Table 1.

Summary of the leading mechanisms by which non-pharmacologic intervention may affect skeletal muscle health in T2D.

Type of Intervention	Possible Positive Effects on Skeletal Muscle	Possible Detrimental Effects on Skeletal Muscle	Overall Effect
Protein supplementation	Attenuates myofibrillar catabolism	-	Prevent sarcopenia
Vitamin D supplementation	Improve insulin sensitivity	-	Prevent sarcopenia
	Boost testosterone synthesis
	Boost myokine synthesis (e.g., irisin)
Diets	Insulin-sensitizing effect	Impairment of testosterone synthesis (low-fat diets, intermittent fasting protocols, vegetable-based diets)	Prevent sarcopenia
	Improve glucose utilization
	Reduce systemic inflammation
	Prevent muscle steatosis
	Induce weight loss
	(Facilitate adherence and resistance to physical exercise)
Physical exercise (high-intensity more than low-to-moderate intensity)	Insulin-sensitizing effect	-	Improve muscle mass and strength
	Improve glucose utilization
	Prevent muscle steatosis
	Induce weight loss
	Boost testosterone synthesis
	Boost myokine synthesis
	Increase myofibrillar synthesis
	Reduce myofibrillar catabolism