Decreased Muscle Strength and Quality in Older Adults With Type 2 Diabetes

Abstract

Adequate skeletal muscle strength is essential for physical functioning and low muscle strength is a predictor of physical limitations. Older adults with diabetes have a twoto threefold increased risk of physical disability. However, muscle strength has never been investigated with regard to diabetes in a population-based study. We evaluated grip and knee extensor strength and muscle mass in 485 older adults with diabetes and 2,133 without diabetes in the Health, Aging, and Body Composition study. Older adults with diabetes had greater arm and leg muscle mass than those without diabetes because they were bigger in body size. Despite this, muscle strength was lower in men with diabetes and not higher in women with diabetes than corresponding counterparts. Muscle quality, defined as muscle strength per unit regional muscle mass, was significantly lower in men and women with diabetes than those without diabetes in both upper and lower extremities. Furthermore, longer duration of diabetes (>6 years) and poor glycemic control (HbA 1c >8.0%) were associated with even poorer muscle quality. In conclusion, diabetes is associated with lower skeletal muscle strength and quality. These characteristics may contribute to the development of physical disability in older adults with diabetes.

Accelerated Loss of Skeletal Muscle Strength in Older Adults With Type 2 Diabetes

“…The Health, Aging, and Body Composition Study (Health ABC) was designed to investigate the impact of changes in body composition and health conditions on age-related physiological and functional status among adults from 70 to 79 years of age. In this cohort, we have reported that older adults with type 2 diabetes had lower skeletal muscle strength and quality (12). However, it is still unclear whether lower muscle strength in diabetes is a consequence of diabetes or just a coincidence because previous studies were cross-sectional observations.…”

“…The Health ABC Study was described in detail elsewhere (12). Among 2,618 participants who had completed baseline assessments for skeletal muscle mass and strength, 1,840 (70.3%) were reexamined 3 years later.…”

Diabetes and Risk of Frailty and Its Potential Mechanisms: A Prospective Cohort Study of Older Adults

“…Some studies have also shown that older diabetic individuals have an accelerated loss of skeletal muscle strength (23,24), which is more pronounced among those with poor glycemic control (HbA1c>8%) (25). Still, to our knowledge only one previous study has evaluated the role of hyperglycemia in frailty development.…”

Diabetic polyneuropathy is associated with respiratory muscle impairment in type 2 diabetes

“…First, neuromuscular function assessment was focused exclusively on respiratory muscles, thus leaving potential peripheral muscle impairment unexplored. Nonetheless, numerous studies have demonstrated that peripheral muscle impairment occurs in diabetic patients and is related to the severity of diabetic polyneuropathy [1][2][3][4]. Furthermore, it remains uncertain whether nerve disorder as such, neuromuscular cross-link disorders, downstream muscle dysfunction or a combination of different pathologies are responsible for impaired muscle force generation.…”

“…Skeletal muscle weakness is well-recognised as an important clinical manifestation of diabetic polyneuropathy [1] and is related to the severity of this condition [1][2][3][4]. In addition, diabetes has a major negative impact on intensive care unit outcome [5,6], including prolonged weaning from mechanical ventilation [7].…”