Evaluation of sarcopenia in nonelderly patients with diabetes mellitus and its association with poor glycemic control

Background Sarcopenia is characterized by low muscle mass and strength, primarily affecting the elderly. It may also present in patients with type 2 diabetes mellitus (T2DM), especially those with poor glycemic control. This study aimed to evaluate the frequency of sarcopenia in nonelderly and overweight patients with T2DM and its association with glycemic control. Methods A total of 60 overweight patients with T2DM (mean duration 10 ± 1.3 years) were included to the study. Patients were classified into two groups according to their HbA1c levels. There were 30 patients (mean age 54 ± 5 years; 14 [46,6%] women) in poor glycemic control group (HbA1c > 7%) and 30 patients (mean age, 54 ± 6 years; 15[50%] women) in adequate glycemic control group (HbA1c ≤ 7). Hand grip strength (HGS) measurements using a dynamometer, skeletal muscle mass index (SMMI) measured by bioelectrical impedance analysis, 4-m walking test, and the Sarcopenia Quality of Life (SARQoL) and Pittsburgh Sleep Quality(PSQ) questionnaires were used to assess the presence of sarcopenia and QoL in all patients. Results Five patients (16.6%) in the poor glycemic control group were diagnosed with sarcopenia based on the assessment of muscle strength and mass. Among patients with adequate glycemic control, none met the criteria for sarcopenia. The median HGS and SMMI were significantly lower in patients with sarcopenia (15.4kg and 7.4kg/m ² ) than in patients with adequate glycemic control (29.8 kg and 10.6kg/m ² ; p = 0.021 and 0.006, respectively). There was a negative correlation between HbA1c and HGS in all patients (r = 0.424; p = 0.001). Multivariate linear regression analysis revealed that an increase in HbA1c leads to a decrease in SMMI (Beta: -0.293; 95% CI: -0.483 to -0.102; p = 0.003) and HGS (Beta: -2,016; 95% CI: -2,885 to -1,147; p = < 0.001). The SARQoL score was also significantly lower in patients with sarcopenia than the patients with adequate glycemic control (p = 0.022) while no significant difference was found in the PSQ score. Conclusion Sarcopenia may occur in nonelderly T2DM patients with poor glycemic control, leading to decreased QoL. Screening for sarcopenia should commence at a younger age if diabetes is uncontrolled and risk factors are present.