The Truth about your Muscle for Type 2 Diabetes
Estimated reading time: 4 minutes
Introduction
Type 2 diabetes is often viewed as a condition of “high sugar” or “too many carbs.” But when you step back, diabetes is far more complex: it’s an inflammatory condition, a cardiovascular risk equivalent, and a metabolic imbalance that involves multiple organ systems.
This past week, I had the privilege of sitting with a gentleman in his mid-50s whose story captures so much of what patients with long-standing diabetes face — frustration, confusion, and the feeling that more medications are the only answer.
His journey reminded me why diabetes care isn’t just about medications. It’s about connecting the dots, using science-based strategies, and empowering patients to truly understand what’s happening in their bodies.
His Story: “I Thought I Was Doing Fine”
This gentleman came to me with a long history of type 2 diabetes, managed within one of the large healthcare systems in California. Over the years, he had been prescribed:
Multiple diabetes medications,
A long-acting nightly insulin, and
A GLP-1 receptor agonist (Ozempic).
Despite all of this, his A1C remained stubbornly high — between 8–9%, which translates to an average blood sugar of 180–210 mg/dL over the last 3–4 months.
When we spoke, he told me his fasting blood sugars were usually between 130–150, which reassured him that “things weren’t too bad.” But this reassurance was misleading.
He also shared that he had started working with a personal trainer and doing physical therapy, and he had seen some weight loss. With Ozempic, his appetite was significantly reduced — to the point that he had told his primary care physician: “Please don’t increase the dose, because then I won’t eat at all.”
On the surface, it seemed like he was doing “everything right.” But his A1C told us there was more beneath the surface.
The Gaps in His Care
During our conversation, a few things became clear:
Fasting glucose doesn’t tell the whole story.
His morning numbers looked decent only because of the large dose of long-acting insulin he was taking at night. What wasn’t being captured were the spikes happening after meals and throughout the day — the very spikes raising his A1C.The A1C is more than just a number.
An A1C of 8–9% means his blood sugars were frequently in ranges that silently damage blood vessels and organs. He wasn’t feeling obvious symptoms — but his body certainly was.Medications weren’t fixing the root problem.
Despite being on insulin and a GLP-1, his sugars weren’t in control. That’s because the real missing piece wasn’t just about appetite or insulin — it was about his muscle health.
The Science: Why Muscle is Medicine
Here’s where the conversation shifted.
I asked him: “Do you know which organ in your body can take up glucose without depending on insulin?”
It isn’t the fat.
It isn’t the liver.
It isn’t even the brain or the heart.
It’s muscle.
Every time we contract our muscles — through walking, resistance training, or even daily physical activity — our muscle fibers act like sponges, pulling glucose out of the bloodstream. More healthy muscle mass = more capacity to store and use glucose effectively.
This process directly improves insulin sensitivity and reduces circulating glucose levels. In other words: muscle is an endocrine organ, and movement is one of the most powerful medicines for diabetes.
My Plan for Him
Instead of increasing medications, here’s what we did together:
Reduced his insulin dose. Adding more insulin wasn’t the answer — it was masking the real issue.
Introduced strength-focused activity. I created a realistic protocol for him to begin engaging his muscles without feeling like he had to “live in the gym.”
Reviewed nutrition to fuel muscles. We discussed protein, hydration, and how to feed his body so the muscles could work as metabolic allies.
Introduced Continuous Glucose Monitoring (CGM). Instead of pricking his finger once a day and missing the real story, I educated him on CGM. Even though he hesitated about wearing a sensor on his arm, he agreed to trial it — with the understanding that education and training would help him interpret the numbers in real time.
This wasn’t about overwhelming him with tasks. It was about empowering him with tools to finally understand his body, instead of being at the mercy of medications and confusing lab reports.
Why This Matters for All Patients
So many people with long-standing type 2 diabetes believe they are “stuck.” They assume:
They’ll be on insulin forever.
They have no choice but to keep increasing medications.
The best they can hope for is “not getting worse.”
But this isn’t true.
When you address the root causes — muscle health, insulin resistance, nutrition, and lifestyle patterns — the picture can change dramatically. Medications can still play an important role, but they work best when layered onto a strong foundation of education and lifestyle support.
Looking Ahead
For this gentleman, the real transformation begins now — not with more prescriptions, but with a strategy that builds resilience, strength, and confidence.
In a year, I don’t just want to see a lower A1C. I want him to know why his numbers are better. I want him to experience energy, strength, and freedom — so that his health is no longer a daily source of anxiety, but a foundation for living fully.
Key Takeaways
An A1C of 8–9% may not cause symptoms, but it silently damages the body.
Fasting glucose alone can be misleading if you’re on insulin.
Muscle is the only organ that can use glucose without insulin, and building muscle improves insulin sensitivity.
Education + lifestyle + smart use of medications = transformation.
Final Thoughts
Type 2 diabetes is not a life sentence of insulin injections or endless medications. With the right guidance, patients can:
✔️ Reduce medications
✔️ Improve blood sugar control
✔️ Prevent complications
✔️ Reclaim their vitality
As an endocrinologist, my mission is to provide that clarity, connect the dots, and walk alongside patients as they transform their health.
📌 If you or someone you know is struggling with diabetes or midlife metabolic changes, share this story with them.
And if you’re ready for clarity and support, I’d be honored to guide you.
Who Is Dr. Chhaya Makhija and What Is Unified Endocrine & Diabetes Care?
Dr. Makhija is a pioneer of direct specialty endocrine and lifestyle medicine care in California, with offices in the San Francisco Bay Area - Lafayette and Fresno serving patients via telemedicine throughout the state of California. She combines deep clinical expertise with personalized lifestyle coaching for managing diabetes, thyroid disorders, metabolic syndrome, and women’s health. Her patient-centered boutique concierge practice prioritizes education, timely access, and comprehensive, individualized care.
How Can Patients Connect With Dr. Makhija?
For ongoing guidance and support: