Cardiovascular
Diabetes: Low muscle mass may increase death risk from heart disease
Oct
- Diabetes is a complex condition that can contribute to poor health outcomes.
- Research is ongoing about the best ways to manage diabetes and what complications and comorbidities can occur among people with diabetes, such as cardiovascular disease.
- One link researchers have been exploring is between diabetes and muscle mass, particularly aging-related muscle loss.
- A recent study indicates that people with diabetes who also have low muscle mass are at an increased risk for all-cause and cardiovascular disease mortality.
Diabetes is a chronic condition that requires careful management, often with the help of many experts. A new study recently examined how low muscle mass among people with diabetes impacted all-cause mortality and mortality from cardiovascular disease.
The researchers found that individuals with diabetes and low muscle mass have a higher risk for cardiovascular disease mortality and all-cause mortality.
This association between low muscle mass and mortality appeared to be independent of factors like frailty, poor control of blood sugar, and microvascular complications.
The results were shared at the Annual Meeting of the European Association for the Study of Diabetes (EASD). The study findings have yet to be published in a peer-reviewed journal.
Diabetes is a disease where there are abnormal responses to or inadequate amounts of insulin. With these insulin problems, the body has difficulty regulating blood sugar levels. Diabetes can further be linked to health complications, like eye, nerve, cardiovascular, and kidney damage.
People with diabetes may also have additional health problems that influence and are influenced by their diabetes. Thus, health management can involve working with several specialists to manage all conditions and promote well-being.
One area of interest is how these health problems and complications influence one another. This can help develop the most effective approaches to diabetes management and establish focus points for treatment.
Low muscle mass affects overall health
For this study, researchers wanted to understand the risks for people with diabetes and sarcopenia.
Sarcopenia has to do with low muscle mass and low strength. People with sarcopenia may have a more challenging time completing activities of daily living. They may have a higher risk of falling. People with obesity, people who have insulin resistance, or diabetes may be at a higher risk for developing sarcopenia.
Effrain Cerrato, lead exercise physiologist with the Susan Samueli Integrative Health Institute from the University of California, Irvine, who was not involved in the study, explained to Medical News Today:
“[Sarcopenia] is intertwined with reduced bone density leading to osteoporosis and increasing the risk of fractures caused by falls and accidents, a particular concern to our aging population. Beyond physical health, low muscle mass diminishes overall quality of life, limiting mobility and independence, potentially leading to mental health challenges like depression and social isolation.”
“Low muscle mass has consequence beyond strength, especially for individuals living with diabetes. Low muscle mass affects the body’s ability to regulate insulin sensitivity which can contribute to obesity and cardiovascular disease.”
— Effrain Cerrato
Researchers noted in their presentation that they wanted to “Investigate the effect of low muscle mass on all-cause and CVD [cardiovascular disease] related mortality in patients with DM [diabetes mellitus] and [examine] the interrelationship between low muscle mass, glycemic control, and microvascular complications.”
To do this, they utilized data from the U.S. National Health and Nutrition Examination Survey from 1999 to 2006 and 2011 to 2018. Ultimately, researchers included 1,514 participants in their analysis. They had specific parameters to define low muscle mass for men and women.
They adjusted for several confounders in their multiple Cox regression analysis, including cancer history, high blood pressure, age, obesity, and alcohol consumption. They also had data on how long participants had had diabetes, average blood sugar levels measured by hemoglobin A1C, and if participants had particular nerve and eye damage.
In their analysis, they looked at both all-cause mortality and cardiovascular disease-related mortality.
The study found low muscle mass was associated with an increased risk for all-cause and cardiovascular-related mortality. They further concluded that this risk is directly related to the effects of sarcopenia instead of indirectly through poor blood sugar control, complications of small blood vessels, or frailty.
Dr. Faye Riley, research communications manager at Diabetes UK, who was also not involved in the study, said:
“Losing muscle is a natural part of aging and has established links to poorer health. This research tells us more about the effects of reduced muscle mass in older people living with diabetes and how it can directly influence health and life expectancy.”
This research does have certain limitations. First, researchers note that they could not assess physical function because they lacked the data in this area. The study findings also cannot establish a causal relationship.
The researchers only included data from individuals in the U.S., indicating that future research could include data from other countries. They did not differentiate between type 1 and type 2 diabetes, which could also indicate the need for future research. The complete study is also not available at this time.
Dr. Robert Gabbay, chief scientific and medical officer at the American Diabetes Association, who was not involved in the study, noted to MNT:
“We know that muscle mass declines with age, and there does seem to be some association with cardiovascular disease as well. The link within diabetes is less clear.”
“I think it is an interesting study, an analysis of previous data, that suggests that sarcopenia (low muscle mass) is associated with increased cardiovascular risk in people [with] diabetes. Presuming that the link is true, and potentially causal, it would be important to see whether increasing muscle mass could reverse some of the cardiovascular risk.”
— Dr. Robert Gabbay
Regardless, the data indicates the importance of addressing sarcopenia, particularly among people with diabetes.
“There are actions you can take to prevent or slow down muscle loss, and this study serves as a reminder of the benefits of building strength, or resistance, training into your activity routine. By increasing muscle mass, this type of exercise can boost how the body uses insulin and help people with diabetes to manage blood sugar levels, and stay healthy,” Dr. Riley said.
“There are lots of ways to help strengthen muscles, such as carrying heavy shopping bags, doing yoga, or gardening.”
— Dr. Faye Riley
