Turkish Journal of Physical Medicine and Rehabilitation 2018 , Vol 64 , Num 1

The effect of blood glucose regulation on sarcopenia parameters in obese and diabetic patients

Zeynel Abidin Öztürk 1 ,İbrahim Halil Türkbeyler 1 ,Zeynep Demir 2 ,Muhammet Bilici 3 ,Yalçın Kepekçi 3
1 Department of Internal Medicine, Division of Geriatrics, Medical Faculty of Gaziantep University, Gaziantep, Turkey
2 Department of Radiology, New York University, Center for Biomedical Imaging, New York, USA
3 Department of Internal Medicine, Medical Faculty of Gaziantep University, Gaziantep, Turkey
DOI : 10.5606/tftrd.2018.1068 Objectives: This study aims to evaluate the effect of blood glucose regulation on sarcopenia parameters in sarcopenic, obese, and poorlyregulated diabetic patients.

Patients and methods: Between June 2013 and December 2013, a total of 147 patients (64 males, 83 females; mean age 70.3±6.3 years; range, 60 to 90 years) who were diagnosed with sarcopenia according to the European Working Group on Sarcopenia in Older People (EWGSOP) criteria were included in the study. All patients were obese with a body mass index (BMI) of >30 kg/m2 and their glycated hemoglobin (HbA1c) levels were above 8%. Sarcopenia parameters including the gait speed, muscle strength, muscle mass, and handgrip strength were assessed. After a six-month treatment period, the patients were divided into two groups according to their HbA1c levels as having <8% or >8%. Sarcopenia parameters were evaluated before and after receiving treatment.

Results: The mean disease duration was 16±6.2 years. Sixty patients were found to have a HbA1c level of <8% and 45 patients with a HbA1c level of ≥8% at sixth months of follow-up. In better regulated group, sarcopenia parameters such as gait speed, muscle mass, and handgrip strength improved; however, only the change in the muscle mass was found to be statistically significant (p=0.041). There was no significant change in the parameters of sarcopenia in the patient group with a HbA1c level ≥8%. A negative correlation was found between the muscle mass and HbA1c levels in good- and poorly-regulated groups (p=0.039 r:-0.327 and p=0.044 r:-0.183, respectively).

Conclusion: Our study demonstrates that lowering HbA1c levels may have positive effects on the muscle mass even in diabetic and sarcopenic obese elderly individuals. Keywords : Diabetes mellitus; obesity; sarcopenia