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Diabetics with kidney disease 2.5 times more likely to suffer muscle loss: Study

Timothy Goh on 26 Nov 2019

The Straits Times


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SINGAPORE - Diabetics here have yet another reason to keep their condition in check.


A new study has found that those with diabetic nephropathy, also known as diabetic kidney disease, are 2½ times more likely to develop sarcopenia, or loss of muscle mass and function, than diabetics who did not have kidney disease.


The study, which was conducted by SingHealth Polyclinics in collaboration with Duke-NUS and shared with The Straits Times on Monday (Nov 25), also found that 58 per cent of the elderly with Type 2 diabetes had pre-sarcopenia and sarcopenia.


Sarcopenia is an age-related condition that can lead to adverse health outcomes such as physical disability, frailty and increased fall risk, particularly in the elderly.


Pre-sarcopenia is characterised by low muscle mass without an impact on muscle strength or physical performance.


The early warning signs of sarcopenia are a history of falls or near falls and unexplained weight loss over a few months, said Dr Fung Foo Yin, house officer at Ng Teng Fong General Hospital, who was involved in the study.


Adjunct Associate Professor Tan Ngiap Chuan, who is SingHealth Polyclinics' director of research, said 10 per cent of the elderly here spend the last 10 years of their lives with some form of disability, largely due to musculoskeletal disorders and often underpinned by sarcopenia.


Prof Tan, who is the study's lead investigator, said: "With (Singapore's) rapidly ageing population, the prevalence of sarcopenia is expected to rise.


"Understanding the magnitude of sarcopenia and its associated mitigating factors will help to prevent further deterioration of muscle strength and function from this disease."


The study involved 792 patients aged 60-89 from Pasir Ris Polyclinic, more than 380 of whom had Type 2 diabetes.


Patients were tested for sarcopenia using a hand grip strength test, a gait speed test, and a measure of muscle mass.


A questionnaire was also given to patients to obtain their medical and nutritional history.


It was found that 28 per cent of the Type 2 diabetes patients had sarcopenia, while 30 per cent of them had pre-sarcopenia.


The data also revealed that diabetics with kidney disease were 2½ times more likely to develop sarcopenia than those without the disease.


Prof Tan said that around 53 per cent of those with Type 2 diabetes are at risk of developing this disease, which involves damage to the tubes in the kidneys.


This results in proteins leaking into the kidneys but not being reabsorbed, leading to them being passed out through the patient's urine and lost from the body.


As proteins are the building blocks of muscles, this in turn causes a drop in body muscle mass, added Dr Fung.


"Therefore, it's important to control diabetes so as to preserve your kidney's function and hopefully maintain your body's muscle mass," she said.


Those with diabetes can manage their condition by keeping active, losing weight, avoiding smoking and alcohol, and picking healthier food choices.


As patients grow older, however, some of them tend to cut down on their protein intake or eat fewer meals, said Prof Tan.


Ms Lim Siew Choo, senior dietitian at SingHealth Polyclinics, said that for those at risk of sarcopenia or who already have the condition, there is a need to consume sources of protein - at least one palm-sized portion of meat per meal for lunch and dinner.


She added that some patients may also need to consume supplements, such as protein powder, as prescribed by a dietitian.


Prof Tan said those at risk of or living with sarcopenia should also engage in a combination of cardio and resistance exercises on a daily basis.


He said: "A balanced diet and regular exercise will improve diabetes control and promote kidney health. Healthy kidneys prevent loss of proteins, which is necessary for optimal muscle health."


Source: The Straits Times © Singapore Press Holdings Limited. Reproduced with permission.



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