touched on diabeticneuropathy, the common kind,
mostly sensory, predominantburning, tingling, numbness,
feet usually first Sure, somemuscle weakness can occur in
really advanced stages but it'sgenerally not severe enough to
cause those dramatic things likeclaw hands or significant foot
(05:43):
drop.
Now contrast that withhereditary neuropathies like
Charcot-Marie tooth disease, cmt.
These are fundamentallydifferent.
They're motor and sensoryneuropathies.
Speaker 2 (05:51):
Motor and sensory.
Speaker 3 (05:53):
Yes, the nerve fibers carrying signals to the muscles
get damaged.
It's like cutting thecommunication lines and that
directly causes progressivemuscle atrophy, basically severe
muscle wasting, particularly inthose small fiddly muscles in
the feet and hands.
Speaker 2 (06:07):
Right the intrinsic muscles.
Speaker 3 (06:08):
Exactly and this leads to very specific signs.
You get foot drop because themuscles lifting the foot, the
ankle dorsiflexors, they getweak.
Speaker 2 (06:16):
Making walking difficult.
Speaker 3 (06:17):
Very difficult.
You see claw toes and clawhands because those intrinsic
muscles waste away.
Often you also see pescavus, avery high arched foot.
That's a classic sign oflong-term muscle imbalance and,
of course, just general handweakness.
That makes everyday things youknow, opening jars, buttoning
shirts really tough.
Speaker 2 (06:38):
So paint the picture.
Yeah, what happens when youhave that kind of muscle loss
driven by the neuropathy and youcombine it with the metabolic
stress that leads towardsdiabetes?
It sounds like a recipe fordisaster.
Speaker 3 (06:50):
You nailed it.
It's a perfect storm, acompounding effect.
You've got significantly lessmuscle mass, so naturally less
glucose disposal.
Plus, these conditions oftenmake physical activity harder,
which doesn't help metabolismeither.
It reduces overall energy use,Makes sense to worsening
(07:10):
diabetes.
But complications like footulcers infections, because
circulation and sensation canalso be impaired.
So, connecting the dots, itstrongly suggests that patients
with these underlying motorneuropathies could be at
increased risk of developingtype 2 diabetes and maybe their
diabetes will look different,perhaps be harder to treat with
(07:31):
standard approaches.
Speaker 2 (07:32):
And this isn't just hypothetical.
The source material reallybrings it home with these
patients' stories.
The doctor saw what twopatients in just one year.
Speaker 3 (07:40):
Yeah, two patients whose symptoms just didn't fit
the usual diabetic neuropathypicture.
Speaker 2 (07:45):
They had that severe muscle wasting in the hands and
feet the claw hand deformities.
The foot drop with gaitdifficulty.
And deformities.
The foot drop with gaitdifficulty.
Speaker 3 (07:52):
Exactly All signs pointing away from typical
diabetic nerve damage and moretowards something like CMT, a
hereditary motor insensorineuropathy.
And one patient's case wasparticularly complex.
They were following the dietadvice, doing what the
nutritionist recommended, butstill had poor glycemic control.
Blood sugars were just stayinghigh.
Speaker 2 (08:11):
Frustrating.
Speaker 3 (08:12):
Very.
The doctor realized the keyissue was likely profound
insulin resistance in skeletalmuscle, made much worse by the
muscle wasting itself.
Speaker 2 (08:21):
Ah, the core problem we discussed.
Speaker 3 (08:23):
Precisely so.
The intervention was well,quite bold.
An elimination approach, Astrict carnivore diet for one
month.
Speaker 2 (08:32):
Wow Okay, strict carnivore.
What was the thinking there?
Speaker 3 (08:36):
The idea, as the source explores, was to
drastically cut carbs, basicallygive the insulin system a
complete rest.
Let the body's cells,especially in the remaining
muscle, hopefully regain somesensitivity to insulin.
Speaker 2 (08:48):
Makes sense conceptually, but how do they
manage that safely, especiallywith insulin involved?
Speaker 3 (08:53):
Technology was key.
They used a Freestyle LibreContinuous Glucose Monitor, a
CGM.
Speaker 2 (08:58):
Ah, constant tracking .
Speaker 3 (08:59):
Yes, close tracking Vital for avoiding overshooting
insulin doses, giving too muchinsulin, which is a real risk
with such a big dietary shift.
Speaker 2 (09:07):
And the results Did it work.
Speaker 3 (09:09):
According to the source.
Yeah, the results were prettyremarkable.
The patient lost weight overthat month.
Their blood sugar levelsgradually normalized Normalized,
yes, and the most striking part, by the end of that one month
trial, they no longer requiredinsulin therapy.
Speaker 2 (09:25):
Went off insulin completely.
Speaker 3 (09:26):
Completely.
It's a powerful example reallyof how targeting the underlying
metabolic issue that profoundinsulin resistance linked to the
muscle loss can lead todramatic improvement.
Speaker 2 (09:40):
That's incredible, but you know, this isn't just
about these specific, perhapsrarer, neuropathies, is it?
The sources connect this tosomething much more common
age-related muscle loss.
Speaker 3 (09:51):
That's right.
It broadens the lensconsiderably.
It brings in sarcopenia.
Speaker 2 (09:55):
Sarcopenia, age-related loss of muscle.
Speaker 3 (09:57):
Exactly, and the link between sarcopenia and a higher
risk of type 2 diabetes isbecoming increasingly clear.
It's consistent.
Speaker 2 (10:04):
And the mechanism is basically the same.
Speaker 3 (10:05):
Pretty much the same principle Less muscle means less
metabolic flexibility.
With less muscle mass, there'sjust less glucose uptake after
you eat.
Speaker 2 (10:13):
Right, the sponge is smaller.
Speaker 3 (10:14):
Exactly, which leads to greater insulin resistance
and also a higher risk of fatbeing stored where you don't
want it in the liver, around theabdominal organs.
That just adds fuel to themetabolic fire, and large
studies now confirm this.
Sarcopenia is recognized as agenuine predictor of type 2
diabetes in older populations.
It's a big deal, often creepingup unnoticed.
Speaker 2 (10:37):
So even though those first patients had
neuropathy-driven muscle loss,the underlying metabolic
consequence is similar tosarcopenia.
Correct?
And then you throw modern dietsinto the mix.
What happens then?
Speaker 3 (10:49):
Well, that just amplifies the risk.
When you combine that reducedmuscle capacity whether from age
or neuropathy with modern dietshigh in refined carbohydrates,
you're putting an even biggerstrain on the insulin system.
Speaker 2 (11:01):
Creates that perfect storm again.
Speaker 3 (11:03):
Exactly.
It really highlights thatpeople with any condition
causing significant muscle loss,hereditary or required modern
neuropathies included, might bethis under-recognized risk group
for diabetes.
Speaker 2 (11:14):
So the muscle loss itself is a major risk factor.
Speaker 3 (11:17):
It seems so, it fundamentally impacts the body's
ability to handle glucose.
It just underscores how crucialmaintaining muscle mass is,
whatever the reason for itspotential decline.
Speaker 2 (11:28):
Okay.
So, given all this, what canpeople actually do?
How do we get ahead of this,especially since, as you said,
this muscle loss can quietlymess with insulin sensitivity
long before blood sugar goes wayup and causes symptoms?
Speaker 3 (11:41):
Yeah, early detection and monitoring are absolutely
key, because you're right, bythe time symptoms are obvious,
things might already be quiteadvanced.
Speaker 2 (11:49):
So what should we be looking at?
Speaker 3 (11:50):
The sources mention several key lab tests.
These are really important forboth detection and management.
First there's HbA1c.
Right, really important forboth detection and management.
First there's HbA1c.
Speaker 2 (11:57):
Right the average sugar over a few months.
Speaker 3 (11:59):
Exactly Then fasting glucose and fasting insulin
Together.
These give you a snapshot ofcurrent glucose handling and,
importantly, insulin resistance.
Okay, a full lipid panel isalso crucial LDL HDL
triglycerides and, importantly,ldl HDL triglycerides and,
importantly, apav.
Speaker 2 (12:15):
APAV.
Why that specifically?
Speaker 3 (12:17):
Well, APAV is a protein marker, and many experts
now consider it a perhaps moreaccurate predictor of
cardiovascular risks linked toinsulin resistance than just LDL
cholesterol alone.
Speaker 2 (12:30):
Interesting Okay, what else?
Speaker 3 (12:36):
Kidney function tests creatinine, EGFR, checking for
albumin in the urine.
Protecting the kidneys isabsolutely paramount.
In diabetes and liver enzymes,Elevated levels can be an early
sign of fatty liver disease,which is very closely tied to
insulin resistance as well.
Speaker 2 (12:49):
Got it, so a pretty comprehensive panel.
Speaker 3 (12:51):
It gives a much clearer picture of overall
metabolic health.
Speaker 2 (12:54):
And you mentioned CGMs earlier, continuous glucose
monitors.
They fit in here too.
Speaker 3 (12:59):
Oh, immensely valuable Used alongside those
lab tests.
Cgms provide that real-timefeedback.
You can see exactly howdifferent foods, activities,
stress affects your blood sugar.
It's incredibly empowering forfine-tuning diet, lifestyle,
even medication.
Speaker 2 (13:14):
Yeah, that real-time data seems like a game changer,
and I thought this practicalpoint was interesting too.
The source mentioned thingslike at-home blood draws
available in places like Miami,apparently making it easier for
people who maybe have mobilityissues from neuropathy or are
just juggling tons ofappointments already.
Accessibility matters.
Speaker 3 (13:32):
Absolutely Removing barriers to regular monitoring
is huge for effective management.
Speaker 2 (13:38):
So, wrapping this all up, the big message today, the
core insight, is this oftenoverlooked reality isn't it that
our muscle mass is central tometabolic health?
Speaker 3 (13:49):
Absolutely.
It's not secondary, it'sfundamental.
Speaker 2 (13:52):
It's not just about strength or looks.
It's about how metabolicallyresilient we are.
Speaker 3 (13:56):
Precisely Conditions that cause significant muscle
wasting, whether it'sage-related sarcopenia or
specific neuropathies likeCharcot-Marie tooth.
They directly impair the body'sability to clear glucose.
Speaker 2 (14:07):
They create, as the source put it, fertile ground
for type 2 diabetes.
Speaker 3 (14:10):
Exactly, and they make managing existing diabetes
much, much harder.
Speaker 2 (14:16):
It just shows how tightly woven our muscular and
metabolic systems really are,and this is important.
A patient's story gives hope.
It shows there's a path forwardeven when things seem really
complex.
Definitely.
Speaker 3 (14:26):
Once you understand the underlying mechanism, you
can use the right tools.
We saw it there Continuousglucose monitoring for that
precise feedback, thoughtfulnutritional strategies, like the
carbohydrate elimination usedin that case, and close,
consistent lab monitoring.
Yeah, with those things,patients can see remarkable
(14:46):
improvements, like normalizingblood sugar, sometimes even
reducing or eliminating theirneed for insulin.
Speaker 2 (14:53):
Which is incredible.
Speaker 3 (14:54):
It really is.
It moves beyond just managingsymptoms.
It's about empowering thebody's own metabolic processes
and helping people regain ameasure of control.
Speaker 2 (15:03):
So thinking about muscle not just for power, but
is this vital metabolic engine?
What really stands out to youlistening to this?
How does understanding thesequite nuanced connections
empower your own health journey?
Does it make you thinkdifferently about supporting
your own metabolic flexibility,maybe through movement or diet?
Speaker 3 (15:21):
It definitely makes you reconsider the role of
muscle in overall health.
Speaker 2 (15:24):
Yeah, it's a deep dive that kind of flips the
script on something you thoughtyou knew.
Thanks, as always, for joiningus.
Speaker 1 (15:34):
Thanks for tuning into the Health Pulse.
If you found this episodehelpful, don't forget to
subscribe and share it withsomeone who might benefit.
For more health insights anddiagnostics, visit us online at
wwwquicklabmobilecom.
Stay informed, stay healthy andwe'll catch you in the next
episode.
Popular Podcasts
24/7 News: The Latest
The latest news in 4 minutes updated every hour, every day.
Dateline NBC
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Follow now to get the latest episodes of Dateline NBC completely free, or subscribe to Dateline Premium for ad-free listening and exclusive bonus content: DatelinePremium.com
The Clay Travis and Buck Sexton Show
The Clay Travis and Buck Sexton Show. Clay Travis and Buck Sexton tackle the biggest stories in news, politics and current events with intelligence and humor. From the border crisis, to the madness of cancel culture and far-left missteps, Clay and Buck guide listeners through the latest headlines and hot topics with fun and entertaining conversations and opinions.