Daijiworld Media Network - London

London, Nov 8: People with Type 2 diabetes who have diabetic peripheral neuropathy combined with low muscle mass may face a higher risk of osteoporosis, falls and fractures, according to a new study.

The research also found higher rates of osteoporosis and falls during follow-up among patients with both conditions. However, the longitudinal analysis did not establish a statistically significant association with fractures, highlighting an important distinction in the findings.

Researchers examined whether diabetic peripheral neuropathy and low appendicular muscle mass together could help identify patients at greater risk of skeletal complications. Appendicular muscle mass refers to the skeletal muscles in the arms and legs.

The study combined an exploratory analysis of the Survey of Health, Ageing and Retirement in Europe with a hospital-based cohort of patients with Type 2 diabetes in China.

While the European analysis examined diabetes, grip strength and skeletal health outcomes, the hospital-based study assessed clinically diagnosed neuropathy and muscle mass measured through dual-energy X-ray absorptiometry.

Researchers noted that low muscle mass alone does not establish sarcopenia, a condition that also requires consideration of muscle strength or physical performance.

In the hospital cohort, patients with both diabetic peripheral neuropathy and low appendicular muscle mass had higher odds of osteoporosis, falls and fractures.

The reported odds ratios were 2.15 for osteoporosis, 4.67 for falls and 2.42 for fractures, indicating stronger associations with falls among patients with both conditions.

During the follow-up period, the combination of neuropathy and low muscle mass was associated with higher hazards of osteoporosis and falls. However, the association with fractures was not statistically significant.

Researchers emphasised that the findings should be interpreted separately, as higher odds of having experienced a fracture do not necessarily establish an increased rate of future fractures.

The findings suggest that assessing nerve function alongside muscle health could help doctors identify diabetic patients who may require closer monitoring of mobility and bone health.

However, the study does not establish that either condition directly causes osteoporosis, falls or fractures, or that treating low muscle mass will necessarily prevent these complications. Other differences between patient groups could also influence the observed associations.

The research highlights the importance of including skeletal health in the broader assessment of diabetes-related complications.

Further studies are needed to determine whether combining assessments of nerve function and muscle health can improve risk prediction and whether targeted interventions can ultimately reduce falls and fractures among people with Type 2 diabetes.