Evaluation of Sarcopenia in Overweight and Middle-Aged Patients with Diabetes and Its Association with Poor Glycemic Control

Objective: Sarcopenia, characterized by reduced muscle mass and strength, commonly affects the elderly. This study aimed to assess sarcopenia in middle-aged, overweight patients with type 2 diabetes (T2D) and examine its relationship with glycemic control.

Methods: This cross-sectional study enrolled 60 patients with T2D, including 30 individuals with poor glycemic control (PGC; glycated hemoglobin (HbA1c) >7%, mean age 54 Å} 5 years, 46.6% women) and 30 with adequate glycemic control (AGC; HbA1c ≤ 7%, mean age 54 Å} 6 years, 50% women). Sarcopenia was evaluated using handgrip strength (HGS), skeletal muscle mass index (SMMI), and the 4-meter walk test, as well as the Sarcopenia Quality of Life (SARQoL) and Pittsburgh Sleep Quality (PSQ) questionnaires.

Results: Sarcopenia was diagnosed in 5 patients (16.6%), all from the PGC group. These patients had significantly lower median HGS (15.4 kg) and SMMI (7.4 kg/m2) compared to those with AGC (29.8 kg and 10.6 kg/m2; P = .021 and .006, respectively). HbA1c negatively correlated with HGS (r = −0.424; P = .001). Multivariate linear regression analysis demonstrated that higher HbA1c levels were independently associated with lower SMMI (β: −0.293; 95% CI: −0.483 to −0.102; P = .003) and lower HGS (β: −2.016; 95% CI: −2.885 to −1.147; P < .001). The SARQoL score was lower in patients with sarcopenia (P = .022), while the PSQ score was similar.

Conclusion: Sarcopenia may develop in non-elderly, overweight patients with poorly controlled diabetes, negatively affecting quality of life. Early screening for sarcopenia should be considered if diabetes is uncontrolled.

Cite this article as: Daloglu OO, Unal MC, Guller PU, et al. Evaluation of sarcopenia in overweight and middle-aged patients with diabetes and its association with poor glycemic control. Endocrinol Res Pract. Published online June 1, 2026. doi: 10.5152/erp.2026.25873