The Diabetic's Guide to a Muscle-Building Diet

What was once a relatively uncommon condition has become one of, if not the fastest-growing non-communicable disease (NCD). It's estimated that around 15% of all adults in the US suffer from diabetes and a lot more qualify as having prediabetes.

That’s a lot of people. With so many people with diabetes, it's inevitable that many of them will be interested in weight training and building muscle. If not, they should be, as the results can literally be life-saving. However, a muscle building diabetic may seem tricky so this article will help make it less confusing. We’ll lay out the important factors of a diabetic muscle building diet.

Disclaimer: This article is meant to be informative but not a substitute for medical guidelines. We are not doctors and you should always consult with your primary health provider before making decisions on diet if you have diabetes.

The Importance Of Working Out And Building Muscle With Diabetes

Many people with diabetes are led to believe that there's nothing they can do to improve their condition apart from taking insulin. This is not true. While it does seem that once you develop diabetes, you can never fully cure it, there is hope and possibility for reversal.

Evidence shows that you can greatly reverse the effect of diabetes and even reach remission, to the point that you will no longer be dependent on insulin. A major part of this is remaining active, increasing muscle mass, and decreasing fat.

If you are diagnosed with diabetes, staying active and getting to the gym is crucial for anyone who wants to get off medication. These benefits occur from more than just one mechanism.

1. For one, regular exercise makes controlling blood sugar levels much easier, which we'll get to in a second. However, resistance training, such as weightlifting or bodyweight exercises like push-ups or squats, can also increase your body's ability to manage glucose levels acutely. This has been found to occur for up to 24 hours after a single round of resistance training.
2. Secondly, chronic resistance training has been shown to improve glucose tolerance and uptake. What's interesting about this, and a crucial point, is that this improvement does not specifically occur due to increased fat-free mass, which is another factor. Rather, the physiological change to resistance-trained muscle seems to be a major mechanism as well¹.
3. Another important benefit of resistance training for diabetes is that it has been found to improve insulin sensitivity. Insulin sensitivity refers to how effectively your body uses insulin to lower your blood sugar levels. Improving sensitivity to insulin is ultimately your primary goal when treating diabetes. Remember that diabetes ultimately occurs from becoming resistant to insulin, meaning improving sensitivity reverses the condition. This means your body can handle spikes in sugar more efficiently and maintain healthy blood sugar levels. 

On the flip side, having diabetes and low levels of muscle mass can mean a greater chance of death. In a large historical cohort study, having low levels of muscle mass in men and women with diabetes proved to be independently associated with all-cause mortality².

This research concludes that increasing and preserving muscle mass is of utmost importance in persons with diabetes.

Related: What You Must Know About Muscle Hypertrophy

Diabetic Muscle Building Diet

You may think that you won't be able to build muscle due to the metabolic disorder. Or, you may think you must follow a special diet. However, this isn't necessarily so, at least in any extreme manner. 

One thing to remember is that even if a diabetic doesn't want to build muscle, they shouldn't just eat whatever they want. Their goal should be to control their blood sugar as best as possible through their diet. This same concept also applies when they're trying to build muscle. 

If there's a main difference between a person with diabetes building muscle and someone without, it would be that those with have less wiggle room and need to be more strict and compliant to mitigate adverse effects.

Here are three aspects to consider and follow:

1. Calculating Total Caloric Needs

For individuals with diabetes, managing caloric intake in relation to their Total Daily Energy Expenditure (TDEE) depends on their specific health goals, such as weight loss, maintenance, or muscle gain:

• Weight Loss: Eating below their TDEE can help reduce body fat. This is often beneficial as reducing body weight can improve insulin sensitivity and help better manage diabetes. A deficit of about 500 calories per day is typically recommended to lose about one pound per week, but it's important to ensure the diet remains balanced and nutrient-dense.
• Maintenance: Eating at their TDEE will help maintain current weight. This is appropriate for diabetics who are at a healthy weight and whose main goal is to manage blood glucose levels while maintaining muscle mass and overall health.
• Muscle Gain: Eating more than their TDEE can be useful for building muscle, provided the exercise regime supports muscle growth. Extra calories should come primarily from nutrient-rich foods to ensure blood sugar levels are still well-managed.

In all cases, the quality of the calories and the timing of meals are crucial to avoid spikes in blood glucose levels. Adjustments should be done carefully, ideally under the guidance of a healthcare provider or a dietitian who specializes in diabetes management.

Use this calculator to find your TDEE (total daily energy expenditure), which is essentially your maintenance level.

Once you know your TDEE and your define your target goal, you can decide on total calories per day which you’ll then use to determine your macros…

2. Macros

I’ll go into each macro briefly below, but here’s the main points to follow for your macro breakdown:

• Protein: 1.4-2.2 grams per kg of body weight.
• Fat: Aim for healthy fats, which should constitute roughly 25-35% of total caloric intake.
• Carbohydrates: Adjust the remainder of your calories to come from carbs, focusing on complex, fiber-rich sources.

Example: For a 180 lb individual targeting a 2,000 calorie diet, the nutritional breakdown would be approximately 540 calories from protein (135 grams), 603 calories from fats (67 grams), and 857 calories from carbohydrates (214 grams).

Macro Calculator

I'll provide some of the best examples for each of the three macros below.

Protein

When it comes to protein, there's no difference for a person putting on muscle mass if they do or don't have diabetes. However, you should still aim for healthy, lean sources. This includes:

• Chicken
• Eggs
• Lean Ground Beef
• Seafood
• Milk

That said, aim to eat 1.4-2.2 grams of protein per kilogram of body weight.

Fat

Fats are similar to proteins in that different fats don't necessarily have any direct effect on diabetes. However, you should still aim to eat healthy fats and stay away from stuff like trans fats. Eating trans fats ultimately means eating junk food, which is likely accompanied by ultra-high calories and excess carbs.

Therefore, concentrate monounsaturated and polyunsaturated fats. This means things like:

• Avocado
• Fatty fish
• Nuts
• Legumes

However, you should also eat some eggs to eliminate cholesterol and support hormone levels.

Further, a bit of saturated fat is also acceptable.

Carbs

Carbohydrates are a major concern for those building muscle with diabetes, as they are primarily responsible for causing large insulin spikes. Therefore, you should focus on healthy carbs, complex carbs, and fiber-rich foods. 

Further, you should aim to eat some protein along with your carbs, even if you're eating a complex carb. By combining them with protein, the carbohydrates will break down slower, resulting in a slower release of sugar.

There is much controversy surrounding the number of carbohydrates one should eat. Numerous studies have found that diabetics who eat less than 100 grams of carbohydrates see significant improvements. 

One interesting study found that individuals with type II diabetes whose diet consisted of no more than 26% carbohydrates had a 32% greater chance of achieving remission³. This would equate to 130g for a 2,000-calorie diet and 195g for a 3,000-calorie diet. 

Also keep in mind that fiber is your friend as a diabetic. Fiber has been found to be a great tool in a diabetics diet and including some in every meal can have tremendous effects on your blood sugar levels⁴.

Some great choices for carbs include:

• Quinoa
• Oats
• Berries
• Lentils
• Legumes
• Oatmeal
• Vegetables
• Nuts
• Leafy Greens

3. Frequent Meals

It's also recommended that diabetics eat more frequent, smaller meals throughout the day. Many bodybuilders do this anyway, so there's not much difference; just but just be sure you do if you have diabetes.

Doing so will limit your food intake during a single feeding, which ultimately means a lower spike in blood sugar. 

So, after you determine your total daily calorie and macro breakdown, split it into approx 4-6 meals (e.g. Breakfast, Snack, Lunch, Snack, Dinner). 

Sample 7-Day Meal Plan

Remember, your TDEE and macro breakdown will determine the quantities of the below meals.

Day 1:

• Breakfast: Scrambled eggs with spinach and mushrooms, whole-grain toast
• Lunch: Grilled chicken salad with mixed greens, cherry tomatoes, avocado, and vinaigrette
• Snack: Greek yogurt with a handful of berries
• Dinner: Baked salmon, quinoa, and steamed broccoli
• Snack: Almonds

Day 2:

• Breakfast: Oatmeal with sliced banana and a spoonful of peanut butter
• Lunch: Turkey and cheese sandwich on whole-grain bread, side of carrot sticks
• Snack: Cottage cheese with pineapple chunks
• Dinner: Stir-fried tofu with mixed vegetables over brown rice
• Snack: Hard-boiled egg

Day 3:

• Breakfast: Protein smoothie with whey protein, almond milk, and mixed berries
• Lunch: Beef stir-fry with bell peppers and snow peas, served with wild rice
• Snack: Apple slices with almond butter
• Dinner: Grilled shrimp with a quinoa salad (quinoa, cucumber, tomatoes, feta cheese)
• Snack: A small handful of walnuts

Day 4:

• Breakfast: Greek yogurt with granola and honey
• Lunch: Chicken Caesar salad with romaine lettuce, Parmesan cheese, and whole-grain croutons
• Snack: Mixed nuts
• Dinner: Pork chops with sweet potato mash and green beans
• Snack: Protein shake

Day 5:

• Breakfast: Two poached eggs on whole-grain toast with avocado slices
• Lunch: Tuna salad stuffed in whole-wheat pita bread
• Snack: Hummus with sliced bell peppers and celery
• Dinner: Grilled chicken breast with farro and roasted Brussels sprouts
• Snack: Greek yogurt

Day 6:

• Breakfast: Cottage cheese with sliced peaches and a sprinkle of flax seeds
• Lunch: Quinoa and black bean stuffed bell peppers
• Snack: A piece of dark chocolate and a small orange
• Dinner: Baked cod with a side of asparagus and a small baked potato
• Snack: A few slices of smoked salmon

Day 7:

• Breakfast: Smoothie with spinach, protein powder, a banana, and a tablespoon of flaxseed
• Lunch: Roast beef wrap with whole-grain tortilla, lettuce, and mustard
• Snack: A pear with a handful of cashews
• Dinner: Turkey meatballs with spaghetti squash and marinara sauce
• Snack: Cottage cheese with a few raspberries

Tips for Managing Blood Sugar:

• Monitor carbohydrate intake: Keep track of the carbs in each meal and snack to manage blood sugar levels effectively.
• Regular meals: Eat at regular times to prevent spikes and drops in blood sugar.
• Portion control: Ensure portion sizes align with dietary needs to maintain energy levels and muscle growth without excess calorie intake.

Note: This meal plan is just a sample and may need adjustments based on individual dietary needs, preferences, and medical advice from a healthcare provider. Always consult with a healthcare professional before making significant changes to your diet, especially if managing a condition like diabetes.

FAQs:

Should I eat before working out?

Having a meal before a workout can help fuel your entire workout, ultimately leading to more muscle mass. If you have diabetes, you should follow a few guidelines. 

The first is that you should check your blood sugar 30-60 minutes before you plan to start training. Knowing your levels will help you determine how to proceed, if you need to eat prior and/or you need to take insulin. This will entirely determine your case. 

If you choose to take a little food before you train, be sure to pair it with some protein. For example, you could eat a banana with some peanut butter. The protein and fats will help slow down the digestion of the carbs, resulting in a lower spike in blood sugar.

How does working out affect my blood sugar?

Not all types of resistance training affect blood sugar levels in the same manner. Cardio training, or even circuit training, that keeps an elevated heart rate, will probably cause your blood sugar levels to drop some.

Now, this may come as a surprise, but resistance training can cause a temporary increase in blood sugar levels⁵. When your body experiences high-intensity exercises like weight training and sprints, it releases hormones, primarily adrenaline, which causes an increase in blood glucose levels. However, an increase in lactic acid can also cause an increase. 

I should note that this occurs in both those with diabetes and those who don't. Further, this is a temporary increase in resting blood sugar levels, not a chronic increase. 

This is important to consider before going to the gym. Many diabetics on insulin still like to eat before they hit the gym. If you do cardio, you may want to decrease your insulin dose as you don't want to cause a low. On the other hand, if you're performing resistance training, you may not want to adjust your insulin dose.

Either way, this is highly personable, and everyone can react differently. I can't stress enough: you must take extra precautions when first seeing how your body reacts. When you first start, you should do some experiments to see how your body reacts and always check with your doctor.

When Should I Check My Blood Sugar?

Always be aware of your blood sugar levels. It's generally recommended that you always check before meals and then 1-2 hours after meals. You should also check before you go to bed. 

When you are training, you should check before and after you train.

Is Building Muscle With Diabetes Hard?

Building muscle with diabetes doesn't need to be overly complicated; you'll just need to be more calculating and strict with your diet. Further, you'll need to be consistent with checking your blood sugar levels. However, keep in mind this is true when you first start training; this is the hardest part. From here, managing your blood sugar levels will become easier and easier, and eventually, you'll have a good chance of going into remission!

Related:

• Meal Plans
• Workout Plans

Understanding Diabetes Better

Diabetes is a metabolic disorder in which the body stops responding to insulin or stops producing it altogether. Insulin is a hormone secreted by the pancreas that helps to control blood sugar levels. 

Upon eating a meal, the food is broken down and ultimately releases a surplus of glucose (sugar) into the blood, causing high blood sugar. To keep blood sugar levels healthy, insulin is released, which promotes glucose uptake into the muscles, where it's stored as glycogen. This glycogen is the primary fuel for your muscles during exercise, making insulin a crucial player in the diabetic muscle-building diet. 

WIth that said, there are two types of diabetes:

• Type I diabetes is an autoimmune disorder caused by genetic factors, meaning you're born with it. This occurs as your body actually doesn't produce insulin.
• Type II diabetes is a chronic disease that occurs over time due to overeating, obesity, and inactivity. In type II diabetes, your pancreas will still produce insulin, but the body stops reacting.

In either condition, the result is generally the same: consistently elevated blood sugar levels. However, low blood sugar levels can also be a possibility, generally caused by the use of insulin. Regardless, the overarching theme is that the body loses its ability to properly control the glucose level in your blood.

Prediabetics and Non-Diabetics

If you have prediabetes, which is defined as blood sugar levels consistently above normal but not high enough to be diabetes (100 to 125 mg/dL), this is even more important!

That's because prediabetes can be relatively easy to reverse by making some lifestyle changes. This includes adopting a healthy diabetic diet and increasing physical activity.

If you don't have diabetes, you want to follow a lifestyle that will keep it that way. Again, this includes following a healthy diabetic diet while increasing physical activity. However, putting on muscle mass is very important and has a specific benefit to keeping diabetes away. 

We usually associate diabetes with high body fat levels, and rightfully so. Yet, diabetes research has now discovered that low levels of muscle mass, even when at a "healthy" weight, can be just as dangerous⁶. On the same note, having greater levels of muscle mass results in lower incidence of diabetes⁷. 

But it gets worse!

The reason is that about 75% of your glycogen is stored in your muscle mass—well, if you have enough muscle. Low muscle mass simply decreases your body's ability to store glycogen, which can also result in consistently elevated blood glucose levels.

Risks Of Diabetes

Mismanaged diabetes can cause a host of very serious issues. Some of these can occur acutely from a sugar high or low, while others occur over time through chronic mismanagement.

This can include⁸:

• Dizziness
• Confusion
• Eye Damage
• Foot Damage
• Nerve Damage
• Kidney Disease
• Heart Disease
• Coma
• Death 

Diabetes has become so prevalent in our population that we sometimes forget how serious of a condition this is. Even though we can 'manage' it with medication, this doesn't take away from the sense of control and responsibility that comes with managing it through diet and exercise.

It's crucial to understand that this condition is a significant part of your life, but with the right approach, you can take control and manage it effectively.

Wrap Up:

In conclusion, while diabetes presents its challenges, it's clear that building muscle and maintaining an active lifestyle can profoundly impact your health and quality of life. By staying informed, committed to your health goals, and vigilant about your body's responses, you can manage diabetes more effectively. Remember, each step towards a stronger, healthier body is a step away from the complications of diabetes. Embrace the journey, and let the strength you build be your greatest ally in the fight against diabetes.

References:

1. Tresierras, M. A., & Balady, G. J. (2009). Resistance Training in the Treatment of Diabetes and Obesity. Journal of Cardiopulmonary Rehabilitation and Prevention, 29(2), 67–75. https://ift.tt/9wIXm7j ‌
2. Miyake, H., Kanazawa, I., Tanaka, K., & Sugimoto, T. (2019). Low skeletal muscle mass is associated with the risk of all-cause mortality in patients with type 2 diabetes mellitus. Therapeutic Advances in Endocrinology and Metabolism, 10, 204201881984297. https://ift.tt/EJSgAy1 ‌
3. Goldenberg, J. Z., Day, A., Brinkworth, G. D., Sato, J., Yamada, S., Jönsson, T., Beardsley, J., Johnson, J. A., Thabane, L., & Johnston, B. C. (2021). Efficacy and safety of low and very low carbohydrate diets for type 2 diabetes remission: systematic review and meta-analysis of published and unpublished randomized trial data. BMJ, 372(372), m4743. ‌
4. CDC. (2024, May 13). Fiber: The Carb That Helps You Manage Diabetes. Diabetes. https://ift.tt/Vsd0bqf ‌
5. American Diabetes Association. (n.d.). Why Does Exercise Sometimes Raise Blood Glucose | ADA. Diabetes.org. https://ift.tt/YIqwvuR ‌
6. Son, J. W., Lee, S. S., Kim, S. R., Yoo, S. J., Cha, B. Y., Son, H. Y., & Cho, N. H. (2017). Low muscle mass and risk of type 2 diabetes in middle-aged and older adults: findings from the KoGES. Diabetologia, 60(5), 865–872. https://ift.tt/mOis4hv ‌
7. Hong, S., Chang, Y., Jung, H.-S., Yun, K. E., Shin, H., & Ryu, S. (2017). Relative muscle mass and the risk of incident type 2 diabetes: A cohort study. PLOS ONE, 12(11), e0188650. https://ift.tt/h0NIAZ1 ‌
8. Diabetes Complications and Risks. (n.d.). Www.heart.org. https://ift.tt/mdBOwJv