In diabetes, most people focus on sugar.

Few realise that one of the hidden drivers of rising blood sugar may be the gradual loss of muscle.

Yet growing evidence suggests that declining muscle mass may be one of the hidden drivers of insulin resistance and type 2 diabetes.

Interestingly, this concept is not entirely new. In Traditional Chinese Medicine (TCM), the Spleen has long been regarded as the organ that governs both muscle health and metabolic function.

Today, modern science and TCM are beginning to converge on the same idea: healthy muscles are essential for healthy ageing and blood sugar control.
 

Muscle: Your Body's Ultimate Sugar "Sink"

Every time we eat, glucose enters the bloodstream and must be transported into cells to be used for energy.

One of the largest destinations for this glucose is skeletal muscle.

Think of muscle as a metabolic sponge. After a meal, healthy muscles absorb glucose from the bloodstream and store it for future use. The more healthy muscle we have, the greater our capacity to clear excess sugar from the blood.

In healthy individuals, muscle acts like a powerful "sink", absorbing and storing excess glucose from the bloodstream under the action of insulin.

Healthy muscle tissue helps:

• remove glucose from the bloodstream
• improve insulin sensitivity
• reduce the risk of insulin resistance

When muscle mass declines due to ageing, inactivity, poor nutrition, or chronic illness, the body's ability to regulate blood sugar may also deteriorate.

This may manifest as:

• rising fasting blood sugar
• poor exercise tolerance
• worsening blood sugar control
• increased risk of developing type 2 diabetes

That is why two individuals of the same weight can have very different metabolic profiles affected by their muscle mass.

One may have healthy muscle mass and good insulin sensitivity.

The other may have less muscle mass, poorer glucose utilisation, and a higher risk of developing metabolic disease.

The Spleen–Muscle Axis in TCM

In TCM, the Spleen governs transformation and transportation (脾主运化), governs the muscles and limbs (脾主肌肉四肢), and is regarded as the source of Qi and Blood production (气血生化之源).

Healthy muscles depend on a continuous supply of nutrients, Qi, and Blood generated by the Spleen and Stomach.

When Spleen function is strong, nutrients are effectively transformed and distributed throughout the body. The muscles receive adequate nourishment, energy levels remain stable, and physical strength is maintained.

However, when Spleen function weakens, nutrient transformation becomes less efficient. Over time, the muscles may become undernourished, leading to fatigue, weakness, reduced exercise capacity, and gradual loss of muscle mass.

Prolonged Spleen deficiency may also contribute to dampness accumulation, weight gain, poor glycaemic control, and an increased susceptibility to diabetes and its complications.

This highlights an important reality:

blood sugar control is not only about reducing sugar intake. Maintaining enough healthy muscle tissue helps to effectively absorb and utilise glucose.

Practical Ways to Strengthen the Spleen–Muscle Axis

Improving metabolic health should involve preserving and building muscle throughout life.

Helpful habits include:

• engaging in regular resistance training
• maintaining adequate protein intake
• staying physically active throughout the day
• prioritising quality sleep
• avoiding prolonged sedentary behaviour

In addition, several TCM herbs and foods have traditionally been used to strengthen Spleen Qi and support muscle nourishment:

• Astragalus (黄芪) — supports Qi production, strengthens the Spleen and physical vitality
• Chinese Yam (山药) — strengthens the Spleen and aids gut health
• Solomon's Seal Rhizome (黄精) — strengthens the Spleen and Kidney
• Poria (茯苓) — strengthens the Spleen and improves fluid metabolism

Closing Insight

Most people think diabetes prevention begins with eating less sugar.

Yet an equally important strategy may be preserving the very tissue that helps remove sugar from the bloodstream.

In both modern medicine and TCM, healthy muscles are more than a source of strength and mobility—they are a cornerstone of metabolic resilience.

By protecting our muscles through exercise, nutrition, and healthy Spleen function, we may be able to improve blood sugar regulation, support diabetes prevention and management, and maintain vitality as we age.