Estimating the Burden of Sarcopenia in Adults With Type 2 Diabetes Mellitus: Implications for Metabolic Health

Background Sarcopenia, the progressive loss of muscle mass and strength, is a significant complication in type 2 diabetes mellitus (T2DM) that worsens insulin resistance and glycemic control. Techniques such as a bioimpedance analyzer, handgrip strength (HGS) tests, and gait speed assessments serve to assess sarcopenia. Aim The aim of this study was to determine the proportion of T2DM patients with sarcopenia (T2DMS+) compared with non-diabetic patients and assess the association between sarcopenia and obesity in T2DM patients. Materials and methods For this observational cross-sectional study, all diabetic and non-diabetic male and female patients in the age group of 18-60 years were recruited during their routine outpatient visits. Sarcopenia was assessed using a bioimpedance analyzer for muscle mass, a handgrip dynamometer for muscle strength, and the Short Physical Performance Battery (SPPB) score for physical performance. Observation and results This study compared the prevalence and impact of sarcopenia in T2DM patients and non-diabetic patients. The study population included 100 T2DM patients and 100 controls. The mean age of the T2DM group (T2DMG) was 47.79 ± 8.64 years, slightly higher than that of the control group (CG), which was 44.31 ± 9.56 years. The gender distribution was consistent, with 70% (n = 70) of female patients and 30% (n = 30) of male patients in both groups. The body mass index (BMI) was similar between the T2DMG (25.9 ± 4.91 kg/m²) and the CG (26.76 ± 5.84 kg/m², p = 0.10). Hemoglobin A1c (HbA1c) levels were markedly higher in the T2DMG (8.05 ± 1.47%) compared with the CG (5.52 ± 0.65%, p < 0.05). Sarcopenia was significantly more prevalent in the T2DM group (53%, n = 53/100) than in the control group (17%, n = 17/100) with an odds ratio of 5.54 (95% confidence interval (CI): 2.84-10.81, p < 0.001), and more frequent in obese diabetics (64.15%, n = 34/53) compared to non-obese diabetics (35.85%, n = 19/53) with an odds ratio of 3.41 (95% CI: 1.38-8.39, p = 0.0001). Compared with the non-sarcopenic T2DM patients (47%, n = 47), sarcopenic T2DM patients (53%, n = 53) were older (52 ± 7.61 years and 43.02 ± 7.17 years, respectively, p < 0.05) and had longer diabetes duration (8.45 ± 5.45 years, p < 0.05). The sarcopenic T2DM patients also had less appendicular lean mass (ALM) (18.5 ± 4.14 kg compared with 21.19 ± 3.95 kg, p < 0.0014), reduced HGS (14.97 ± 3.83 kg compared with 25.78 ± 4.34 kg, p < 0.05), lower SPPB scores (6.49 ± 1.4 compared with 10.06 ± 0.76, p < 0.05), and higher HbA1c (8.54 ± 1% compared with 7.5 ± 1.47%, p = 0.00037). Conclusion T2DM patients exhibited lower appendicular lean mass, muscle strength, and physical performance, and had significantly lower handgrip strength and SPPB scores than the non-sarcopenic T2DM patients. Further, sarcopenia was more pronounced in the older patients and those with a longer duration of diabetes.