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Skeletal muscle plays a major role in glucose uptake and insulin sensitivity. Subtle structural changes in muscle may be early physical signs of metabolic dysfunction, showing up before blood tests or symptoms raise red flags. The fact that these patterns differ by s*x also highlights that diabetes doesn’t remodel the body the same way in everyone.

Most people think of muscle health in terms of size or strength. New imaging research suggests shape might matter just as much. It could be quietly reflecting metabolic health.

A new study presented by the Radiological Society of North America used advanced MRI techniques to analyze the gluteus maximus (yes, the butt muscle) in over 61,000 people from the UK Biobank.

Instead of measuring muscle volume alone, researchers created detailed 3D maps of muscle shape and compared those patterns with lifestyle data, physical performance, and disease status.

People with type 2 diabetes showed distinct changes in the shape of the gluteus maximus, and those changes differed between men and women. In men with diabetes, the muscle tended to shrink.

In women, the muscle often appeared large. But not because it was stronger, but because fat had infiltrated the muscle tissue, altering its contours without improving function.

These shape differences weren’t random. More physically active individuals, especially those engaging in vigorous movement and showing higher grip strength, tended to have healthier muscle shapes.

Age, frailty, and prolonged sitting were associated with muscle thinning and unfavorable shape changes.