The Lost Glucose Sink: Association of Sarcopenia Risk with Disproportionate Postprandial Glycemic Excursions in Older Adults with Type 2 Diabetes Mellitus
- 1West Bengal University of Health Sciences
Abstract
BackgroundMany adults with type 2 diabetes mellitus (T2DM) in India have a "thin fat" body type, with low skeletal muscle mass for their body mass index. Muscle is the main site of glucose disposal after a meal. Fasting blood sugar (FBS) mostly reflects glucose output from the liver, whereas postprandial blood sugar (PPBS) depends more on insulin driven glucose uptake by muscle.
ObjectiveTo show how the association between sarcopenia risk and postprandial glycemic excursion would be tested in older adults with T2DM and controlled fasting glucose.
MethodsA cross sectional design is planned for adults aged 50 years or more with T2DM, FBS of 90-130 mg/dL and a stable oral regimen. Sarcopenia risk is measured with the SARC F questionnaire (score [≥]4 = high risk). Glycemic excursion ({Delta}BG) is PPBS minus FBS. The method was applied to a dataset of 300 patients collected over an OPD setting. Groups were compared with Welch's t test, the relationship between SARC F score and {Delta}BG was tested with Pearson's correlation, and multiple linear regression adjusted for age, diabetes duration, FBS and drug regimen.
ResultsIn the patient dataset (mean age 67.6 {+/-} 6.8 years), 64 patients (21.3%) had a high risk SARC F score. Mean {Delta}BG was 119.4 {+/-} 29.1 mg/dL in the high risk group and 74.8 {+/-} 22.8 mg/dL in the low risk group (difference 44.6 mg/dL, 95% CI 36.8-52.5; p<0.0001). SARC F score and {Delta}BG were positively correlated (r = 0.777, p<0.0001). After adjustment, each 1 point rise in SARC F score was linked to a 10.2 mg/dL higher {Delta}BG (95% CI 8.6-11.7). The high risk group was about 6 years older, and age and diabetes duration explained part of the crude difference.
ConclusionThe analysis plan can detect and quantify a link between SARC F score and post meal glucose rise while accounting for age, diabetes duration, FBS and drug regimen. Clinical treatment algorithms must shift from exclusively targeting insulin secretion to restoring the mechanical glucose sink through resistance training and age appropriate pharmacological adjustments
Related
- Feedforward–feedback mismatch as a biocybernetic hypothesis for postprandial glycemic dysregulation in type 2 diabetes mellitus
- Acute Postprandial Glycemic and Antioxidant Responses to Maqui Berry Gummies in Adults with Overweight/Obesity: A Small Within-Subject Pilot Study
- Acute Postprandial Glycemic Responses to Breads Made from Five Commercial Wheat-Flour Formulations: A Small Exploratory Nonrandomized Within-Participant Crossover Study
- Effects of Breakfasts with Different Carbohydrate Contents and Glycemic Index Values on Postprandial Subjective Satiety and Plasma Gut Hormone Concentrations in Healthy Adults: An Exploratory Secondary Analysis of an Acute Randomized Crossover Controlled-Feeding Study
- Ultra-processed food intake and postprandial glycemic responses in healthy Korean young adults
BibTeX
@misc{chakraborty2026lost,
title = {{The Lost Glucose Sink: Association of Sarcopenia Risk with Disproportionate Postprandial Glycemic Excursions in Older Adults with Type 2 Diabetes Mellitus}},
author = {D. Chakraborty},
howpublished = {medRxiv},
year = {2026},
month = oct,
doi = {10.64898/2026.10.05.26364797},
url = {https://www.medrxiv.org/content/10.64898/2026.10.05.26364797v1},
note = {CC BY-ND},
}
RIS
TY - UNPB
TI - The Lost Glucose Sink: Association of Sarcopenia Risk with Disproportionate Postprandial Glycemic Excursions in Older Adults with Type 2 Diabetes Mellitus
AU - D. Chakraborty
PY - 2026
DA - 2026/10/05
PB - medRxiv
DO - 10.64898/2026.10.05.26364797
UR - https://www.medrxiv.org/content/10.64898/2026.10.05.26364797v1
AB - BackgroundMany adults with type 2 diabetes mellitus (T2DM) in India have a "thin fat" body type, with low skeletal muscle mass for their body mass index. Muscle is the main site of glucose disposal after a meal. Fasting blood sugar (FBS) mostly reflects glucose output from the liver, whereas postprandial blood sugar (PPBS) depends more on insulin driven glucose uptake by muscle. ObjectiveTo show how the association between sarcopenia risk and postprandial glycemic excursion would be tested in older adults with T2DM and controlled fasting glucose. MethodsA cross sectional design is planned for adults aged 50 years or more with T2DM, FBS of 90-130 mg/dL and a stable oral regimen. Sarcopenia risk is measured with the SARC F questionnaire (score [≥]4 = high risk). Glycemic excursion ({Delta}BG) is PPBS minus FBS. The method was applied to a dataset of 300 patients collected over an OPD setting. Groups were compared with Welch's t test, the relationship between SARC F score and {Delta}BG was tested with Pearson's correlation, and multiple linear regression adjusted for age, diabetes duration, FBS and drug regimen. ResultsIn the patient dataset (mean age 67.6 {+/-} 6.8 years), 64 patients (21.3%) had a high risk SARC F score. Mean {Delta}BG was 119.4 {+/-} 29.1 mg/dL in the high risk group and 74.8 {+/-} 22.8 mg/dL in the low risk group (difference 44.6 mg/dL, 95% CI 36.8-52.5; p<0.0001). SARC F score and {Delta}BG were positively correlated (r = 0.777, p<0.0001). After adjustment, each 1 point rise in SARC F score was linked to a 10.2 mg/dL higher {Delta}BG (95% CI 8.6-11.7). The high risk group was about 6 years older, and age and diabetes duration explained part of the crude difference. ConclusionThe analysis plan can detect and quantify a link between SARC F score and post meal glucose rise while accounting for age, diabetes duration, FBS and drug regimen. Clinical treatment algorithms must shift from exclusively targeting insulin secretion to restoring the mechanical glucose sink through resistance training and age appropriate pharmacological adjustments
ER -