(HealthDay News) — For patients with type 2 diabetes, proximal and distal leg muscle strength is reduced, and proximal but not distal muscle volume is also reduced, according to a study published in Diabetes Care.

Monirah M. Almurdhi, from the Manchester Academic Health Science Center in the United Kingdom, and colleagues matched 20 patients with type 2 diabetes and 20 healthy controls by age, sex, and body mass index. The researchers examined the strength and size of knee extensor, flexor, and ankle plantar and dorsiflexor muscles in relation to the severity of diabetes sensorimotor polyneuropathy, amount of intramuscular noncontractile tissue (IMNCT), and serum 25-hydroxyvitamin D levels.

The researchers found that patients with type 2 diabetes had significantly reduced knee extensor strength (P=.003) and reduced muscle volume of knee extensors and flexors (P=.045 and .019, respectively) compared with controls. They also had a reduction in ankle plantar flexor strength (P=.001), but no reduction in ankle plantar flexor and dorsiflexor muscle volumes (P=.23 and .45, respectively). 

There was a significant increase in IMNCT in the ankle plantar and dorsiflexors (P=.006 and .005, respectively).

“Patients with [type 2 diabetes] have a significant reduction in proximal and distal leg muscle strength and a proximal but not distal reduction in muscle volume possibly due to greater intramuscular fat accumulation in distal muscles,” the researchers wrote.


  1. Almurdhi MM, Reeves ND, Bowling FL, Boulton AJM, Jeziorska M, Malik RA. Reduced Lower-Limb Muscle Strength and Volume in Patients With Type 2 Diabetes in Relation to Neuropathy, Intramuscular Fat, and Vitamin D Levels. Diabetes Care. 2016;doi:10.2337/dc15-0995.