SKELETAL MUSCLE: ONE OF THE SILENT TARGETS OF DIABETIC COMPLICATIONS
Objective: Muscle weakness in diabetes has been considered a rare manifestation associated with severe diabetic neuropathy. However, similar
findings are lacking in individuals with early diabetes. Handgrip strength is a reliable measurement of the disability index. The present study was
designed to determine the effect of early Type 2 diabetes on handgrip strength in adults by handgrip dynamometer.
Methods: 30 subjects with diabetes (1-5 years duration) were taken as case, and thirty age and sex-matched subjects without diabetes were taken
as controls. Subjects with hypertension, heart diseases, and neuromuscular disorders were excluded. Skeletal muscle function was determined using
hand grip dynamometer. Maximum voluntary contraction (MVC) was measured thrice and best of that it was taken. For endurance time (ET) 50% of
MVC was taken. Anthropometric measurements were taken, and random blood sugar testing was done.
Results: Compared to controls, cases had decreased mid forearm circumference (23.97Â±1.7 cm vs. 23.8Â±2.7 cm, p<0.005). MVC and ET were also
significantly reduced in cases when compared with control subjects (MVC, 32.46Â±6.865 kg vs. 22.48Â±4.420 kg, p<0.025) and ET (44.57Â±17.294 seconds
vs. 16.63Â±9.810 seconds, p<0.022).
Conclusion: Our study suggests that there is a decline in skeletal muscle strength in type 2 diabetes even before the disease manifests severely.
This provides evidence that impaired grip strength is associated with adverse metabolic profile, in addition, to the loss of physical function, and the
potential for grip strength to be used in the clinical setting needs to be explored.
Keywords: Skeletal muscle function, Handgrip, Diabetes, Endurance time, Maximum voluntary contraction.
1. Innes EV. Handgrip strength testing: A review of the literature. Aust
Occup Ther J 1999;46(3):120-40.
2. Petersen KF, Shulman GI. Pathogenesis of skeletal muscle insulin
resistance in Type 2 diabetes mellitus. Am J Cardiol 2002;90(5A):11G-8.
3. Delmonico MJ, Harris TB, Visser M, Park SW, Conroy MB,
Velasquez-Mieyer P, et al. Longitudinal study of muscle strength, quality,
and adipose tissue infiltration. Am J Clin Nutr 2009;90(6):1579-85.
4. Wild SH, Roglic G, Green A, Sicree R, King H. Global prevalence of
diabetes: Estimates for the year 2000 and projections for 2030 response
to Rathman and Giani. Diabetes Care 2004;27(10):2568-9.
5. Bohannon RW. Dynamometer measurements of hand-grip strength
predict multiple outcomes. Percept Mot Skills 2001;93(2):323-8.
6. Khatri DK, Juvekar AR. Î±-glucosidase and Î±-amylase inhibitory
activity of Indigofera cordifolia seeds and leaves extract. Int J Pharm
Pharm Sci 2014;6(11):152-5.
7. van der Kooi AL, Snijder MB, Peters RJ, van Valkengoed IG. The
association of handgrip strength and Type 2 Diabetes Mellitus in
Six Ethnic Groups: An analysis of the HELIUS study. PLoS One
8. Bonora E, Targher G. Increased risk of cardiovascular disease and
chronic kidney disease in NAFLD. Nat Rev Gastroenterol Hepatol
9. Ohlendieck K. Pathobiochemical changes in diabetic skeletal muscle
as revealed by mass-spectrometry-based proteomics. J Nutr Metab
10. Lillioja S, Mott DM, Howard BV, Bennett PH, Yki-JÃ¤rvinen H,
Freymond D, et al. Impaired glucose tolerance as a disorder of insulin
action. Longitudinal and cross-sectional studies in Pima Indians.
N Engl J Med 1988;318(19):1217-25.
11. Warram JH, Martin BC, Krolewski AS, Soeldner JS, Kahn CR. Slow
glucose removal rate and hyperinsulinemia precede the development
Asian J Pharm Clin Res, Vol 9, Issue 2, 2016, 206-208
Poornima, et al.
of Type II diabetes in the offspring of diabetic parents. Ann Intern Med
12. Bogardus C, Lillioja S, Stone K, Mott D. Correlation between muscle
glycogen synthase activity and in vivo insulin action in man. J Clin
13. Helmersson J, Vessby B, Larsson A, Basu S. Association of Type 2
diabetes with cyclooxygenase-mediated inflammation and oxidative
stress in an elderly population. Circulation 2004;109(14):1729-34.
14. Cotter MA, Cameron NE. Metabolic, neural and vascular influences on
muscle function in experimental models of diabetes mellitus and related
pathological states. Basic Appl Myol 1994;4:293-307.
15. Ramamurthy B, Jones AD, Larsson L. Glutathione reverses early
effects of glycation on myosin function. Am J Physiol Cell Physiol
The publication is licensed under CC By and is open access. Copyright is with author and allowed to retain publishing rights without restrictions.