O-45: Muscle function, strength and functional capacity in pediatric type 1 diabetes: implications for sarcopenia
A Jalilova, D Özalp Kızılay, Ö Kurt, A Suner, Y Atik Altınok, G Demir, S Özen, D GökşenAbstract
Introduction
Type 1 diabetes mellitus (T1DM) may affect skeletal muscle beyond glycemic control. However, pediatric data integrating muscle mass, strength, and functional performance are limited. Moreover, early alterations in muscle function may have important implications for long-term metabolic and physical health.
Objectives
To evaluate muscle mass, strength, and functional performance in children with T1DM and to assess their association with glycemic control.
Methods
This cross-sectional study included 82 children with T1DM and 89 healthy controls. Body composition (ASM/height2, muscle-to-fat ratio) was assessed by bioimpedance. Muscle strength was measured by handgrip dynamometry, and functional performance by the 6-minute walk test (6MWT). Low muscle parameters were defined using sex-specific 5th percentile cut-offs. Correlations between HbA1c, TIR, and CV with muscle outcomes were analyzed. Multivariable regression adjusted for age, sex, and BMI.
Results
ASM/height2 and handgrip strength were comparable between groups. Muscle-to-fat ratio was higher in T1DM (p<0.001), indicating a leaner body composition. In contrast, functional performance was reduced, with shorter 6MWT distance in T1DM (450 vs 485 m, p=0.007). Sarcopenia prevalence was low and similar (4.9% vs 4.5%). Glycemic metrics (HbA1c, TIR, CV) were not associated with muscle mass, strength, or performance. In adjusted analyses, T1DM remained independently associated with lower 6MWT distance (β=−26.6 m, p=0.015), while handgrip strength was higher (β=+3.77 kg, p=0.004). These findings suggest a dissociation between preserved muscle quantity and reduced functional capacity.
Conclusions
Children with T1DM demonstrate preserved muscle mass and strength but reduced functional exercise capacity. Muscle function was not associated with glycemic metrics, suggesting that factors beyond glucose control contribute to early functional impairment. Functional assessment may provide additional clinical insight in pediatric T1DM.