Evaluation of changes in muscle mass and strength after insulin therapy in newly diagnosed type 1 diabetes patients

Evaluation of changes in muscle mass and strength after insulin therapy in newly diagnosed Type 1 diabetes patients Introduction and Purpose; Type 1 DM occurs with absolute insulin deficiency due to beta cell damage in the pancreas caused by genetic or environmental factors. The incidence of childhood T1DM is increasing worldwide. In hyperglycemia that occurs in the absence of the anabolic hormone insulin; Complications such as diabetic ketoacidosis, cardiovascular diseases, diabetic neuropathy, nephropathy and retinopathy can be seen. In our study, the relationship between insulin therapy was evaluated muscle mass and strength in newly diagnosed T1DM cases. Patients and Methods; 36 male and female cases aged 5-18 years, diagnosed with T1DM in the Pediatric Endocrinology service of Akdeniz University Faculty of Medicine, were included. The control group consisted of 43 boys and girls of similar age and gender. Laboratory results of all cases were obtained from the hospital data system and muscle strength was measured by dynamometer, and muscle and adipose tissue measurements were made by bioelectrical impedance analysis (BIA) at the beginning of the study. In the group with T1DM, these measurements were repeated at 3 and 6 months. Data of T1DM and control groups were compared at the beginning of the study. Three-period measurement data of the T1DM group receiving insulin therapy were evaluated. Results; A significant increase was observed in body mass index (BMI), fat and muscle mass in the first 3 months in the T1DM group after the initiation of insulin therapy. Although the muscle mass of boys was measured more than girls, BMI, BMI sds, muscle and fat mass in 3 periods showed similar increases in both groups (p=0,04; p=0,021; p<0,001; p<0,001).. While BMI and BMI sds increased significantly in the girl group, the increase in the boy group was not significant. A significant increase was observed in fat and muscle mass in the girls and boys groups. It showed a positive correlation with BMI, fat and muscle mass affected by height, age, gender. BMI, BMI sds, height, fat and muscle mass were found to be similar when the girls and boys were compared with the time of diagnosis at the 6th month (p=0,751; p=0,751; p=0,5; p=0,684; p=0,851). The mean muscle and fat mass of the pubertal group was found to be significantly higher than the prepubertal group. The increase in muscle mass between the diagnosis and the 6th month was significant only in the pubertal group (p=0,038). BMI was found to be higher in the pubertal group. BMI sds were similar in both groups. Muscle mass was found to be similar in the patient and control groups at the beginning of the study, while muscle strength was found to be significantly lower in the patient group (p=0,738; p=0,001). There was a positive correlation between muscle mass and muscle strength in the patient group. Although calcium and phosphorus were in the reference range in the T1DM group, it was found to be significantly lower than the control group (p<0,001). However, no correlation was found between calcium and muscle strength. In T1DM cases, HbA1c decreased significantly during 3 periods. When the groups were compared according to gender and puberty, they were found to be similar. In the T1DM group, the 3rd month HbA1c level was negatively correlated with muscle mass and muscle strength. At the time of diagnosis, the muscle strength of male cases is significantly higher. There was no significant difference between male and female muscle strength changes in the following periods. Muscle strength and muscle mass increased significantly in both sexes after insulin therapy. Conclusion; We found low muscle strength value in T1DM patients. Type 1 DM negatively affects muscle mass and muscle strength in patients. Fat and muscle mass increase and muscle strength is positively affected in patients whose glycemic control is achieved with insulin therapy, which is an anabolic hormone. Keywords: Type 1 DM, insulin, dynamometer, bioelectrical impedance