Purpose We aimed to analyze the relationship between handgrip strength/relative handgrip strength among older Han adults with type 2 diabetes mellitus (T2DM) by gender to determine the optimal cut-off value of grip strength for older adults. Methods A multi-stage sampling method was used to conduct a questionnaire survey and physical examination of 6128 older adults in Anhui Province. Chi-squares tests, t -tests, analysis of variance, and logistic regression analysis were used to analyze the association between handgrip strength/relative handgrip strength and T2DM between the sexes. The decision tree model (CRT) was used to explore the predictive value of handgrip strength /relative handgrip strength on T2DM. Results There was an association between handgrip strength and T2DM ( P = 0.006, OR = 0.985, 95% CI = 0.975, 0.996), which was found in females ( P = 0.013, OR = 0.978, 95% CI = 0.961, 0.995) but not in males ( P = 0.125, OR = 0.989, 95% CI = 0.976, 1.003). Relative handgrip strength was also correlated with T2DM ( P = 0.014, OR = 0.730, 95% CI = 0.568, 0.939), which was found in females ( P = 0.003, OR = 0.534, 95% CI = 0.352, 0.809) but not in males ( P = 0.432, OR = 0.879, 95% CI = 0.638, 1.212). The incidence of T2DM in elderly females with hypertension who were uneducated and with a handgrip strength of <17.350 kg was 24.3% (115 cases), whereas that in elderly females with hypertension and a relative handgrip strength of <0.240 was 29.0% (127 cases). Conclusion According to our results, handgrip strength and relative handgrip strength were associated with T2DM. People with hypertension had a higher risk of T2DM in women with a handgrip strength of ≤ 17.350kg and a relative grip strength of ≤ 0.240. Further research is needed to validate the effectiveness of this cut-off for implementing interventions and avoiding risks.
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