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”
- out every 2 persons having diabetes across the globe, are undiagnosed.
- 79% of all people having diabetes are from low or middle income countries.
Negligent outlook towards regular body checkups
Undiagnosed percentage and undiagnosed cases of diabetes (20-79 years) by region
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, which is the decline of muscle mass in a person’s body
- Under nutrition
- sedentary lifestyle
- oxidative stress
- decreased testosterone
Skeletal muscles are the primary site of insulin  stimulated glucose disposal at euglycemia.
Patients afflicted with diabetes have a 2x loss in thigh muscle, as compared to people who don’t have diabetes
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.
- 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.
- *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
- *Percent Body Fat is a better indicator of cardiovascular risk factors than BM
- 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.
- 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
- 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