Declines in muscle strength and muscle mass are common in type 2 diabetes mellitus (T2DM), but their relative association with future diabetes-related complications remains unclear. A prospective cohort study published in Diabetes Research and Clinical Practice evaluated the associations of grip strength and muscle mass with incident complications in adults with T2DM.

The analysis included 10,844 participants with T2DM from the UK Biobank who were free of complications at baseline. Participants were followed for a median of 13.2 years. Grip strength was measured using a Jamar hydraulic hand dynamometer, while skeletal muscle mass was estimated using bioelectrical impedance analysis and the Janssen equation. Both measures were categorized into sex-specific tertiles. Cox proportional hazards models were used to assess associations with 12 incident complications.

Findings

• During follow-up, 11,373 incident complications were recorded.
• Compared with the high grip strength group, low grip strength was associated with significantly higher risks of CAD, HF, PAD, dementia, diabetic kidney disease, diabetic neuropathy, diabetic retinopathy, COPD, steatotic liver disease, and osteoporosis. The strongest association was observed for osteoporosis (HR 1.84; 95% CI, 1.37-2.47).
• The inverse association between grip strength and CAD risk was stronger in women than in men.
• Compared with the high muscle mass group, low muscle mass was associated only with higher COPD risk (HR 1.40; 95% CI, 1.11-1.76).

The findings suggest that lower grip strength may provide broader prognostic information for diabetes-related complications than low muscle mass in adults with T2DM.