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The emergence of frailty and sarcopaenia in diabetes mellitus: description of inter-relationships and clinical importance

Sinclair, Alan J.; Sinclair, Harriet; Bellary, Sri; Rodriguez-Manas, Leocadio

Cardiovascular Endocrinology: June 2016 - Volume 5 - Issue 2 - p 40–50
doi: 10.1097/XCE.0000000000000075
Review article

Diabetes mellitus is a highly prevalent chronic disease, with an associated heavy personal and public health burden of disability, morbidity and mortality. The focus of care for older patients with diabetes is prevention of functional decline, with early intervention rather than attempting to recover function later. Diabetes doubles the risk of frailty. An important contributor towards physical frailty is sarcopaenia, which manifests as an age-related loss of skeletal muscle volume and power. Frailty is not an inevitable consequence of the ageing process; it is a dynamic and potentially reversible condition that highlights the importance of early recognition and intervention. In this review, we examine the evidence for linking diabetes to frailty and sarcopaenia and how the emergence of these conditions should lead to changes in clinician behaviour in terms of assessment of function and goal setting. High-quality, focused research in this area is now mandatory.

aFoundation for Diabetes Research in Older People, Diabetes Frail Ltd, Worcester

bFaculty of Health and Life Sciences, University of Aston, Birmingham, UK

cGeriatric Medicine, Hospital Universitario de Getafe, Madrid and the European University, Madrid, Spain

Correspondence to Alan J. Sinclair, MSc, MD, Clinical Trials Unit, Medici Medical Practice, 3 Windsor Street, Luton LU1 3 UA, UK Tel: +44 7469 178232; e-mail:

Received December 23, 2015

Accepted February 22, 2016

Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.