Association between possible sarcopenia, peripheral neuropathy, and the risk of falls in patients with type 2 diabetes mellitus
Keywords:
sarcopenia, peripheral neuropathy, falls, type 2 diabetes mellitusAbstract
Type 2 diabetes is a health problem that affects various systems of the body, especially the muscular and nervous systems. Sarcopenia is common in diabetic patients and may increase the risk of peripheral neuropathy and falls, which affect quality of life and can lead to serious complications. This retrospective study aimed to study the relationship between possible sarcopenia peripheral neuropathy and the risk of falls in patients with type 2 diabetes. The sample consisted of 455 patients diagnosed with type 2 diabetes for 5 years or more and were aged 50 years or older and received treatment between October 1, 2023 and September 30, 2024. The study used medical record review and statistical data analysis using ready-made programs, including frequency, percentage, mean, standard deviation, and analysis of the relationship using Pearson Chi-square, Fisher's exact test, and Multiple logistic regression. The results showed that 31.6% of the patients had sarcopenia, 17.8% had neuropathy, and 47.5% were at risk of falls. Sarcopenia was associated with neurological deficits (p = 0.014) and falls risk (p < 0.001). Multiple logistic regression analysis showed that those with sarcopenia were approximately 2.11 times more likely to fall than those without sarcopenia (OR = 2.11; 95% CI: 1.26, 3.55; p =0.005). Therefore, surveillance and development of preventive measures, such as exercise and nutritional care, are important to reduce the risk and improve the quality of life of patients. These findings support the integration of sarcopenia screening into routine diabetes care to reduce fall risk.
References
Department of Disease Control. NCDs situation report 2019: Diabetes, hypertension, and related risk factors. Nonthaburi: Bureau of Non-Communicable Diseases, Department of Disease Control, Ministry of Public Health; 2021. p. 20–21. Available from: https://ddc.moph.go.th/dncd/journal_detail.php?publish=10358
Mesinovic J, Zengin A, De Courten B, et al. Sarcopenia and type 2 diabetes mellitus: A bidirectional relationship. Diabetes Metab Syndr Obes 2019;12:1057–72. doi:10.2147/DMSO.S186600
Pongchaiyakul C, Limpawattana P, Kotruchin P, et al. Prevalence of sarcopenia and associated factors among Thai population. J Bone Miner Metab 2013;31(3):346–50. doi:10.1007/s00774-013-0422-4
Cruz-Jentoft AJ, Baeyens JP, Bauer JM, et al. Sarcopenia: Europeanconsensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People. Age Ageing 2010;39(4):412–23. doi:10.1093/ageing/afq034
Rosenberg IH. Sarcopenia: Origins and clinical relevance. J Nutr 1997;127(5 Suppl):990S–1S. doi:10.1093/jn/127.5.990S
Chen L-K, Liu L-K, Woo J, et al. Sarcopenia in Asia: Consensus report of the Asian working group for sarcopenia. J Am Med Dir Assoc 2014;15(2):95–101. doi:10.1016/j.jamda.2013.11.025
Gupta P, Aravindhan A, Gand ATL, et al. Association between the severity of diabetic retinopathy and falls in an Asian population with diabetes: The Singapore epidemiology of eye diseases study. JAMA Ophthalmol 2017;135(12):1410–6. doi:10.1001/jamaophthalmol.2017.4983
Timar B, Timar R, Gaiță L, et al. The impact of diabetic neuropathy on balance and on the risk of falls in patients with type 2 diabetes mellitus: a cross-sectional study. PLoS One 2016;11(4):e0154654. doi:10.1371/journal.pone.0154654
Supharat W, Jampaa J. Association between diabetic retinopathy on sarcopenia and risk of falls in patients with type 2 diabetes. J Prim Care Fam Med 2021;4(2):167-81. Available from: https://so03.tci-thaijo.org/index.php/PCFM/article/view/249235.
Pourhoseingholi MA, Vahedi M, Rahimzadeh M. Sample size calculation in medical studies. Gastroenterol Hepatol Bed Bench 2013;6(1):14–7.
Charan J, Biswas T. How to calculate sample size for different study designs in medical research? Indian J Psychol Med 2013;35(2):121–6. doi:10.4103/0253-7176.116232
Wu X, Li X, Xu M, et al. Sarcopenia prevalence and associated factors among older Chinese population: Findings from the China Health and Retirement Longitudinal Study. PLoS One 2021;16(3):e0247617. doi:10.1371/journal.pone.0247617
Pham H, Simmons D, Kerr M, et al. Semmes-Weinstein monofilament testing for the detection of peripheral neuropathy in diabetic patients. Diabetes Care 2000;23(5):729–32.
Muir SW, Berg K, Chesworth B, et al. Balance and fall risk assessment in older adults: The single-leg stance test and its relationship with the Berg Balance Scale. J Gerontol A Biol Sci Med Sci 2010;65A(11):1189–94.
Boontanom N, Kooncumchoo P, Yuenyougchaiwat K. Prevalence of sarcopenia and respiratory muscle strength in people: a survey preliminary study cross-sectional study. Health Sci Sci Technol Rev 2023;16(3):Article 3.
Gonzalez-Freire M, de Cabo R, Studenski SA, et al. The neuromuscular junction: Aging at the crossroad between nerves and muscle. Front Aging Neurosci 2014;6:208. doi:10.3389/fnagi.2014.00208.
Rudolf R, Khan MM, Labeit S, et al. Degeneration of neuromuscular junction in age and dystrophy. Front Aging Neurosci 2014;6:99. doi:10.3389/fnagi.2014.00099.
Warzecha M, Amarowicz J, Berwecka M, et al. Relation between risk of falls, sarcopenia and parameters assessing quality of skeletal. 2020.
Trindade LP, Prieto AV, Costa RMD, et al. Correlation between sarcopenia, risk of falls and mortality in the elderly: Systematic review and meta-analysis of observational studies. Arq Cienc Saude Unipar [Internet]. 2023 Oct 23 [cited 2025 Aug 25];27(10):5704-21. Available from: https://revistas.unipar.br/index.php/saude/article/view/10759
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