Morphological and functional changes in skeletal muscle in type 2 diabetes mellitus: A systematic review and meta-analysis

Abstract

ABSTRACT Introduction Changes in the skeletal muscle are common in patients with type 2 diabetes mellitus (T2DM). These changes impair your motor skills. Objective This systematic review aimed to investigate changes in skeletal muscle in patients with T2DM. Methods The search was carried out in the PubMed, Scopus, and Web of Science databases until December 1, 2021. Observational studies that evaluated musculoskeletal changes in people with T2DM were included. The review was based on PRISMA recommendations. The primary parameters analyzed were muscle strength, muscle mass, muscle power, and muscle endurance. Results Forty-eight studies were included, with a total of 26,042 participants. The results revealed that T2DM is associated with a reduction in handgrip [−2.64 (CI 95% = −3.33 to −1.95, Z = −7.50, p < .0001], and knee extension muscle strength [−0.56 (CI 95% = −0.76 to −0.36, Z = −5.64, p < .0001)], a higher percentage of type II fibers [11.74 (CI 95% = 6.24 to 17.25, Z = 4.18, p < .0001)], and a lower percentage of type I fibers [−15.69 (CI 95% = −18.22 to −13.16, Z = −12.16, p < .0001], in addition to a greater thickness of the calcaneus tendon (p < .0001). Conclusion Individuals with T2DM present skeletal muscle impairments, mainly reduced muscle strength, mass, and endurance; increase in the thickness of the calcaneus tendon, and alteration in the proportion of type I and II fibers, even in the initial stage of the disease.