Bone Abstracts

Objective: Type 1 diabetes (T1D) in one of the commonest chronic childhood disorders; poor muscle function and sarcopenia has been reported among T1D in adults. Reports on the impairment of muscle function are scarce in children. Our objective was to assess muscle mass and function in children with diabetes and study association of muscle mass and function with control of blood glucose (as measured by HbA1C) and disease duration.

Methodology: This was a cross sectional observational study conducted at a tertiary level pediatric endocrine and growth unit in Pune, India. Children with T1D with disease duration of >1 year with no other co-morbidity or associated illness were included in the study. Demographic data, anthropometric measurements, details of insulin treatment, disease duration and HbA1c were collected. Muscle mass was measured using iDXA (Lunar iDXA, GE Healthcare, WI, fan beam scanner, encore software – version 16) and sarcopenia index was calculated using the formula -Appendicular lean mass/body mass index (BMI). Muscle function was tested with 2 tests: a single two legged jump and multiple one legged hopping on a portable ground reaction force platform (Leonardo Mechanograph, Novotec).

Results: Data on 38 children were analyzed (20 boys and 18 girls), their mean age was 13.6±2.6 years and mean disease duration was 4.9±2 years. Their mean height, weight and BMI Z scores were −0.6±0.9, −0.6±0.9 and −0.4±0.9 respectively. Mean HbA1c in boys was 9.9% and in girls 9.8% (P>0.05). The mean Z scores in comparison with healthy Indian children, for maximum voluntary force, maximum voluntary force relative to body weight, maximum power and relative maximum power were −0.36±1, −0.2±1.1, −0.35±1.3 and −0.5±1.1 respectively. Mean sarcopenia index in girls was 684.9±233.7 and 662.2±170.3 m². On co-relation analysis, HbA1c had a significant negative correlation with sarcopenia index in boys (R²=−0.53, P=0.02) but not in girls (R²=0.3, P=0.16). Disease duration also had a negative correlation with power max in boys (R²=−0.5, P=0.01) but not in girls (R²=0.24, P=0.3).

Conclusion: Mean muscle function parameters were lower in children with diabetes in comparison with healthy controls. Poor glucose control and increasing duration of diabetes may increase the risk of compromised muscle function, especially in boys.

Disclosure: The authors declared no competing interests.