Insulin sensitizers may attenuate lean mass loss in older men with diabetes
Open accessAbstract
OBJECTIVE: To examine longitudinal changes in total and appendicular lean body mass in older men with impaired fasting glucose (IFG) or diabetes and to determine whether these changes differ by diabetes treatment. RESEARCH DESIGN AND METHODS: A total of 3,752 ambulatory men aged ≥65 years at baseline participated in a multicenter longitudinal cohort study. Baseline glycemic status was categorized as normoglycemia, IFG, undiagnosed/untreated diabetes, or treated diabetes. Insulin sensitizer medication use (metformin and/or thiazolidinediones) was assessed by prescription medication inventory. The change in total lean and appendicular lean mass was derived from dual X-ray absorptiometry scans taken at baseline and 3.5 ± 0.7 years later. RESULTS: This male cohort included 1,853 individuals with normoglycemia, 1,403 with IFG, 234 with untreated diabetes, 151 with diabetes treated with insulin sensitizers, and 111 with diabetes treated without insulin sensitizers. Men with untreated diabetes, diabetes treated without insulin sensitizers, or IFG had greater percentage loss in total or appendicular lean mass (P ≤ 0.05 in comparison to normoglycemic men). There remained a significantly greater percentage loss in appendicular lean mass for these groups even after adjustment for medical comorbidities or lifestyle factors. In contrast, the percentage loss in total or appendicular lean mass in men with diabetes treated with insulin sensitizers was significantly less than that in normoglycemic men in minimally and fully adjusted models. CONCLUSIONS: Skeletal muscle loss was accelerated in men with IFG and diabetes, except when the latter was treated with insulin sensitizers. These findings suggest that insulin sensitizers may attenuate muscle loss.
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Diabetes is associated with accelerated loss of muscle mass and strength; this loss is greater with longer diabetes duration or higher HbA1c and is attenuated by insulin sensitisers.
“In both cross-sectional and longitudinal studies, accelerated loss of muscle mass and strength is recorded in individuals with diabetes, is greater with longer diabetes duration or higher HbA1c, and is attenuated by use of insulin sensitisers.36-38”
From Age-related and disease-related muscle loss: The effect of diabetes, obesity, and other diseases (2014) · cites this paper as [38]
Metformin might enhance strength and muscle growth.
“Metformin, the primary choice for T2DM treatment, might enhance strength and muscle growth.28”
From Imaging of Sarcopenia in Type 2 Diabetes Mellitus (2024) · cites this paper as [28]
Epidemiological research indicates a link between thiazolidinediones and reduced loss of muscle mass as well as improved walking pace among patients with T2DM.
“Epidemiological research indicates a link between thiazolidinediones and reduced loss of muscle mass as well as improved walking pace among patients with T2DM.28,32”
From Imaging of Sarcopenia in Type 2 Diabetes Mellitus (2024) · cites this paper as [28]
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- Authors
- Lee, C. G., Boyko, E. J., Barrett-Connor, E., Miljkovic, I., Hoffman, A. R., Everson-Rose, S. A., Lewis, C. E., Cawthon, P. M., Strotmeyer, E. S., Orwoll, E. S., & for the Osteoporotic Fractures in Men (MrOS) Study Research Group
- Affiliations
- Oregon Health & Science University (US)
- VA Puget Sound Health Care System (US)
- University of California San Diego (US)
- University of Pittsburgh (US)
- Stanford Medicine (US)
- University of Minnesota, Minneapolis, Minnesota
- University of Alabama at Birmingham (US)
- California Pacific Medical Center (US)
- Corresponding author
- Lee, Christine G.
- ORCID
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2011-10-15
- Volume
- 34
- Issue
- 11
- Pages
- 2381-2386
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- PMC
- PMC3198278
- OpenAlex
- W2138781309
- Cited by
- 168
- References
- 22
- Citations by year
- 2026: 7 · 2025: 8 · 2024: 16 · 2023: 18 · 2022: 12 · 2021: 18 · 2020: 12 · 2019: 9 · 2018: 10 · 2017: 12 · 2016: 13 · 2015: 4 · 2014: 15 · 2013: 12 · 2012: 1
- FWCI
- 5.98
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Diabetes Care (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Funders
- American Diabetes Association (1‐04‐JF‐46)
- National Institutes of Health
- National Institute on Aging (U01AG018197, U01AG027810)
- National Institute of Diabetes and Digestive and Kidney Diseases (K01DK083029)
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (U01AR045583, U01AR045580, U01AR045632, U01AR045654, U01AR045614, U01AR045647)
- National Center for Research Resources (UL1RR024140)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (K12-HD043488-09, K12HD043488)
- Topics
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- insulin sensitizers, lean mass loss, appendicular lean mass, sarcopenia, metformin, thiazolidinediones, impaired fasting glucose, untreated diabetes, skeletal muscle atrophy, dual-energy X-ray absorptiometry
- MeSH terms
- Adipose Tissue, Aged, Aged, 80 and over, Aging, Blood Glucose, Body Composition, Body Weight, Diabetes Mellitus, Follow-Up Studies, Humans, Hypoglycemic Agents, Insulin, Longitudinal Studies, Male, Metformin, Regression Analysis, Absorptiometry, Photon, Body Mass Index, Muscle, Skeletal, Thiazolidinediones
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