Grip Strength and Diabetes: What You Need to Know
"New research sheds light on the connection between muscle strength and the risk of developing type 2 diabetes. Is your grip a sign of your health?"
Type 2 diabetes mellitus (T2DM) is a major public health concern, with cases rising globally. While the link between obesity and T2DM is well-established, the connection between body composition, muscle performance, and diabetes risk is more complex. Understanding this relationship could provide new strategies for prevention and management.
Previous research has suggested that low grip strength might be associated with prevalent T2DM and pre-diabetes, leading some to propose it as a marker for identifying at-risk individuals. However, conflicting results from various studies have created uncertainty about this association. Some studies suggest the association is more pronounced in specific groups. This has fueled ongoing research to clarify whether grip strength can truly predict the development of T2DM, especially in generally healthy individuals.
A recent study published in Diabetes Research and Clinical Practice investigated the predictive value of grip strength on the incidence of T2DM in healthy adults aged 50-75 years. This prospective, population-based study, known as the CoLaus study, followed participants over several years to determine if baseline grip strength could forecast the development of diabetes.
Grip Strength and Diabetes Risk
Research has examined grip strength as a marker associated with type 2 diabetes mellitus (T2DM), although its prognostic value has not been consistent across studies. A Korean cross-sectional study investigated relative grip strength, body mass index, and T2DM prevalence among 2,811 men and women. Longitudinal research has also assessed grip strength at ages 53, 60–64, and 69 in relation to prediabetes or diabetes defined using HbA1c and doctor diagnosis. More recent work is examining whether grip strength reflects the accumulation of complications measured by the Diabetes Complications Severity Index (DCSI).
Simple Testing, Limited Interpretation
Grip strength assessment is described as a simple and inexpensive method that could help identify muscle weakness and people at higher risk of developing T2DM. Studies distinguish between absolute grip strength, measured in kilograms, and relative grip strength, expressed in relation to body weight. Associations with diabetes risk have been reported as stronger when grip strength is expressed relative to body weight, which may reflect the importance of muscle quality. However, proposed diabetes-risk cut points and the relative value of muscle strength versus muscle mass remain active areas of investigation.
From Association to Longitudinal Evidence
Early cross-sectional studies suggested a relationship between diabetes status and weaker grip strength in adulthood. Later research began examining changes in grip strength over time, including trajectories measured at ages 53, 60–64, and 69. Investigators also evaluated both absolute and relative handgrip strength in relation to incident T2DM, reflecting uncertainty about which measure has greater prognostic value. U.S. research published in 2020 further explored muscular-strength cut points for identifying diabetes risk.
Does Grip Strength Really Predict Diabetes Risk?
The CoLaus study involved 2,318 participants initially free from T2DM. Baseline grip strength was measured using a handheld dynamometer, and participants were followed for an average of 5.5 years, with a second follow-up after 10.7 years. The study aimed to determine if grip strength at the beginning of the study could predict who would develop T2DM.
- Age and Sex: When adjusted for age and sex, the association between grip strength and incident T2DM became negative.
- BMI: Further adjustment for body mass index (BMI) reinforced the negative association.
- Diabetes Risk Scores: Incorporating established diabetes risk scores eliminated any significant association between grip strength and the development of T2DM.
Evidence From Reviews
A systematic review and meta-analysis of observational cohort studies included 10 unique studies, 177,826 participants, and more than 5,167 T2D cases. Another systematic review and meta-analysis examined cardiorespiratory fitness, muscular strength, and type 2 diabetes risk, with several reported estimates below 1.0. A broader review of 94 cohort studies found that a 5 kg increase in handgrip strength was associated with a lower risk of developing most of the long-term health conditions assessed. These findings support grip strength as a potentially useful health-risk indicator, but they come primarily from observational evidence.
Evidence Is Not Uniform
Not all studies have found that grip strength predicts new-onset T2DM. In the CoLaus study, 131 additional T2DM cases, representing 7.3% of participants, were identified after 10.7 years of follow-up, but grip strength was not associated with incident T2DM in either bivariate or multivariable analysis. The authors suggested that the study may have lacked statistical power. In a European survey of health, ageing, and retirement, only 62.6% of the initial cohort was included, leaving a relatively small sample of 2,318 participants and creating an important limitation.
Diabetes and Control Comparisons
Comparative studies generally evaluate grip strength in people with diabetes against healthy controls or compare groups within diabetes populations. A reported meta-analysis of studies published between 1990 and 2017 found significantly lower grip strength, pinch strength, hand function, and dexterity in people with T2DM than in healthy controls, in both dominant and nondominant hands. A separate study of 100 people with T2DM divided participants according to HbA1c into controlled and uncontrolled groups, using 6.5%–9% and above 9% as the respective ranges. In a dialysis population, grip strength was significantly lower among patients with hemoglobin below 10 g/dL, while no significant association was reported with diabetic status.
What Does This Mean for You?
The CoLaus study suggests that grip strength alone may not be a reliable predictor of T2DM in healthy, non-elderly adults. While maintaining muscle strength is undoubtedly beneficial for overall health, it might not directly translate into a reduced risk of developing diabetes. Instead, factors like age, sex, BMI, and comprehensive risk scores appear to be more influential in predicting T2DM. Further research is needed to fully understand the interplay between muscle strength and diabetes risk, particularly in younger cohorts.
Toward Risk Stratification
Recent work is connecting grip strength with sarcopenia, insulin resistance, triglyceride-glucose index, obesity, and age-related changes in body composition. A 2024 report describes the increase in T2DM among older adults in the context of sarcopenia, obesity, and insulin resistance. A 2025 study of 1,935 adults aged 51 to 81 followed participants for an average of 6.5 years while examining absolute and relative grip strength in relation to metabolic syndrome and diabetes risk. Research has also evaluated receiver operating characteristic curves for absolute and relative handgrip strength to detect incident T2DM in both sexes.
A Broader Diabetes Biomarker
Grip strength is being studied not only as a diabetes-risk indicator but also as a marker of complications and overall health. Research comparing grip strength with muscle mass reports that grip strength showed broader and stronger associations across complication-related outcomes in diabetes. This suggests that grip strength may provide more effective information about overall health and complication risk than muscle mass alone. The finding comes from a study focused on incident complications in patients with type 2 diabetes and should be interpreted within that clinical context.