805-P: Sarcopenia in Insulin-Treated Older Adult Patients with Type 2 Diabetes

Abstract

Background: The relationship of sarcopenia with relevant features of T2D and its treatment are inconsistent in the literature. Aims: To evaluate the prevalence of sarcopenia in insulin treated older adults with T2DM. Methods: This is a cross sectional data from a prospective observational cohort study that evaluated subjects older than 65 y/o with T2D on insulin therapy, with or without oral agents, and HbA1c between 7% and 9%, identified from a public hospital and a private diabetes clinic and invited by phone to participate (n= 462) . Patients treated with GLP1 agonists; eGFR <30 ml/min; Hb <11g/dL; ALT> 3x ULN; glucocorticoid use in the previous 3 months, and active malignancy were excluded. The diagnosis of sarcopenia was based on the European Working Group on Sarcopenia in Older People (EWGSOP2) . The SARC-F questionnaire was applied and considered high risk if score > 4. Muscle strength was assessed by handgrip strength (HS) using a manual dynamometer (Jamar®) . The muscle mass was assessed by electrical bioimpedance (BIA - Inbody®) obtaining the skeletal muscle mass index (SMI = MM appendicular / height2) . The physical performance was assessed by the timed up-and-go test (TUG) . The presence of sarcopenia was considered when HS <16Kg for women and <27Kg for men and confirmed when SMI <7.00 kg /m2 for men and ≤5.50 kg / m2 for women. The severity was evaluated when TUG was ≥20s. Results: We assessed 125 patients aged 72.8 ± 5.8 y/o, 53% women and T2D median duration of 21 years (min 1; max 47) ; HbA1c=8.5 ± 1,5%. 50,5% of patients had macrovascular complications history; 25.8% retinopathy; 48,3% neuropathy and 14,3% nephropathy. 18,8% had SARC-F score > 4 indicating high risk of sarcopenia. However, the clinical tests confirmed sarcopenia in only 1,6% of the participants. Conclusions: The prevalence of sarcopenia in older adults with T2D on insulin treatment was lower than general population, which may be explained by the insulin anabolic effects. Disclosure S.A.O.Leite: None. M.Bastos: None. M.Silva: None. A.C.R.Lavalle: None. M.C.Bertogy: None. S.C.Vieira: None. G.E.Umpierrez: Research Support; AstraZeneca, Dexcom, Inc., Novo Nordisk. Funding Abbott Diabetes Care ADC-OUS-IIS-19-47