Nutrition counseling is associated with less sarcopenia in diabetes: a cross-sectional and retrospective cohort study

Abstract Background Muscle is crucial for blood glucose regulation. There is a need to prevent and treat sarcopenia in diabetes mellitus (DM). This study aimed to estimate the prevalence of sarcopenia and evaluate the association of nutritional counseling with the development of sarcopenia for DM outpatients. Methods In a cross-sectional and retrospective cohort study, type 2 DM outpatients were recruited from the Diabetes Shared Care Program of a teaching hospital. Muscle mass, muscle strength, and physical functional performance were evaluated using the Asian Working Group for Sarcopenia criteria. The skeletal muscle mass index (SMI) was determined by dividing muscle mass by height in meters squared. Clinical information, including the nutrition counseling record, was retrospectively obtained from medical records for a 2-year period. Results The prevalence of low SMI (pre-sarcopenia) and sarcopenia were 20.4% and 9.6% (including 3.1% severe) among 1292 participants, respectively. Specifically, 15.3% of participants ≥ 65 years were sarcopenic. With a greater frequency of nutritional counseling, there was a lesser risk of sarcopenia; adjusted odds ratio (95% confidence intervals) was 0.51 (0.27-0.94) for ≥ 3 times/2 yrs compared to no counseling. DM duration and age, glycemic status and medication, as well as BMI and counseling frequency had no joint effects; however, these variables (except HbA1c) were independent risk factors for low SMI and sarcopenia. Conclusions Type 2 DM patients have a high risk of sarcopenia. Increased nutrition counseling among outpatients was associated with less sarcopenia. Education about sarcopenia-associated risk factors should be encouraged early in the onset of DM.