Your Butt May Reveal Your Diabetes Risk

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A new imaging study suggests that the size and shape of the gluteus maximus — the large muscle that forms your butt — could provide early clues about metabolic health and even reveal that you’re at risk of developing type 2 diabetes before symptoms appear.

In a study presented at the annual meeting of the Radiological Society of North America, researchers identified structural changes in the gluteus maximus muscle associated with type 2 diabetes.

Diabetic men showed areas of localized muscle thinning, while women showed an outward bulging of the muscle, likely due to fat accumulation between or within the muscle fibers.

“We found that the size and shape of the gluteal muscles varies with age, physical activity, frailty, osteoporosis and type 2 diabetes,” says lead author Marjola Thanaj, PhD, a senior researcher at the University of Westminster in London.

The results suggest that the gluteus maximus may be a good indicator of metabolic health, adds Dr. Thanaj.

Researchers scanned people’s butts with MRI machines

The research team used an MRI technique called 3D statistical shape analysis, which allows scientists to create highly detailed models of muscle structure rather than just measuring volume or fat content.

Using data from more than 61,000 MRI scans, investigators explored how 86 different factors, including age, physical activity, biomarkers, lifestyle habits and health conditions, were linked to subtle changes in the gluteus max.

The researchers quantified these changes using “surface-to-surface distance,” a measurement of whether a given muscle area bulges outward or shrinks inward relative to a sex-specific pattern.

This approach allowed them to determine exactly where the muscle was changing and how these patterns differed across health conditions.

Changes in the buttocks were different in men and women with diabetes

Researchers have discovered key differences between the buttocks of men and women with type 2 diabetes:

In men, 3D MRI mapping showed very specific small “dips” or indentations in the gluteus maximus muscle – a sign that certain areas of the muscle are thinning. Rather than shrinking the entire muscle, these changes appeared in targeted locations, which the researchers said is typical of early muscle atrophy. “These localized areas where the muscle dips inward likely reflect regional atrophy,” says Thanaj. They can be early indicators of metabolic dysfunction, he adds.
In women, the pattern was completely different. Instead of getting thinner, women showed small pockets where the muscle appeared to bulge outwards.
These outward curves correspond to an accumulation of fat inside the muscle – sometimes called fatty infiltration or “fat hypertrophy” – which can occur when muscle tissue is gradually replaced by fat.

“These opposing signatures indicate that the same disease manifests differently in male and female muscles,” says Thanaj. The study suggests that men are more likely to lose muscle tissue in certain areas, while women are more likely to accumulate fat in muscles.

Why muscle impacts diabetes risk

The risk of type 2 diabetes increases steadily as people age and become less active, lose muscle mass and accumulate fat.

All of these changes contribute to insulin resistance, which is when cells stop responding effectively to insulin. As this resistance increases, blood sugar (sugar) rises, ultimately leading to diabetes.

Over time, insulin resistance itself contributes to muscle change, intensifying the metabolic cycle that leads to type 2 diabetes.

The gluteus maximus is the largest muscle in the body and a major metabolic driver. Because it plays a major role in the body’s ability to use glucose, structural changes can be a sign of metabolic problems.

“I think this study is a reminder that muscle mass is essential for metabolic health,” says Marilyn Tan, MD, associate professor of medicine and endocrinologist at Stanford Health Care in California, who was not involved in the study.

“It would be interesting to see how the gluteus maximus changes in people with better or worse blood sugar control or whether other chronic illnesses impact the muscle in the same way,” adds Richard Marottoli, MD, a geriatrician at Yale Medicine in New Haven, Connecticut, who was not involved in the study.

Strong glute muscles can help prevent diabetes

The key message is that a strong glute can help you avoid diabetes, so make the effort, says Thanaj.

“Maintaining strong, well-conditioned gluteal muscles appears to protect against future risk of type 2 diabetes, while early structural changes, particularly increased intramuscular fat, may signal emerging metabolic dysfunction,” she says.

If you want to strengthen your butt – and potentially reduce your risk of diabetes – reducing the time you spend sitting, maintaining a healthy weight and exercising regularly can help.

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