Diabetes mellitus and sarcopenia pose a substantial challenge to public health, especially among the elderly. These conditions share common pathophysiological mechanism and are linked bidirectionally, with each contributing to an increased risk of the other. Previous research has shown that both diabetes and sarcopenia are individually linked to serious health complications including cardiovascular conditions that may result in death. However, there is limited research on the combined health impact of diabetes and sarcopenia, particularly in vulnerable populations such as the elderly.
To address this gap, a research team led by Professor Eyun Song and Professor Kyung Mook Choi from the Korea University College of Medicine, South Korea performed a longitudinal study to assess the combined impact of diabetes and sarcopenia on all-cause and cardiovascular death in the South Korean population. This study was made available online on 21 August 2023 and was published in Volume 148 Issue 155678 of the journal Metabolism on 1st November 2023.
The study analyzed data from the Korea National Health and Nutrition Examination Survey (2008–2011) and mortality data from the Korean National Death Registry. The study's findings revealed that the co-occurrence of diabetes and sarcopenia nearly doubled the risk of cardiovascular and all-cause death. Notably, the incidence of cardiovascular mortality was significantly elevated in the group exhibiting both diabetes and sarcopenia but not in groups exhibiting either condition.
Approximately 22%–24% of South Koreans suffer from both diabetes and sarcopenia, a significant portion of the population faces a doubled risk of mortality.
Implementing preventive healthcare strategies such as preventing muscle loss in patients with diabetes can potentially mitigate the co-occurrence & high mortality risk associated with both conditions. It is recommended that individuals in the high-risk category incorporate lifestyle changes, regular exercise, and a balanced diet to reduce the likelihood of muscle loss. In fact, elderly patients with diabetes are advised to undergo screenings for sarcopenia to promptly receive care to address the combined threat of these conditions.
There is a need to develop new healthcare guidelines aimed at patients with both diabetes and sarcopenia, considering their unique health challenges and risks. Adding to this, Dr. Song says, "In the future, it might become mandatory for patients with diabetes to receive healthcare assessments that capture their muscle mass, muscle strength, and physical performance during clinical visits and for patients with sarcopenia to monitor their blood glucose levels and make lifestyle changes to maintain their glycemic status."
Summarizing the results of their research Dr. Choi says, "When diabetes and sarcopenia 'coexist,' there is an additive increase in all-cause and cardiovascular mortalities which underscores the importance of careful screening and prevention strategies in high-risk populations. Additionally, further research is needed to understand the intricate mechanisms linking diabetes and sarcopenia to and develop targeted treatments to enhance health outcomes."
In conclusion, healthcare systems may benefit from investing in preventive measures for sarcopenia & diabetes by potentially reducing costs associated with cardiovascular emergencies and lowering the overall healthcare burden.
About Korea University College of Medicine
Korea University College of Medicine is the medical school of Korea University. It is located in Seoul, South Korea. As one of the oldest medical schools in South Korea, it has been historically regarded as one of the country's top medical schools. The school was founded as Chosun Women's Medical Training Institute in 1928 by Rosetta Sherwood Hall. The institute was subsequently renamed several times and ultimately merged with Korea University to become Korea University College of Medicine. So far, the school has produced over 7,000 graduates, most of whom are working as prominent physicians and public health advocates worldwide.
About the authors
Prof. Eyun Song and Prof. Kyung Mook Choi from the Korea University College of Medicine are world-renowned scholars who are globally recognized for their persistent contributions toward sarcopenia research. By leading prospective studies like the Korean Sarcopenic Obesity Study (KSOS) and the Korean Frailty & Aging Cohort Study (KFACS), they have significantly advanced the understanding of muscle-related conditions. Their expertise is evident in numerous original research and review publications featured in esteemed medical journals like Diabetes Care, Hepatology, Metabolism, and JCEM. Recognized for their expertise, they are highly sought-after speakers at international conferences, thus emphasizing their dedication to advancing medical knowledge within the field of sarcopenia.
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