Muscular involvement in long-term type 1 diabetes: Does it represent an underestimated complication?

Nutrition. 2023 Aug:112:112060. doi: 10.1016/j.nut.2023.112060. Epub 2023 May 1.

Abstract

Objectives: Structural, metabolic, and functional signs of skeletal muscle damage have been identified in individuals affected by type 1 diabetes (T1D), but, to our knowledge, no guidelines for the diagnosis and treatment of muscle impairment exist and studies on T1D and muscle health remain limited. The aim of this study was to evaluate the prevalence of sarcopenia in a long-term T1D population and to assess the effects of some clinical parameters on muscle mass and function.

Methods: Thirty-nine patients affected by T1D were enrolled. Body mass index (BMI), body composition (appendicular lean mass index [ALMI] and fat mass [FM]), and muscle strength were measured. Additionally, the relationship between Mediterranean diet adherence and sarcopenia was assessed.

Results: In the present sample (mean age 49.32 ± 13.49 y, 41.1% women, mean duration of diabetes 30.13 ± 12.28 y), the prevalence of sarcopenia was 7.7% (12.5 % in women and 4.35% in men). The prevalence of low ALMI was 23.1% (25% in women and 21.74% in men). Significant inverse correlations were found between ALMI and duration of diabetes and ALMI and FM; and significant positive correlations between ALMI and BMI, physical activity level, and muscle strength. At the same time, significant inverse correlations were observed between muscle strength and duration of diabetes and muscle strength and FM.

Conclusions: We observed a high prevalence of low muscle mass, similar to those found in the older age groups of the general population (25 years in advance) and our findings suggest a possible pathogenetic role of T1D duration on muscle trophism and function.

Keywords: Accelerated muscle aging; Muscle function; Muscle mass; Sarcopenia; Type 1 diabetes.

MeSH terms

  • Adult
  • Aged
  • Body Composition / physiology
  • Body Mass Index
  • Diabetes Mellitus, Type 1* / complications
  • Diabetes Mellitus, Type 1* / epidemiology
  • Female
  • Hand Strength / physiology
  • Humans
  • Male
  • Middle Aged
  • Muscle Strength
  • Muscle, Skeletal
  • Sarcopenia* / diagnosis
  • Sarcopenia* / epidemiology
  • Sarcopenia* / etiology