Future of muscle research in diabetes: a look into the crystal ball

In type 2 diabetes, skeletal muscle is not only responsible for early metabolic abnormalities, but its contractile activity also offers an efficient prevention and treatment strategy. This outlook into the coming decades summarises challenges and opportunities for translational research on skeletal muscle in diabetes and related diseases. Currently, our understanding of the interactions between myocellular networks, the master regulators of resting metabolism, and muscle’s position within multi-organ crosstalk, is incomplete. In the face of an ageing population, changes within muscle tissue appear to be the predominant mechanisms responsible for sarcopenia, but the relative roles of obesity and ageing as driving forces of its development are less clear. To address these research questions, innovative approaches to optimising exercise training or minimising sedentarism will need to be devised and tested in large-scale standardised prospective studies. Finally, another major challenge will be the identification and evaluation of muscle targets to prevent and treat metabolic diseases. This is one of a series of commentaries under the banner ‘50 years forward’, giving personal opinions on future perspectives in diabetes, to celebrate the 50th anniversary of Diabetologia (1965–2015).