Decreased Muscle Strength and Quality in Older Adults With Type 2 Diabetes

The Health, Aging, and Body Composition Study

  1. Seok Won Park12,
  2. Bret H. Goodpaster3,
  3. Elsa S. Strotmeyer2,
  4. Nathalie de Rekeneire4,
  5. Tamara B. Harris5,
  6. Ann V. Schwartz6,
  7. Frances A. Tylavsky7 and
  8. Anne B. Newman2
  1. 1Department of Internal Medicine, Pochon CHA University, Pochon, Korea
  2. 2Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania
  3. 3Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
  4. 4Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia
  5. 5Laboratory for Epidemiology, Demography and Biometry, National Institute on Aging, Bethesda, Maryland
  6. 6Department of Epidemiology and Biostatistics, University of California, San Francisco, California
  7. 7Department of Preventive Medicine, University of Tennessee, Memphis, Tennessee
  1. Address correspondence and reprint requests to Seok Won Park, MD, MPH, PhD, Department of Internal Medicine, Pochon CHA University, 351 Yatap-dong, Sungnam, 463-712, Korea. E-mail: parks{at}


Adequate skeletal muscle strength is essential for physical functioning and low muscle strength is a predictor of physical limitations. Older adults with diabetes have a two- to threefold increased risk of physical disability. However, muscle strength has never been investigated with regard to diabetes in a population-based study. We evaluated grip and knee extensor strength and muscle mass in 485 older adults with diabetes and 2,133 without diabetes in the Health, Aging, and Body Composition study. Older adults with diabetes had greater arm and leg muscle mass than those without diabetes because they were bigger in body size. Despite this, muscle strength was lower in men with diabetes and not higher in women with diabetes than corresponding counterparts. Muscle quality, defined as muscle strength per unit regional muscle mass, was significantly lower in men and women with diabetes than those without diabetes in both upper and lower extremities. Furthermore, longer duration of diabetes (≥6 years) and poor glycemic control (HbA1c >8.0%) were associated with even poorer muscle quality. In conclusion, diabetes is associated with lower skeletal muscle strength and quality. These characteristics may contribute to the development of physical disability in older adults with diabetes.


  • DOI: 10.2337/db05-1183

    The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.

    • Accepted February 23, 2006.
    • Received September 8, 2005.
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