Sarcopenia in type 1 diabetes mellitus: a systematic review

Introduction: Sarcopenia is the progressive skeletal muscle impairment that affects 10–16 % of the elderly worldwide. Sarcopenia can be recognised at any age, particularly in subjects with a wide range of conditions, including metabolic diseases. We conducted a systematic review of current evidence on the association between sarcopenia and type 1 diabetes (T1D). Methods: We searched in PubMed-Medline and Web of Science databases. PRISMA guidelines were applied, and the risk of bias was assessed following the RoB 2.0 and ROBINS-I V2 tools. Results: A total of 15 studies were included. Most of the studies were published in the last five years (n = 13), were undertaken in Europe (n = 7) or Asia (n = 6), had a cross-sectional design (n = 13), and enrolled adult T1D subjects (n = 12). The sample size of the included studies varied from 16 to 177 T1D subjects. Conclusion: Sarcopenia represents a relevant issue in T1D subjects in all age groups. Older age and lower BMI are the main determinants of muscle decline, while conflicting data are available on diabetes duration, glucose control, dietary and physical exercise behaviours. Despite these initial findings, future research should clarify the molecular basis of muscle impairment in T1D and establish accurate diagnostic procedures, preventive and therapeutic trajectories.