Daijiworld Media Network - Health
New Delhi, Nov 8: People with Type 2 diabetes who have both diabetic peripheral neuropathy and low muscle mass may face higher risks of osteoporosis, falls and fractures, according to a new study.
The research found that patients with both conditions had significantly higher odds of osteoporosis, falls and fractures. During the follow-up period, however, the combined conditions were associated with higher rates of osteoporosis and falls, while the association with subsequent fractures was not statistically significant.
Researchers examined whether the combination of diabetic peripheral neuropathy and low appendicular muscle mass could help identify people with Type 2 diabetes who are more vulnerable to skeletal problems. 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. The European analysis examined diabetes, grip strength and skeletal health outcomes, while the hospital-based study assessed clinically diagnosed neuropathy and measured muscle mass using dual-energy X-ray absorptiometry.
In the hospital cohort, patients with both neuropathy and low appendicular muscle mass had 2.15 times higher odds of osteoporosis, 4.67 times higher odds of falls and 2.42 times higher odds of fractures compared with those without the combined conditions.
During follow-up, the researchers also observed higher risks of developing osteoporosis and experiencing falls among patients with both conditions. However, the analysis did not establish a statistically significant association with subsequent fractures.
The researchers highlighted the importance of distinguishing between the odds of having experienced a fracture and the likelihood of sustaining a new fracture during follow-up. The findings indicate an association with fracture history but do not conclusively demonstrate an increased rate of future fractures.
They also cautioned that low muscle mass alone does not establish sarcopenia, a condition that involves consideration of muscle strength or physical performance in addition to muscle quantity.
The findings suggest that assessing nerve function alongside muscle health could help healthcare professionals identify patients who may need closer monitoring of mobility and bone health.
However, the observational nature of the research means it cannot establish that neuropathy or low muscle mass directly causes osteoporosis, falls or fractures. Nor does it demonstrate that treating low muscle mass will necessarily prevent these outcomes.
The researchers said further studies are needed to determine whether combining assessments of nerve function and muscle health can improve risk prediction and whether targeted interventions can reduce falls and fractures among people with Type 2 diabetes.