Sarcopenia and Type 2 Diabetes Mellitus: Evaluation, Pathophysiological Links, and Management Strategies

Sarcopenia refers to the rapid loss of skeletal muscle mass and strength, which can result in serious consequences such as falls, fractures, and a higher risk of mortality. The prevalence of sarcopenia is observed to be twice as high in individuals with type 2 diabetes mellitus. Notably, there is a bidirectional relationship between sarcopenia and type 2 diabetes mellitus, where each condit‑‑ion can exacerbate the progression of the other. Overlapping pathophysiological mechanisms, such as insulin resistance, inflammation, oxidative stress, accumulation of advanced glycation end products, mitochondrial dysfunction, myosteatosis, and the aging process itself contribute to the development of both conditions. A few treatments, such as myostatin antagonists, testosterone supplementation, and selective androgen receptor modulators have been explored, but many remain in the experimental or clinical trial stages. The cornerstone of management involves nutritional intervention with foods rich in protein, essential amino acids, vitamin D, and omega-3 fatty acids. Additionally, incorporating regular physical activity, particularly resistance exercises, and minimizing sedentary behavior are key components for management of sarcopenia.