A 6-month study of 48 patients with type 2 diabetes found that a supplement containing HMB increased muscle mass in 58% of participants, but the gains were small and not statistically significant. According to Gram Research analysis, younger patients and those with lower triglyceride levels saw better results, though individual responses varied widely. The research suggests HMB may help some people maintain muscle, but larger studies are needed to confirm effectiveness.
Researchers studied whether a supplement called HMB could help people with type 2 diabetes build muscle while losing fat. They gave 48 patients with diabetes and fatty liver disease this supplement for 6 months and measured their muscle mass using special scanning equipment. About 58% of patients gained some muscle, but the gains were small and varied widely between people. Younger patients and those with lower triglyceride levels (a type of blood fat) saw better results. While the supplement appeared safe, the study was too small to prove it really works, and researchers say larger studies are needed.
Key Statistics
A cross-sectional study of 48 patients with type 2 diabetes found that 58% gained some muscle mass after 6 months of HMB supplementation, with only 4 patients (8%) gaining more than 10% of their original muscle mass.
In a 2026 study of 48 diabetic patients, younger age and lower triglyceride levels predicted better muscle gain response to HMB supplements, with age showing a negative correlation (r = -0.39, p = 0.05) and triglycerides showing a negative correlation (r = -0.41, p = 0.04).
A 6-month HMB supplementation trial in 48 patients with type 2 diabetes and fatty liver disease showed muscle changes that did not reach statistical significance, with the study authors concluding the results were negative despite individual patient variation.
The Quick Take
- What they studied: Whether a dietary supplement containing HMB (a compound that may help build muscle) could increase muscle mass in people with type 2 diabetes who also have fatty liver disease and excess body fat.
- Who participated: 48 patients with type 2 diabetes, mostly women, with an average age of 72 years. All had fatty liver disease and were overweight. Researchers compared them to 20 healthy people of similar age without diabetes or liver problems.
- Key finding: After 6 months, 28 out of 48 patients (58%) gained some muscle mass. However, the gains were modest: 16 patients gained up to 5% of their original muscle, 8 gained more than 5%, and only 4 gained more than 10%. The other 20 patients lost a small amount of muscle. These changes were not large enough to be statistically significant.
- What it means for you: HMB supplements may help some people maintain or slightly increase muscle, but results are unpredictable and often small. Age and blood fat levels appear to influence who benefits most. This research is preliminary, and you should consult your doctor before starting any supplement, especially if you have diabetes or liver disease.
The Research Details
This was a cross-sectional study, meaning researchers took a snapshot of patients at one point in time rather than following them over many years. Researchers enrolled 48 patients with type 2 diabetes who were overweight and had fatty liver disease. All patients received a diabetes-specific dietary supplement containing HMB for 6 months. Before and after treatment, researchers used a special scanning machine called densitometry to measure exactly how much muscle and fat each person had. They also measured blood markers like hemoglobin A1c (which shows long-term blood sugar control), C-peptide (which shows how much insulin the body is making), and triglycerides (a type of fat in the blood). The researchers looked for patterns between muscle gain and these various measurements to see if any factors could predict who would benefit most from the supplement.
Understanding which patients benefit from muscle-building supplements is important because people with diabetes often lose muscle as they age, even when they are overweight. This combination, called sarcopenic obesity (weak muscles with excess fat), makes it harder to stay active and control blood sugar. If researchers can identify which patients will respond well to supplements, doctors could target treatment more effectively. However, this study’s small size and snapshot design mean the findings are preliminary and need confirmation with larger, longer studies.
This study has several limitations that readers should understand. First, it included only 48 patients, which is a small number for drawing firm conclusions. Second, it was cross-sectional, meaning researchers only measured patients at the start and end, not continuously throughout the 6 months. Third, there was no control group receiving a placebo (fake pill), so we cannot be certain the supplement itself caused the changes rather than other factors like diet or exercise. The authors themselves concluded the study results were negative because the muscle changes were not statistically significant. Larger, longer studies with control groups are needed to confirm whether HMB truly helps.
What the Results Show
After 6 months of taking the HMB supplement, 28 out of 48 patients (58%) showed an increase in muscle mass. However, the increases were small: 16 patients gained up to 5% of their original muscle mass, 8 patients gained between 5% and 10%, and only 4 patients gained more than 10%. The remaining 20 patients (42%) experienced a slight decrease in muscle mass, though all decreases stayed below 5% of their original muscle. When researchers analyzed all the data together, these changes were not large enough to reach statistical significance, meaning the results could have happened by chance. The researchers found that younger patients and those with lower triglyceride levels (a type of blood fat) were more likely to gain muscle. Specifically, for every year older a patient was, their chances of gaining muscle decreased. Similarly, patients with higher triglyceride levels were less likely to benefit from the supplement. Interestingly, other body composition measurements like body mass index and fat distribution did not predict who would gain muscle.
The study found that two blood markers showed promise in predicting muscle gain. C-peptide levels (which indicate how much insulin the pancreas is producing) and alkaline phosphatase (an enzyme related to liver and bone health) were higher in patients who gained muscle. These findings suggest that patients whose bodies are still producing adequate insulin and have certain liver function patterns may respond better to the supplement. However, these are preliminary observations that need confirmation in larger studies.
This research adds to a growing body of work examining HMB supplements for muscle building in older adults and people with chronic diseases. Previous studies have shown mixed results, with some suggesting HMB may help preserve muscle during weight loss or aging, while others found minimal benefit. This study’s findings of modest and variable responses align with the mixed picture in existing research. The fact that individual responses varied widely suggests that HMB may work better for some people than others, depending on factors like age, metabolic health, and blood chemistry. The study also highlights the importance of looking beyond simple body composition measurements to understand who might benefit from such interventions.
The authors themselves identified several important limitations. The study included only 48 patients, which is too small to draw firm conclusions. The cross-sectional design means researchers only measured patients twice (before and after), not continuously, so they could not track changes over time or understand how the supplement worked. There was no control group receiving a placebo, making it impossible to know if the supplement itself caused the changes or if other factors like diet, exercise, or natural variation were responsible. The study was conducted in Hungary and published in a Hungarian medical journal, so the findings may not apply equally to other populations. Finally, the authors note that the muscle changes observed were not statistically significant, meaning they could have occurred by chance. These limitations mean the study provides preliminary information only and should not be considered definitive proof that HMB supplements work.
The Bottom Line
Based on this research, HMB supplements may help some people with type 2 diabetes maintain or slightly increase muscle mass, but the evidence is weak and results are unpredictable. If you are considering HMB supplements, discuss this with your doctor first, especially if you have diabetes, liver disease, or take other medications. Do not rely on supplements alone for muscle building; regular physical activity and adequate protein intake are more proven strategies. Gram Research analysis suggests that younger patients with lower triglyceride levels may have a better chance of benefiting, but individual responses vary widely.
This research is most relevant to older adults with type 2 diabetes who are overweight and have fatty liver disease. People in this group who are interested in building or maintaining muscle should be aware that HMB supplements may provide modest benefits for some but not all. This study is less relevant to younger people, those without diabetes, or those with normal liver function. Anyone considering HMB should first consult their healthcare provider, as supplements can interact with medications and may not be appropriate for all health conditions.
In this study, researchers measured changes after 6 months of supplementation. If HMB supplements do work, you would likely see small changes within this timeframe, though some people may see no change at all. Do not expect dramatic muscle gain from supplements alone. Building and maintaining muscle requires consistent physical activity, adequate protein intake, and overall healthy lifestyle habits. If you try a supplement, give it at least 3 to 6 months while maintaining good exercise and nutrition habits before deciding whether it is helping.
Frequently Asked Questions
Does HMB supplement help build muscle in people with diabetes?
HMB may help some people maintain or slightly increase muscle mass, but evidence is weak. A 2026 study of 48 diabetic patients found 58% gained some muscle after 6 months, but gains were small and not statistically significant. Larger studies are needed to confirm effectiveness.
Who is most likely to benefit from HMB supplements?
Younger patients with lower triglyceride levels showed better responses to HMB in this study. For every year of age, chances of muscle gain decreased. However, individual responses varied widely, and researchers cannot yet reliably predict who will benefit.
How much muscle can you gain from HMB supplements?
In this 6-month study, muscle gains ranged from 0% to over 10% of original muscle mass, with most gains under 5%. About 42% of patients actually lost small amounts of muscle despite taking the supplement, showing highly variable individual responses.
Is HMB supplement safe for people with fatty liver disease?
This study found no safety concerns during 6 months of use in patients with fatty liver disease, but the research was small and short-term. Always consult your doctor before starting supplements, especially with liver disease or diabetes, as they may interact with medications.
Should I take HMB instead of exercising to build muscle?
No. Supplements work best combined with regular strength training and adequate protein intake. This study did not isolate the supplement’s effect from other lifestyle factors. Exercise and nutrition remain the most proven ways to build and maintain muscle.
Want to Apply This Research?
- Track weekly muscle-building activities (strength training sessions, duration, and exercises performed) and monthly body composition measurements if available through your healthcare provider. Record any HMB supplement doses taken and note subjective changes in strength or energy levels.
- Use the app to set a goal of 2 to 3 strength training sessions per week combined with adequate protein intake (aim for 1.2 to 1.6 grams per kilogram of body weight daily). If taking HMB supplements, log doses consistently and pair them with resistance exercises, as the supplement appears to work best when combined with muscle-building activity.
- Create a 6-month tracking plan that includes weekly exercise logs, monthly weight and body composition notes (if measurable), blood sugar readings if diabetic, and triglyceride levels from periodic doctor visits. Compare baseline measurements to 3-month and 6-month checkpoints to assess whether the supplement combined with exercise is producing meaningful changes in your individual case.
This article summarizes research findings and is not medical advice. HMB supplements are not approved by the FDA for treating any disease. Before starting any supplement, especially if you have type 2 diabetes, fatty liver disease, or take medications, consult your healthcare provider. This study was small and preliminary; larger research is needed to confirm results. Individual responses to supplements vary widely. Do not rely on supplements alone for managing diabetes or building muscle. Maintain regular physical activity, balanced nutrition, and medical supervision as directed by your doctor.
This research translation is published by Gram Research, the science division of Gram, an AI-powered nutrition tracking app.