Research Article
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The Effect of Novel Antihyperglycemic Treatments on Sarcopenia in Type 2 Diabetic Patients

Year 2025, Volume: 9 Issue: 2, 97 - 106, 31.08.2025
https://doi.org/10.25048/tudod.1695390

Abstract

Aim: Previous studies indicate a possible association between weight losing interventions and reduced muscle function. There is scarce
research on how novel glucose-lowering agents effect sarcopenia parameters. The present study aims to investigate the longitudinal
relationship between current antihyperglycemic treatments and sarcopenia.
Material and Methods: Type 2 diabetic patients aged 18 and above were enrolled in this longitudinal observational study. Patient
characteristics, list of medications, hours of physical activity per week, laboratory values, anthropometric measurements, handgrip
strength and body composition analyzed with bioelectrical impedance analysis were recorded at the initial presentation and at 6 months.
Results: A total of 109 women (76%) and 34 men (24%) with type 2 diabetes mellitus (DM) were included. The mean age of study
participants was 53.4±10.4 years, and the mean duration of DM was 10.2±8 years. At 6 months, weight, total fat mass, visceral fat mass,
waist circumference, HbA1c, fasting glucose, serum insulin, LDL (low density lipoprotein) and vitamin B12 levels were significantly
lower while muscle strength was significantly higher (p=0.012). There was a significant inverse association between age and muscle
strength both initially and at 6 months (p=0.001 and 0.001 for women; p=0.005 and 0.001 for men, respectively). Duration of DM was
inversely associated with muscle strength only for women (p=0.02 at initial presentation and p=0.001 at month 6). Frequency of probable
sarcopenia was reduced at month 6 for both genders (p=0.029 for women and 0.5 for men).
Conclusion: Glycemic control has a favorable effect on muscle function despite weight loss. Effective management of DM with novel
antihyperglycemic agents may help prevent sarcopenia

References

  • 1. Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O, Cederholm T, Cooper C, Landi F, Rolland Y, Sayer AA, Schneider SM, Sieber CC, Topinkova E, Vandewoude M, Visser M, Zamboni M. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16-31.
  • 2. Larsson L, Degens H, Li M, Salviati L, Lee YI, Thompson W, Kirkland JL, Sandri M. Sarcopenia: Aging-Related Loss of Muscle Mass and Function. Physiol Rev. 2019;99(1):427-511.
  • 3. Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the Global Burden of Disease Study 2021. Lancet. 2023;402(10397):203-34.
  • 4. Bahat G, Ozkok S. The Current Landscape of Pharmacotherapies for Sarcopenia. Drugs Aging. 2024;41(2):83-112.
  • 5. Witham MD, Granic A, Pearson E, Robinson SM, Sayer AA. Repurposing Drugs for Diabetes Mellitus as Potential Pharmacological Treatments for Sarcopenia - A Narrative Review. Drugs Aging. 2023;40(8):703-19.
  • 6. Cui M, Gang X, Wang G, Xiao X, Li Z, Jiang Z, Wang G. A cross-sectional study: Associations between sarcopenia and clinical characteristics of patients with type 2 diabetes. Medicine (Baltimore). 2020;99(2):e18708.
  • 7. Anagnostis P, Gkekas NK, Achilla C, Pananastasiou G, Taouxidou P, Mitsiou M, Kenanidis E, Potoupnis M, Tsiridis E, Goulis DG. Type 2 Diabetes Mellitus is Associated with Increased Risk of Sarcopenia: A Systematic Review and Meta-analysis. Calcif Tissue Int. 2020;107(5):453-63.
  • 8. Volpato S, Bianchi L, Lauretani F, Lauretani F, Bandinelli S, Guralnik JM, Zuliani G, Ferrucci L. Role of muscle mass and muscle quality in the association between diabetes and gait speed. Diabetes Care. 2012;35(8):1672-9.
  • 9. Witham MD, McDonald C, Wilson N, Rennie KJ, Bardgett M, Bradley P, Clegg AP, Connolly S, Hancock H, Hiu S, Nicholson K, Robertson L, Simms L, Steel AJ, Steves CJ, Storey B, Wason J, von Zglinicki T, Sayer AA. Metformin and physical performance in older people with probable sarcopenia and physical prefrailty or frailty in England (MET-PREVENT): a double-blind, randomised, placebo-controlled trial. Lancet Healthy Longev. 2025;6(3):100695.
  • 10. Bahat G, Tufan A, Tufan F, Kilic C, Akpinar TS, Kose M, Erten N, Karan MA, Cruz-Jentoft AJ. Cut-off points to identify sarcopenia according to European Working Group on Sarcopenia in Older People (EWGSOP) definition. Clin Nutr. 2016;35(6):1557-63.
  • 11. Asmat U, Abad K, Ismail K. Diabetes mellitus and oxidative stress-A concise review. Saudi Pharm J. 2016;24(5):547-53.
  • 12. Mesinovic J, Zengin A, De Courten B, Ebeling PR, Scott D. Sarcopenia and type 2 diabetes mellitus: a bidirectional relationship. Diabetes Metab Syndr Obes. 2019;12:1057-72.
  • 13. Teng S, Huang P. The effect of type 2 diabetes mellitus and obesity on muscle progenitor cell function. Stem Cell Res Ther. 2019;10(1):103.
  • 14. Meex RCR, Blaak EE, van Loon LJC. Lipotoxicity plays a key role in the development of both insulin resistance and muscle atrophy in patients with type 2 diabetes. Obes Rev. 2019;20(9):1205-17.
  • 15. Welch AA. Nutritional influences on age-related skeletal muscle loss. Proc Nutr Soc. 2014;73(1):16-33.
  • 16. Abdulla H, Smith K, Atherton PJ, Idris I. Role of insulin in the regulation of human skeletal muscle protein synthesis and breakdown: a systematic review and meta-analysis. Diabetologia. 2016;59(1):44-55.
  • 17. Mihaylova MM, Shaw RJ. The AMPK signalling pathway coordinates cell growth, autophagy and metabolism. Nat Cell Biol. 2011;13(9):1016-23.
  • 18. Kalyani RR, Corriere M, Ferrucci L. Age-related and disease- related muscle loss: the effect of diabetes, obesity, and other diseases. Lancet Diabetes Endocrinol. 2014;2(10):819-29.
  • 19. Rizzo MR, Barbieri M, Fava I, Desiderio M, Coppola C, Marfella R, Paolisso G. Sarcopenia in Elderly Diabetic Patients: Role of Dipeptidyl Peptidase 4 Inhibitors. J Am Med Dir Assoc. 2016;17(10):896-901.
  • 20. Kalyani RR, Metter EJ, Egan J, Golden SH, Ferrucci L. Hyperglycemia predicts persistently lower muscle strength with aging. Diabetes Care. 2015;38(1):82-90.
  • 21. Sugimoto K, Tabara Y, Ikegami H, Takata Y, Kamide K, Ikezoe T, Kiyoshige E, Makutani Y, Onuma H, Gondo Y, Ikebe K, Ichihashi N, Tsuboyama T, Matsuda F, Kohara K, Kabayama M, Fukuda M, Katsuya T, Osawa H, Hiromine Y, Rakugi H. Hyperglycemia in non-obese patients with type 2 diabetes is associated with low muscle mass: The Multicenter Study for Clarifying Evidence for Sarcopenia in Patients with Diabetes Mellitus. J Diabetes Investig. 2019;10(6):1471-9.
  • 22. Sugimoto K, Ikegami H, Takata Y, Katsuya T, Fukuda M, Akasaka H, Tabara Y, Osawa H, Hiromine Y, Rakugi H. Glycemic Control and Insulin Improve Muscle Mass and Gait Speed in Type 2 Diabetes: The MUSCLES-DM Study. J Am Med Dir Assoc. 2021;22(4):834-8.e1.
  • 23. Cava E, Yeat NC, Mittendorfer B. Preserving Healthy Muscle during Weight Loss. Adv Nutr. 2017;8(3):511-9.
  • 24. Newman AB, Lee JS, Visser M, Goodpaster BH, Kritchevsky SB, Tylavsky FA, Nevitt M, Harris TB. Weight change and the conservation of lean mass in old age: the Health, Aging and Body Composition Study. Am J Clin Nutr. 2005;82(4):872-8; quiz 915-6.
  • 25. Volkert D, Beck AM, Cederholm T, Cruz-Jentoft A, Goisser S, Hooper L, Kiesswetter E, Maggio M, Raynaud-Simon A, Sieber CC, Sobotka L, van Asselt D, Wirth R, Bischoff SC. ESPEN guideline on clinical nutrition and hydration in geriatrics. Clin Nutr. 2019;38(1):10-47.
  • 26. Zahide Betül Tayfur, Esra Atılgan, Tip 2 Diyabetli Hastalarda Kan Glukoz Seviyesi ile Kas Gücü, Propriosepsiyon ve Vücut Kompozisyonu Arasındaki İlişkiAraştırma Makalesi. Türkiye Diyabet ve Obezite Dergisi, 2020; 4(3):207-213, 10.25048/tudod. 732903.

Yeni Antihiperglisemik Tedavilerin Tip 2 Diyabetik Hastalarda Sarkopeni Üzerine Etkisi

Year 2025, Volume: 9 Issue: 2, 97 - 106, 31.08.2025
https://doi.org/10.25048/tudod.1695390

Abstract

Amaç: Sarkopeni parametrelerinin glisemik kontrol ile ilişkisini inceleyen çok az sayıda araştırma bulunmaktadır. Bu çalışma, yeni
diyabet tedavileri ile sarkopeni arasındaki uzunlamasına ilişkiyi araştırmayı amaçlamaktadır.
Gereç ve Yöntemler: Tip 2 diyabetik 18 yaş ve üzeri hastalar bu çalışmaya dahil edildi. Hastaların demografik özellikleri, kullandıkları
ilaçlar, haftalık fiziksel aktivite saati, laboratuvar değerleri, antropometrik ölçümleri, el kavrama kuvveti ve biyoelektrik empedans
analizi ile analiz edilen vücut kompozisyonu başvuruda ve altıncı ayda kaydedildi.
Bulgular: Tip 2 diabetes mellitus tanılı toplam 109 kadın (%76) ve 34 erkek (%24) dahil edildi. Çalışmaya katılanların ortalama yaşı
53,4±10,4 yıl ve ortalama diyabet süresi 10,2±8 yıldı. 6. ayda, kilo, toplam yağ kütlesi, viseral yağ kütlesi, bel çevresi, HbA1c, açlık glikozu,
serum insülin, LDL (düşük yoğunluklu lipoprotein) ve B12 vitamini düzeyleri azalırken kas gücü anlamlı düzeyde arttı (p=0,012).
Yaş ve kas gücü arasında hem başlangıçta hem de 6. ayda önemli bir ters ilişki vardı (kadınlar için p=0,001 ve 0,001; erkekler için
sırasıyla p=0,005 ve 0,001). Diyabet süresi yalnızca kadınlarda kas gücüyle ters ilişkiliydi (ilk başvuruda p=0,02 ve 6. ayda p=0,001).
Olası sarkopeni sıklığı her iki cinsiyet için de 6. ayda azaldı (kadınlar için p=0,029 ve erkekler için 0,5).
Sonuç: Glisemik kontrolün kas fonksiyonu üzerinde olumlu bir etkisi vardır. Kilo verdirici özelliği olan yeni antidiyabetik tedaviler
sarkopeniyi önlemektedir.

References

  • 1. Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O, Cederholm T, Cooper C, Landi F, Rolland Y, Sayer AA, Schneider SM, Sieber CC, Topinkova E, Vandewoude M, Visser M, Zamboni M. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16-31.
  • 2. Larsson L, Degens H, Li M, Salviati L, Lee YI, Thompson W, Kirkland JL, Sandri M. Sarcopenia: Aging-Related Loss of Muscle Mass and Function. Physiol Rev. 2019;99(1):427-511.
  • 3. Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the Global Burden of Disease Study 2021. Lancet. 2023;402(10397):203-34.
  • 4. Bahat G, Ozkok S. The Current Landscape of Pharmacotherapies for Sarcopenia. Drugs Aging. 2024;41(2):83-112.
  • 5. Witham MD, Granic A, Pearson E, Robinson SM, Sayer AA. Repurposing Drugs for Diabetes Mellitus as Potential Pharmacological Treatments for Sarcopenia - A Narrative Review. Drugs Aging. 2023;40(8):703-19.
  • 6. Cui M, Gang X, Wang G, Xiao X, Li Z, Jiang Z, Wang G. A cross-sectional study: Associations between sarcopenia and clinical characteristics of patients with type 2 diabetes. Medicine (Baltimore). 2020;99(2):e18708.
  • 7. Anagnostis P, Gkekas NK, Achilla C, Pananastasiou G, Taouxidou P, Mitsiou M, Kenanidis E, Potoupnis M, Tsiridis E, Goulis DG. Type 2 Diabetes Mellitus is Associated with Increased Risk of Sarcopenia: A Systematic Review and Meta-analysis. Calcif Tissue Int. 2020;107(5):453-63.
  • 8. Volpato S, Bianchi L, Lauretani F, Lauretani F, Bandinelli S, Guralnik JM, Zuliani G, Ferrucci L. Role of muscle mass and muscle quality in the association between diabetes and gait speed. Diabetes Care. 2012;35(8):1672-9.
  • 9. Witham MD, McDonald C, Wilson N, Rennie KJ, Bardgett M, Bradley P, Clegg AP, Connolly S, Hancock H, Hiu S, Nicholson K, Robertson L, Simms L, Steel AJ, Steves CJ, Storey B, Wason J, von Zglinicki T, Sayer AA. Metformin and physical performance in older people with probable sarcopenia and physical prefrailty or frailty in England (MET-PREVENT): a double-blind, randomised, placebo-controlled trial. Lancet Healthy Longev. 2025;6(3):100695.
  • 10. Bahat G, Tufan A, Tufan F, Kilic C, Akpinar TS, Kose M, Erten N, Karan MA, Cruz-Jentoft AJ. Cut-off points to identify sarcopenia according to European Working Group on Sarcopenia in Older People (EWGSOP) definition. Clin Nutr. 2016;35(6):1557-63.
  • 11. Asmat U, Abad K, Ismail K. Diabetes mellitus and oxidative stress-A concise review. Saudi Pharm J. 2016;24(5):547-53.
  • 12. Mesinovic J, Zengin A, De Courten B, Ebeling PR, Scott D. Sarcopenia and type 2 diabetes mellitus: a bidirectional relationship. Diabetes Metab Syndr Obes. 2019;12:1057-72.
  • 13. Teng S, Huang P. The effect of type 2 diabetes mellitus and obesity on muscle progenitor cell function. Stem Cell Res Ther. 2019;10(1):103.
  • 14. Meex RCR, Blaak EE, van Loon LJC. Lipotoxicity plays a key role in the development of both insulin resistance and muscle atrophy in patients with type 2 diabetes. Obes Rev. 2019;20(9):1205-17.
  • 15. Welch AA. Nutritional influences on age-related skeletal muscle loss. Proc Nutr Soc. 2014;73(1):16-33.
  • 16. Abdulla H, Smith K, Atherton PJ, Idris I. Role of insulin in the regulation of human skeletal muscle protein synthesis and breakdown: a systematic review and meta-analysis. Diabetologia. 2016;59(1):44-55.
  • 17. Mihaylova MM, Shaw RJ. The AMPK signalling pathway coordinates cell growth, autophagy and metabolism. Nat Cell Biol. 2011;13(9):1016-23.
  • 18. Kalyani RR, Corriere M, Ferrucci L. Age-related and disease- related muscle loss: the effect of diabetes, obesity, and other diseases. Lancet Diabetes Endocrinol. 2014;2(10):819-29.
  • 19. Rizzo MR, Barbieri M, Fava I, Desiderio M, Coppola C, Marfella R, Paolisso G. Sarcopenia in Elderly Diabetic Patients: Role of Dipeptidyl Peptidase 4 Inhibitors. J Am Med Dir Assoc. 2016;17(10):896-901.
  • 20. Kalyani RR, Metter EJ, Egan J, Golden SH, Ferrucci L. Hyperglycemia predicts persistently lower muscle strength with aging. Diabetes Care. 2015;38(1):82-90.
  • 21. Sugimoto K, Tabara Y, Ikegami H, Takata Y, Kamide K, Ikezoe T, Kiyoshige E, Makutani Y, Onuma H, Gondo Y, Ikebe K, Ichihashi N, Tsuboyama T, Matsuda F, Kohara K, Kabayama M, Fukuda M, Katsuya T, Osawa H, Hiromine Y, Rakugi H. Hyperglycemia in non-obese patients with type 2 diabetes is associated with low muscle mass: The Multicenter Study for Clarifying Evidence for Sarcopenia in Patients with Diabetes Mellitus. J Diabetes Investig. 2019;10(6):1471-9.
  • 22. Sugimoto K, Ikegami H, Takata Y, Katsuya T, Fukuda M, Akasaka H, Tabara Y, Osawa H, Hiromine Y, Rakugi H. Glycemic Control and Insulin Improve Muscle Mass and Gait Speed in Type 2 Diabetes: The MUSCLES-DM Study. J Am Med Dir Assoc. 2021;22(4):834-8.e1.
  • 23. Cava E, Yeat NC, Mittendorfer B. Preserving Healthy Muscle during Weight Loss. Adv Nutr. 2017;8(3):511-9.
  • 24. Newman AB, Lee JS, Visser M, Goodpaster BH, Kritchevsky SB, Tylavsky FA, Nevitt M, Harris TB. Weight change and the conservation of lean mass in old age: the Health, Aging and Body Composition Study. Am J Clin Nutr. 2005;82(4):872-8; quiz 915-6.
  • 25. Volkert D, Beck AM, Cederholm T, Cruz-Jentoft A, Goisser S, Hooper L, Kiesswetter E, Maggio M, Raynaud-Simon A, Sieber CC, Sobotka L, van Asselt D, Wirth R, Bischoff SC. ESPEN guideline on clinical nutrition and hydration in geriatrics. Clin Nutr. 2019;38(1):10-47.
  • 26. Zahide Betül Tayfur, Esra Atılgan, Tip 2 Diyabetli Hastalarda Kan Glukoz Seviyesi ile Kas Gücü, Propriosepsiyon ve Vücut Kompozisyonu Arasındaki İlişkiAraştırma Makalesi. Türkiye Diyabet ve Obezite Dergisi, 2020; 4(3):207-213, 10.25048/tudod. 732903.
There are 26 citations in total.

Details

Primary Language English
Subjects Endocrinology
Journal Section Research Article
Authors

Büşra Can 0000-0002-7170-8044

Zehra Kaya 0009-0003-9761-9060

Bülent Can 0000-0001-6382-1306

Publication Date August 31, 2025
Submission Date May 8, 2025
Acceptance Date August 21, 2025
Published in Issue Year 2025 Volume: 9 Issue: 2

Cite

APA Can, B., Kaya, Z., & Can, B. (2025). The Effect of Novel Antihyperglycemic Treatments on Sarcopenia in Type 2 Diabetic Patients. Turkish Journal of Diabetes and Obesity, 9(2), 97-106. https://doi.org/10.25048/tudod.1695390
AMA Can B, Kaya Z, Can B. The Effect of Novel Antihyperglycemic Treatments on Sarcopenia in Type 2 Diabetic Patients. Turk J Diab Obes. August 2025;9(2):97-106. doi:10.25048/tudod.1695390
Chicago Can, Büşra, Zehra Kaya, and Bülent Can. “The Effect of Novel Antihyperglycemic Treatments on Sarcopenia in Type 2 Diabetic Patients”. Turkish Journal of Diabetes and Obesity 9, no. 2 (August 2025): 97-106. https://doi.org/10.25048/tudod.1695390.
EndNote Can B, Kaya Z, Can B (August 1, 2025) The Effect of Novel Antihyperglycemic Treatments on Sarcopenia in Type 2 Diabetic Patients. Turkish Journal of Diabetes and Obesity 9 2 97–106.
IEEE B. Can, Z. Kaya, and B. Can, “The Effect of Novel Antihyperglycemic Treatments on Sarcopenia in Type 2 Diabetic Patients”, Turk J Diab Obes, vol. 9, no. 2, pp. 97–106, 2025, doi: 10.25048/tudod.1695390.
ISNAD Can, Büşra et al. “The Effect of Novel Antihyperglycemic Treatments on Sarcopenia in Type 2 Diabetic Patients”. Turkish Journal of Diabetes and Obesity 9/2 (August2025), 97-106. https://doi.org/10.25048/tudod.1695390.
JAMA Can B, Kaya Z, Can B. The Effect of Novel Antihyperglycemic Treatments on Sarcopenia in Type 2 Diabetic Patients. Turk J Diab Obes. 2025;9:97–106.
MLA Can, Büşra et al. “The Effect of Novel Antihyperglycemic Treatments on Sarcopenia in Type 2 Diabetic Patients”. Turkish Journal of Diabetes and Obesity, vol. 9, no. 2, 2025, pp. 97-106, doi:10.25048/tudod.1695390.
Vancouver Can B, Kaya Z, Can B. The Effect of Novel Antihyperglycemic Treatments on Sarcopenia in Type 2 Diabetic Patients. Turk J Diab Obes. 2025;9(2):97-106.

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