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Life sciences · Journal article
The Journal of Nutrition Health & Aging · August 8, 2026
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This cross-sectional study identified three body composition-defined sarcopenia phenotypes in 107 frail older adults with diabetes (78.9% sarcopenic), each showing distinct metabolic and complication profiles. Sarcopenic obesity was associated with insulin resistance markers and metabolic syndrome; sarcopenia without adiposity with microvascular and macrovascular complications despite similar glycemic control. The authors acknowledge preliminary status and call for larger longitudinal confirmation before clinical translation.
Cross-sectional study. 109 adults aged 70 years or older with diabetes and frailty; 107 included in final analysis after exclusion of 2 participants in a small non-sarcopenic with adiposity subgroup.. Intervention: Sarcopenia phenotype classification based on body composition (sarcopenic obesity, sarcopenia without adiposity, non-sarcopenic with adiposity).. n = 107.
Sarcopenia identified in 86 of 109 participants (78.9%) Sarcopenic obesity phenotype showed metabolic syndrome in all participants with greater central adiposity and higher triglycerides Sarcopenia without adiposity phenotype showed more neuropathy, albuminuria, and cerebrovascular disease with lower time in range despite similar glycated hemoglobin
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These findings suggest that sarcopenia phenotyping may identify clinically distinct subgroups with different complication risks in frail older adults with diabetes, but current evidence is insufficient to guide management decisions. Larger longitudinal studies are required before phenotype-aware assessment can be recommended in clinical practice.
Cross-sectional descriptive study in a small, frail population identifying distinct sarcopenia phenotypes with different complication profiles; findings are exploratory and explicitly require confirmation in larger longitudinal cohorts before clinical application.
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These findings suggest that sarcopenia phenotyping may identify clinically distinct subgroups with different complication risks in frail older adults with diabetes, but current evidence is insufficient to guide management decisions. Larger longitudinal studies are required before phenotype-aware assessment can be recommended in clinical practice.
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Background and aims Sarcopenia in older adults with diabetes may encompass clinically distinct phenotypes. We examined whether body composition-defined phenotypes differed in diabetes complications, insulin resistance-related metabolic features, and continuous glucose monitoring (CGM)-derived glycemic profiles. Methods This cross-sectional study included 109 adults aged 70 years or older with diabetes and frailty. Sarcopenia was defined according to the European Working Group on Sarcopenia in Older People 2 criteria; adiposity was defined using body mass index, body fat percentage, and central obesity. Analyses were mainly descriptive; exploratory logistic regression assessed poor CGM time in range (TIR), defined as TIR below 70%. Results Sarcopenia was identified in 86 participants (78.9%). After exclusion of 2 participants in a small non-sarcopenic with adiposity subgroup, 107 participants formed three phenotypes. Sarcopenic obesity showed an insulin resistance-related cluster comprising greater central adiposity, higher triglycerides and TyG index, metabolic syndrome in all participants, and greater insulin requirements. Sarcopenia without adiposity showed more neuropathy, albuminuria, cerebrovascular disease, and lower TIR despite similar glycated hemoglobin. Glycated hemoglobin was the only independent correlate of poor TIR; phenotype was not significant overall. Conclusions Phenotypes showed distinct clinical, insulin resistance-related, and CGM profiles. These preliminary findings support phenotype-aware assessment but require confirmation in larger longitudinal studies before informing management.
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