Sarcopenia and Diabetes: A Detrimental Liaison of Advancing Age

Abstract

Sarcopenia is an age-related clinical complaint characterized by the progressive deterioration of skeletal muscle mass and strength over time. Type 2 diabetes (T2D) is associated with faster and more relevant skeletal muscle impairment. Both conditions influence each other, leading to negative consequences on glycemic control, cardiovascular risk, general health status, risk of falls, frailty, overall quality of life, and mortality. PubMed/Medline, Scopus, Web of Science, and Google Scholar were searched for research articles, scientific reports, observational studies, clinical trials, narrative and systematic reviews, and meta-analyses to review the evidence on the pathophysiology of di-abetes-induced sarcopenia, its relevance in terms of glucose control and diabetes-related outcomes, and diagnostic and therapeutic challenges. The review comprehensively addresses key elements for the clinical definition and diagnostic criteria of sarcopenia, the pathophysiological correlation be-tween T2D, sarcopenia, and related outcomes, a critical review of the role of antihyperglycemic treatment on skeletal muscle health, and perspectives on the role of specific treatment targeting myokine signaling pathways involved in glucose control and the regulation of skeletal muscle metabolism and trophism. Prompt diagnosis and adequate management, including lifestyle inter-vention, health diet programs, micronutrient supplementation, physical exercise, and pharmaco-logical treatment, are needed to prevent or delay skeletal muscle deterioration in T2D.

Association of Combining Diet and Physical Activity on Sarcopenia and Obesity in Elderly Koreans with Diabetes

“…Diabetes mellitus stands out as the most prevalent chronic metabolic disorder worldwide, exhibiting an increasing trend in prevalence among the elderly due to the extension of life expectancy [1,2]. As aging progresses, alterations in body composition manifest, characterized by a decline in muscle mass and strength coupled with an increase in body fat, become prominent due to decreased physical activity and metabolic rate.…”

“…In the elderly, sarcopenia is not only a consequence but also a potential cause of diabetes, highlighting a bidirectional relationship between these two conditions [1,2]. Sarcopenia in the elderly has been reported to elevate the risk of diabetes by approximately two-fold [9], while conversely, the presence of diabetes increases the risk of sarcopenia by 1.5-fold [10].…”

“…Sarcopenia in the elderly has been reported to elevate the risk of diabetes by approximately two-fold [9], while conversely, the presence of diabetes increases the risk of sarcopenia by 1.5-fold [10]. In the elderly, diabetes and sarcopenia are intricately linked, resulting in negative outcomes such as increased cardiovascular disease risk, overall health decline, elevated fall risk, frailty, diminished overall quality of life, chronic diabetes complications, and mortality [2]. Therefore, in the elderly with diabetes, it is crucial to manage both preserving skeletal muscle mass and strength and preventing excessive fat accumulation.…”

“…Lifestyle modification can be an effective strategy to delay and ameliorate age-related sarcopenia and obesity in diabetes [1,2]. Long-term lifestyle interventions focusing on diet and physical activity have been shown to delay disability and extend healthy life expectancy in the elderly with diabetes [11].…”

“…Moreover, high-quality diets rich in antioxidants have been inversely associated with fasting glucose, abdominal obesity, and sarcopenia in diabetic patients [13], and higher dietary quality was associated with a reduced risk of metabolic syndrome [14]. Furthermore, regular exercise in older adults with diabetes is widely used to prevent muscle breakdown and decline in physical function associated with the aging process, contributing to improved glycemic control, insulin resistance, body fat, lipid profiles, and cardiovascular health [1,2]. Therefore, a combination of exercise and a high-quality balanced diet appears to be the safest and most promising strategy for managing both sarcopenia and obesity in the elderly with diabetes.…”