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

TLDR

Adults with type 1 or type 2 diabetes have lower skeletal muscle strength than nondiabetic adults, as shown by cross‑sectional studies. This study aimed to examine longitudinal changes in muscle mass and strength among older adults with and without type 2 diabetes. Researchers measured leg and arm muscle mass by dual‑energy X‑ray absorptiometry and muscle strength with isokinetic and isometric dynamometers in 1,840 community‑dwelling adults aged 70–79 at baseline and after 3 years. Older adults with type 2 diabetes experienced accelerated declines in leg muscle mass, strength, and quality over three years, whereas arm changes were similar to non‑diabetics, and these differences persisted after adjusting for demographics and inflammatory markers.

Abstract

OBJECTIVE—It has been shown that adults with either long-standing type 1 or type 2 diabetes had lower skeletal muscle strength than nondiabetic adults in cross-sectional studies. The aim of the study was to investigate longitudinal changes of muscle mass and strength in community-dwelling older adults with and without type 2 diabetes. RESEARCH DESIGN AND METHODS—We examined leg and arm muscle mass and strength at baseline and 3 years later in 1,840 older adults aged 70–79 years in the Health, Aging, and Body Composition Study. Regional muscle mass was measured by dual energy X-ray absorptiometry, and muscle strength was measured using isokinetic and isometric dynamometers. RESULTS—Older adults with type 2 diabetes (n = 305) showed greater declines in the leg muscle mass (−0.29 ± 0.03 vs. −0.23 ± 0.01 kg, P < 0.05) and strength (−16.5 ± 1.2 vs. −12.4 ± 0.5 Nm, P = 0.001) compared with older adults without diabetes. Leg muscle quality, expressed as maximal strength per unit of muscle mass (Newton meters per kilogram), also declined more rapidly in older adults with diabetes (−1.6 ± 0.2 vs. −1.2 ± 0.1 Nm/kg, P < 0.05). Changes in arm muscle strength and quality were not different between those with and without diabetes. Rapid declines in leg muscle strength and quality were attenuated but remained significant after controlling for demographics, body composition, physical activity, combined chronic diseases, interleukin-6, and tumor necrosis factor-α. CONCLUSIONS—In older adults, type 2 diabetes is associated with accelerated loss of leg muscle strength and quality.