Handgrip Strength as a Measure of Sarcopenia in Type 2 Diabetes Mellitus

Context and Aim: Diabetes mellitus is a growing cause of morbidity and mortality in India and worldwide. It can be attributed as one of the cause as well as consequence of sarcopenia. There is paucity of data on sarcopenia and its correlation with metabolic control in diabetic patients. Therefore this study was undertaken to measure the Hand Grip Strength (HGS) in type 2 diabetic patients as a measure of sarcopenia and compare it with age-sex matched non-diabetic subjects. Further correlation between HGS and the glycaemic control (HbA1c level) was also evaluated. Settings and Design: This was a comparative cross- sectional pilot study carried out in the Medical Out-patient Department (OPD) and Diabetes Clinic of Maulana Azad Medical College and associated Lok Nayak Hospital, New Delhi. The study included fifty diabetic patients of more than 50 years of both sexes with type 2 Diabetes for at least five years and fifty age- sex matched healthy non-diabetic controls. Methods and Material: After taking an informed consent, theHand Grip Strength (HGS) of all subjects was measured using Jamar’s Handheld Dynamometer. Biochemical investigations including glycatedhemoglobin levels (HbA1c) were done using auto analyzer in central lab of Lok Nayak Hospital. Statistical analysis used: The mean of the maximum right and left handgrip strength of the cases and controls were compared using a Paired Sample t-test. The correlation between the handgrip strength of cases and glycaemic control (HbA1C levels) was studied using the Pearson Correlation coefficient test. Results: Out of total 50 cases 15 were women and 35 were men. The mean age and BMI was 58.86 ± 5.92 years and 26.13 ± 5.53 kg/m2 respectively. Mean HGS among diabetic group was significantly lowered compared to controls (19.34 and 35.07 kg respectively. Similarly, mean HGS of women was significantly lower as compared to men. There was no significant correlation between HGS and HbA1C in patient group. Conclusions: This is the first Indian study to measure the loss of muscle strength in old diabetic patients. We conclude that hand grip strength is lower in diabetic patients as compared to controls. Further studies are needed to evaluate impact of physical activity on HGS and morbidity and mortality in diabetes population.