Association between sarcopenia and diabetes: a systematic review and meta-analysis of observational studies

  • Nicola VeroneseEmail author
  • Damiano Pizzol
  • Jacopo Demurtas
  • Pinar Soysal
  • Lee Smith
  • Cornel Sieber
  • Timo Strandberg
  • Isabelle Bourdel-Marchasson
  • Alan Sinclair
  • Mirko Petrovic
  • Stefania Maggi
  • on behalf of the Special Interest Groups of Systematic Reviews and Meta-Analysis for Healthy Ageing, Diabetes, Sarcopenia of European Geriatric Medicine Society (EuGMS)

Key summary points


To summarize the prevalence of diabetes in people with sarcopenia (and vice versa) through a meta-analytic approach of available observational studies.


In this work, we have presented the findings of the first full methodological systematic review and meta-analysis of observational studies exploring the relationship between diabetes and sarcopenia. Our findings overall emphasize the reciprocal relationship between diabetes and sarcopenia in terms of risk of occurrence, that is sarcopenia increases the risk of diabetes being present and vice versa.


This study provides support for further research into the prognosis of people with both diabetes and sarcopenia and the value of interventional strategies in sarcopenia to minimize adverse outcomes such as premature death, hospitalization, and disability.



Sarcopenia and diabetes are two common conditions in older people. Some recent literature has proposed that these two conditions can be associated. However, to date, no attempt has been made to collate this literature. Therefore, we aimed to summarize the prevalence of sarcopenia in diabetes (and vice versa) and the prevalence of sarcopenia in people with diabetes complications, through a systematic review and meta-analysis.


Two authors searched major electronic databases from inception until March 2019 for case control/cross-sectional/longitudinal studies investigating sarcopenia and diabetes. The strength of the reciprocal associations between sarcopenia and diabetes was assessed through odds ratios (ORs) with 95% confidence intervals (CIs), adjusted for potential confounders, where possible.


From 953 potential eligible articles, 20 were included in the systematic review, with 17 providing data for meta-analysis. Overall, 54,676 participants were included (mean age = 65.4 years). Diabetic participants had an increased prevalence of sarcopenia compared to controls (n = 10; OR = 1.635; 95% CI 1.204–2.220; p = 0.002; I2 = 67%), whilst, after adjusting for potential confounders, sarcopenia was associated with an increased odds of having diabetes (OR = 2.067; 95% CI 1.396–3.624; p < 0.0001; I2 = 0%). In 1868 diabetic participants with a complication, there was an increased prevalence of sarcopenia (OR = 2.446; 95% CI 1.839–3.254; p < 0.0001; I2 = 0%), as compared with those with no complication. Very limited data existed regarding studies with a longitudinal design.


Our study suggests a bidirectional association between diabetes and sarcopenia, particularly when diabetic complications are present.


Diabetes Sarcopenia Physical performance Meta-analysis 



None to declare.

Compliance with ethical standards

Conflict of interest

The authors have not conflict of interest to declare for this work.

Ethical approval

Not required since it is a review of already published works.

Informed consent

For this type of study, formal consent is not required.

Supplementary material

41999_2019_216_MOESM1_ESM.docx (39 kb)
Supplementary material 1 (DOCX 39 kb)


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Copyright information

© European Geriatric Medicine Society 2019

Authors and Affiliations

  • Nicola Veronese
    • 1
    Email author
  • Damiano Pizzol
    • 2
  • Jacopo Demurtas
    • 3
  • Pinar Soysal
    • 4
  • Lee Smith
    • 5
  • Cornel Sieber
    • 6
  • Timo Strandberg
    • 7
    • 8
  • Isabelle Bourdel-Marchasson
    • 9
    • 10
  • Alan Sinclair
    • 11
  • Mirko Petrovic
    • 12
  • Stefania Maggi
    • 1
  • on behalf of the Special Interest Groups of Systematic Reviews and Meta-Analysis for Healthy Ageing, Diabetes, Sarcopenia of European Geriatric Medicine Society (EuGMS)
  1. 1.National Research Council, Neuroscience InstitutePaduaItaly
  2. 2.Operational Research UnitDoctors with AfricaDar es SalaamMozambique
  3. 3.Primary Care DepartmentAzienda USL Toscana Sud EstGrossetoItaly
  4. 4.Department of Geriatric MedicineBezmialem Vakif UniversityIstanbulTurkey
  5. 5.The Cambridge Centre for Sport and Exercise SciencesAnglia Ruskin UniversityCambridgeUK
  6. 6.Institute for Biomedicine of Ageing (IBA)Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU)NurembergGermany
  7. 7.University of Helsinki, Clinicum and Helsinki University HospitalHelsinkiFinland
  8. 8.Center for Life Course Health ResearchUniversity of OuluOuluFinland
  9. 9.CNRS, University of Bordeaux, RMSBBordeauxFrance
  10. 10.Pôle de Gérontologie Clinique, CHU de BordeauxBordeauxFrance
  11. 11.Diabetes Frail Ltd and King’s CollegeLondonUK
  12. 12.Department of Internal Medicine and Paediatrics, Section of GeriatricsGhent UniversityGhentBelgium

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