Poor glycaemic control ups sarcopaenia risk in diabetics

Sarcopaenia may be more likely to develop in diabetics with poor glycaemic control, particularly in older patients with type 1 vs type 2 diabetes, reports a new study.

The study included 812 Japanese diabetes patients, in whom sarcopaenia was defined as a low handgrip strength or slow gait speed, combined with low appendicular skeletal muscle mass. Most participants (n=755; mean age 69.9 years, 40 percent women) had type 2 diabetes; only 57 (mean age 62.7 years, 57.9 percent women) had type 1 disease.

The prevalence of sarcopaenia was more than twice as high in older patients (≥65 years) with type 1 vs type 2 diabetes (20.0 percent vs 8.1 percent; p=0.04), an effect driven by low handgrip strength (26.7 percent vs 15.5 percent; p=0.02). Neither sarcopaenia nor its components differed between disease types in younger patients.

In addition, low handgrip strength (31.7 percent vs 22.5 percent; p=0.0097) and slow gait speed (31.2 percent vs 23.7 percent; p=0.035) were significantly more prevalent in type 2 diabetes patients who were receiving insulin treatment. A similar effect was reported for sarcopaenia prevalence, but it fell short of statistical significance.

Of note, sarcopaenia prevalence in type 1 diabetes patients was similar to that in type 2 counterparts receiving insulin treatment. Logistic regression confirmed these findings, showing that type 1 diabetes was indeed associated with worse handgrip strength. Similarly, insulin medication was tied to sarcopaenia prevalence, an effect that was attenuated after adjusting for glycated haemoglobin.

“A longitudinal study is needed to clarify whether type 1 diabetes mellitus remains as a risk factor for sarcopaenia in patients with adequate glycaemic control,” the researchers said.