Knowledge, Attitudes, and Practices About Sarcopenia in Adults With Type 2 Diabetes: A Cross-Sectional Survey

Sarcopenia is a frequent and clinically significant complication in individuals with type 2 diabetes mellitus (T2DM) and is linked to unfavorable outcomes, including loss of physical function and disability. Yet, little is known about how patients themselves understand and manage this condition, and data on their knowledge, attitudes, and practices (KAP) toward sarcopenia are particularly scarce among people with T2DM in China. Therefore, this study sought to investigate T2DM patients' KAP related to sarcopenia.

This cross-sectional survey enrolled adults with T2DM, recruited consecutively from both outpatient clinics and inpatient wards of a tertiary hospital in China (November 2022-April 2023). Participants completed a self-administered KAP questionnaire on sarcopenia (12 knowledge items scored 0-12; 12 attitude items scored 12-60; 7 scored practice items scored 7-35, plus 3 open-ended practice questions). Descriptive statistics were used to summarize KAP scores, Spearman correlation assessed associations among KAP domains, and structural equation modeling was employed to test the hypothesized pathways.

A total of 475 completed questionnaires were included in the analysis. Mean scores for KAP were 4.55 ± 1.98 (range: 0-12), 47.27 ± 2.89 (range: 12-60), and 19.63 ± 3.51 (range: 7-35), respectively. Spearman correlation analysis indicated weak but statistically significant positive associations between each pair of domains: knowledge and attitude (r = 0.222), knowledge and practice (r = 0.375), and attitude and practice (r = 0.485) (all p  < 0.001). In the structural equation model, knowledge was positively associated with both attitude and practice, and attitude was likewise associated with practice (β = 0.160, p = 0.012; β = 0.281, p = 0.003; β = 0.267, p = 0.006). Despite the high-risk nature of this population, only 2.53% of participants reported having ever received a clinical diagnosis of sarcopenia, indicating that sarcopenia was rarely documented in routine diabetes care in this cohort.

Patients with T2DM demonstrated limited knowledge but overall favorable attitudes and moderate practice behaviors related to sarcopenia. The low proportion of sarcopenia identified by clinicians highlights limited detection in routine care and supports more structured education and opportunistic screening during diabetes visits.