Abstract
Objective
Children with type 1 diabetes mellitus (T1DM) are at risk for reduced muscle mass and strength, which may be influenced by insulin deficiency. Although insulin is known to regulate muscle metabolism, data on its effects in newly diagnosed pediatric patients are limited. To describe changes in muscle mass and muscle strength after insulin treatment in children newly diagnosed with T1DM.
Methods
This was a prospective analysis of hospitalized children with newly diagnosed T1DM and age, sex-matched outpatient healthy controls between 2020 and 2021. The primary outcome was muscle strength, muscle mass measured at diagnosis, and three and six months after insulin initiation in patients with T1DM, compared with age- and sex-matched healthy controls. Total body muscle mass were assessed using bioelectrical impedance analysis and muscle strength was measured by handgrip dynamometry.
Results
The study included 36 children with newly diagnosed T1DM and 43 matched controls. Baseline muscle mass did not differ significantly between T1DM patients and controls (p=0.73), but muscle strength was significantly lower in the T1DM group (p=0.001). During follow-up, both muscle mass and muscle strength increased significantly within the T1DM group compared with baseline (p<0.001 for both). No significant correlations were found between muscle parameters and biochemical markers.
Conclusion
Insulin treatment in children with newly diagnosed T1DM was associated with improvements in muscle mass and strength during early follow-up. However, the honeymoon (partial remission) period was not specifically assessed; therefore, its potential contribution to these improvements could not be determined. Regular glycemic control and insulin therapy may contribute to delaying or mitigating complications related to impaired muscle development. Longitudinal studies are warranted to explore the long-term musculoskeletal outcomes of insulin therapy in pediatric T1DM.
Keywords: Type 1 diabetes mellitus, muscle strength, muscle mass
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