Sarcopenia and Type 2 diabetes mellitus as predictors of 2-year mortality after hospital discharge in a cohort of hospitalized older adults

Diabetes Res Clin Pract. 2020 Jan:159:107969. doi: 10.1016/j.diabres.2019.107969. Epub 2019 Dec 2.

Abstract

Introduction: Sarcopenia has been discussed as a possible predictor of mortality in the older people, but there are few studies evaluating the relationship between mortality and sarcopenia in the population of patients with type 2 diabetes (T2D), especially after hospital discharge.

Objective: To evaluate whether coexistence of sarcopenia and T2D predicts mortality after two years of hospital discharge in older patients compared to a control group without diabetes.

Methodology: A prospective study that included patients hospitalized between July 2015 and December 2017. To assess sarcopenia, a Timed Up and Go (TUG) test was performed, muscle strength was measured by handgrip, and muscle mass was measured across the largest calf circumference region. This project was approved by the HCPA Ethics Committee under number 150068.

Results: 610 patients were included. The group was stratified according to the presence of diabetes, 306 (51%) patients had TD2. Patients with T2D had lower muscle strength (19.62 ± 7.53 vs. 21.19 ± 7.31p = 0.009), were slower in TUG test (23 vs. 16 s; p < 0.001) than those without T2D, 46.3% being classified as sarcopenic. The mortality rate among T2D was 28%. After adjustment, the coexistence of T2D and sarcopenia was independently associated with mortality after hospital discharge (HR: 1.78; 95% CI: 1.06-2.30).

Conclusion: Older patients with T2D and sarcopenia had a higher risk of mortality after hospital discharge compared to a control group.

Keywords: Mortality; Sarcopenia; Type 2 diabetes.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Case-Control Studies
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / mortality*
  • Diabetes Mellitus, Type 2 / pathology
  • Female
  • Hand Strength / physiology*
  • Humans
  • Male
  • Mortality / trends*
  • Muscle Strength / physiology*
  • Patient Discharge / statistics & numerical data*
  • Prognosis
  • Prospective Studies
  • Sarcopenia / etiology
  • Sarcopenia / mortality*
  • Sarcopenia / pathology
  • Survival Rate