Sarcopenic diabetes is an under-recognized and unmet clinical priority. A call for action from the European Society for Clinical Nutrition and Metabolism and the Diabetes Nutrition Study Group

Abstract

Diabetes mellitus is a systemic chronic disease with growing prevalence and potential multiorgan complications leading to clinical, social, and economic burdens. Nutritional and metabolic derangements are important components of both type 1 (T1DM) and type 2 diabetes (T2DM), but assessment of nutritional state, body composition and muscle function is commonly neglected. Likely reasons include high prevalence of overweight, obesity, or excess visceral fat in highly-prevalent T2DM, potentially diverting attention from undernutrition risk. Diabetes and adiposity are mechanistically related to sarcopenia, defined as reduction of skeletal muscle strength and mass, through complex muscle-catabolic derangements, conferring additional risk for negative outcomes. Awareness of diabetes-induced muscle abnormalities remains low among healthcare professionals, patients and policymakers, contributing to research, knowledge and practice gaps. Lifestyle recommendations and treatments centered on nutritional care and physical activity to preserve and improve muscle mass and function remain poorly implemented. The European Society for Clinical Nutrition and Metabolism (ESPEN) and the Diabetes Nutrition Study Group (DNSG), reference group for the European Association for the Study of Diabetes, recognize sarcopenic diabetes as a distinct clinical condition and priority for research and education, and call for action to enhance awareness, stimulate research and promote consensus on sarcopenic diabetes diagnostic criteria, prevention and management.

Keywords: Complications; Diabetes; Obesity; Sarcopenia; Skeletal muscle.