High prevalence and clinical impact of dynapenia and sarcopenia in Japanese patients with type 1 and type 2 diabetes: Findings from the Impact of Diabetes Mellitus on Dynapenia study

Abstract

Aims/introduction: The present study aimed to clarify the prevalence and clinical characteristics of sarcopenia and dynapenia, which are muscle weakness with and without low muscle mass, respectively, in Japanese patients with type 1 diabetes mellitus and type 2 diabetes mellitus.

Materials and methods: This cross-sectional study enrolled 1,328 participants with type 1 diabetes (n = 177), type 2 diabetes (n = 645) and without diabetes (n = 506). Sarcopenia was defined as a low grip strength and slow gait speed with low skeletal muscle mass index, whereas dynapenia was defined as low strengths of grip and knee extension with a normal skeletal muscle mass index. Participants without sarcopenia and dynapenia were defined as robust.

Results: Among participants aged ≥65 years, sarcopenia and dynapenia were observed in 12.2% and 0.5% of individuals without diabetes, 42.9% and 11.4% of type 1 diabetes patients, and 20.9% and 13.9% of type 2 diabetes patients. In both type 1 diabetes and type 2 diabetes patients, sarcopenic patients were significantly older and thinner, and showed a significantly higher rate of diabetic neuropathy than robust patients. In patients with type 1 diabetes and type 2 diabetes, dynapenic patients were older, and showed a higher rate of diabetic neuropathy and lower estimated glomerular filtration rate than robust patients. Patients complicated with sarcopenia and dynapenia showed a significantly lower physical quality of life and higher rate of incidental falls than robust patients.

Conclusions: Sarcopenia and dynapenia were more frequent in patients with type 1 diabetes and type 2 diabetes than in individuals without diabetes, which might contribute to their impaired quality of life and incidental falls.

Keywords: Dynapenia; Sarcopenia; Type 1 and type 2 diabetes.

Figure 1

Prevalence rate of sarcopenia and dynapenia, and these components in individuals without diabetes (non‐DM), and patients with type 1 diabetes (T1DM) and type 2 diabetes (T2DM; vs non‐DM *P < 0.05, **P < 0.01, ***P < 0.001, vs T1DM ^† P < 0.05, ^†† P < 0.01. DM, diabetes mellitus; SMI, skeletal muscle mass index.

Figure 2

Physical quality of life and incidental fall in the sarcopenic and dynapenic patients with type 1 diabetes (T1DM) and type 2 diabetes (T2DM). An analysis of the Mantel–Haenszel test adjusted by age ≥65 years. Both versus robust; *P < 0.05, **P < 0.01, ***P < 0.001, vs sarcopenia ^† P < 0.05, ^†† P < 0.01. QOL, quality of life.