Why diabetics maybe twice at risk of death from heart disease

Low muscle mass is associated with a two-fold risk of death from cardiovascular disease in individuals with diabetes, finds a study.

The study showed that the association is independent of frailty, glycaemic control and the microvascular complications retinopathy (damage to the blood vessels of the retina) and nephropathy (kidney disease).

Sarcopenia -- age-related loss of muscle mass and strength -- was known to be associated with cardiovascular disease (CVD) and mortality in individuals with diabetes.

However, it wasn’t clear to what extent the relationship was being influenced by their blood sugar control or by complications of their diabetes.

The research presented at the recent Annual Meeting of the European Association for the Study of Diabetes (EASD) showed that people with low muscle mass were 44 per cent more likely to die of any cause during follow-up than those with normal muscle mass.

They were also twice as likely to die from CVD as those with normal muscle mass.

Further analysis showed that low muscle mass was linked with all-cause mortality and CVD mortality, irrespective of HbA1c (a measure of blood sugar control) and microvascular complications.

“Our results suggest that the increased risk of death in individuals with diabetes who have low muscle mass isn’t mediated or influenced by frailty, poor blood sugar control or microvascular complications but due to the loss of muscle itself," Dr Jae Myung Yu and Dr Shinje Moon, from the Hallym University, in Seoul, Republic of South Korea.

They pressed the need for more research to determine just how sarcopenia increases the risk of death.

Meanwhile, “it is important to consider body composition when treating obesity and managing weight in people with diabetes”, they noted.

For the study, they used data from the 1,514 adults with diabetes (older than 20 years) in the US.

About 55.6 per cent females had low muscle mass. The participants with low muscle mass had an average age of 63.5 years and an average diabetes duration of 14.5 years.

About 1,318 participants (48.3 per cent female) had normal muscle mass. Their average age was 54 years and average diabetes duration was 10.4 years.

The participants were followed up for an average of 9.3 years. There were 413 deaths from any cause during this time (106 low muscle mass and 307 normal muscle mass). About 147 of these deaths were from CVD (42 low muscle mass, 105 normal muscle mass.)