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EARLY DETECTION OF TYPE 2 DIABETES MELLITUS

  • India is rapidly becoming the capital of diabetes in the world.
  • About 73 million Indians affected by Diabetes Mellitus says statistic by the “IDF”[1]
  1. out every 2 persons having diabetes across the globe, are undiagnosed.[2]

Reason?

  • 79% of all people having diabetes are from low or middle income countries.[2]
  • Negligent outlook towards regular body checkups
     

Undiagnosed percentage and undiagnosed cases of diabetes (20-79 years) by region[1]

3 Points to be monitored early:

  • Leg Muscle Mass
  • Visceral Fat & Percent Body Fat (PBF)
  • Extra Cellular Water (ECW) Ratio

17.5% of Indians at or below the age of 65 years are sarcopenic[3], which is the decline of muscle mass in a person’s body

Causes:

  • Aging
  • Under nutrition
  • sedentary lifestyle
  • nflammation
  • oxidative stress
  • decreased testosterone[4]

 

Skeletal muscles are the primary site of insulin [4] stimulated glucose disposal at euglycemia.[4]

RESEARCH POINTS

Patients afflicted with diabetes have a 2x loss in thigh muscle, as compared to people who don’t have diabetes[5]

A higher thigh muscle area is recommended to prevent insulin resistance, for people in normal range of BMI. However, in the case of obese/ overweight people higher thigh muscle area could be cause for concern.[6]

InBody APPLICATION

  • Lower leg muscle mass could be an early indicator for type 2 diabetes, which can be monitored through a Body Composition Analysis.
  • InBody gives a comprehensive and detailed segmental lean analysis within 60 seconds, of the Right Leg, Left Leg, Right Arm, Left Arm and Trunk.
  • Muscle mass below 90 percent on the legs, and SMI values below or close to 7.0 kg/m2 in men and 5.7 kg/m2 in women can be considered to be a red flag and the subject can be advised to go in for further tests.[7]

RESEARCH POINTS

  • *A research conducted on 198 peritoneal patients (141 non diabetics and 57 diabetics) concluded that the ratio of ECW to TBW is higher in diabetic patients 0.40 ± 0.01 vs 0.39 ± 0.01 for men; 0.39 ± 0.01 vs 0.38 ± 0.01. Hence proving a direct relation between the ECW ratio and diabetes mellitus[12]
  • *Percent Body Fat is a better indicator of cardiovascular risk factors than BM[13]
  • A research published in the Diabetes Research and Clinical Practice Journal, carried out a study on 61 patients with untreated DM, to calculate the M/I value as the insulin resistance reference indicator, elementary Body Composition was measured by impedance analysis using InBody 770. The study concluded that “muscle/fat ratio derived from InBody770 is useful as a clinical surrogate indicator of insulin resistance in type 2 DM.[9]
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REFERENCES

  • https://www.idf.org/our-network/regions-members/south-east-asia/members/94-india
  • https://www.idf.org/aboutdiabetes
  • Stefanos Tyrovolas et.al; Factors associated with skeletal muscle mass, sarcopenia, and sarcopenic obesity in older adults: A multi-continent study; Journal of Cachexia, Sarcopenia and Muscle 7(3):n/a-n/a· October 2015
  • Seung Won Lee et.al; Appendicular Skeletal Muscle Mass and Insulin Resistance in an Elderly Korean Population: The Korean Social Life, Health and Aging Project-Health Examination Cohort; Diabetes Metab J; 2015; Page No. 38
  • Seok Won Park et.al; Excessive Loss of Skeletal Muscle Mass in Older Adults With Type 2 Diabetes, Diabetes Care. 2009 Nov
  • Seung Jin Han et.al; Association of Thigh Muscle Mass with Insulin Resistance and Incident Type 2 Diabetes Mellitus in Japanese Americans; Diabetes Metab J. 2018 Dec
  • J Am Med Dir Assoc. 2014 Feb;15(2):95-101
  • Seok Hui Kang et al; Association of Visceral Fat Area with Chronic Kidney Disease and Metabolic Syndrome Risk in the General Population: Analysis Using Multi-Frequency Bioimpedance; Kidney Blood Press Res 2015; 40:223-230
  • Noboru Kurinami et al; Correlation of body muscle/fat ratio with insulinsensitivity using hyperinsulinemiceuglycemicclamp in treatment-naive type 2 diabetes mellitus; Diabetes and Research Clinical Practice 120 (2016) 65-72
  • Dr. Anoop Dinesh Shah et al; Type 2 diabetes and incidence of cardiovascular diseases: a cohort study in 1·9 million people; The Lancet Diabetes & Endocrinology Volume 3, Issue 2, February 2015, Pages 105-113
  • https://www.kidney.org/atoz/content/diabetes
  • Davenport A. et al; Does Diabetes Mellitus Predispose to Increased Fluid Overload in Peritoneal Dialysis Patients? Nephron Clin Pract 2010;114:c60–c66
  • Qiang Zeng; Percent body fat is a better predictor of cardiovascular risk factors than body mass index; Braz J Med Biol Res. 2012 Jul; 45(7): 591–600
Tag : Health

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