PMID- 37489121
OWN - NLM
STAT- MEDLINE
DCOM- 20230727
LR  - 20230727
IS  - 2167-8359 (Electronic)
IS  - 2167-8359 (Linking)
VI  - 11
DP  - 2023
TI  - Hand grip strength is inversely associated with total daily insulin dose 
      requirement in patients with type 2 diabetes mellitus: a cross-sectional study.
PG  - e15761
LID - 10.7717/peerj.15761 [doi]
LID - e15761
AB  - BACKGROUND: Short-term (2 weeks to 3 months) insulin intensive therapy using 
      continuous subcutaneous insulin infusion (CSII) can improve islet beta cell 
      function and prolong glycemic remission in patients with newly diagnosed type 2 
      diabetes mellitus (T2DM). However, the total daily insulin dose (TDD, IU/kg/d) 
      required to achieve near-normoglycemic control with CSII still needs to be 
      frequently adjusted based on blood glucose monitoring. Although real-time 
      continuous glucose monitoring (rtCGM), which measures the interstitial fluid 
      glucose concentration continuously without much difficulty, facilitates the 
      adjustment of insulin dosage, its adoption in the T2DM population is strictly 
      limited by insurance coverage and lack of awareness of rtCGM among clinicians. 
      Thus, it is of clinical significance to identify easy-to-use parameters that may 
      allow a more rapid and accurate prediction of TDD requirement. This study aimed 
      to explore the association between hand grip strength (HGS) and TDD requirement 
      in patients with T2DM receiving CSII therapy. METHODS: A total of 180 eligible 
      patients with T2DM were enrolled in the study and divided into three groups based 
      on their HGS: low (L), medium (M), and high (H). The TDD requirement was 
      calculated on day 7 or 8 of CSII treatment. Anthropometric parameters, including 
      HGS, skeletal muscle mass, skeletal muscle index (SMI) and 6-m gait speed, and 
      laboratory data, were collected on the morning of the second day after admission, 
      within the first 24 h of CSII therapy. These parameters were used to identify 
      significant predictors of TDD requirement using Pearson or Spearman correlation 
      test, and stepwise multiple regression analysis. RESULTS: There were no 
      significant differences in age, duration of T2DM, waist-to-hip ratio (WHR), body 
      mass index (BMI), blood pressure, liver function, estimated glomerular filtration 
      rate, triglyceride, total cholesterol, glycosylated hemoglobin A1c (HbA1c), 
      homeostatic model assessment of insulin resistance (HOMA-IR), and homeostasis 
      model assessment of beta cell function (HOMA-beta) among the groups. The H group had 
      higher body muscle mass-to-fat ratio (BMFR), skeletal muscle mass-to-fat ratio 
      (SMFR), SMI, 6-m gait speed, and lower TDD requirement than the M and L groups. 
      The HGS negatively correlated with TDD requirement (r = -0.33, p < 0.001) after 
      adjusting for sex, age, BMI, WHR, HbA1c, Ln (HOMA-beta), Ln (HOMA-IR), Ln (BMFR), Ln 
      (SMFR), SMI, and 6-m gait speed. Multivariate stepwise regression analysis 
      indicated that HGS was an independent predictor of TDD requirement in patients 
      with T2DM (beta = -0.45, p < 0 001). CONCLUSION: Lower HGS is associated with an 
      increased TDD requirement in T2DM patients. HGS may facilitate the prediction of 
      TDD requirement in T2DM patients receiving CSII therapy.
CI  - (c) 2023 Chen et al.
FAU - Chen, Da-Shuang
AU  - Chen DS
AD  - Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, 
      Nanjing, Jiangsu, China.
FAU - Zhu, Yun-Qing
AU  - Zhu YQ
AD  - Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, 
      Nanjing, Jiangsu, China.
FAU - Ni, Wen-Ji
AU  - Ni WJ
AD  - Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, 
      Nanjing, Jiangsu, China.
FAU - Li, Yu-Jiao
AU  - Li YJ
AD  - Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, 
      Nanjing, Jiangsu, China.
FAU - Yin, Guo-Ping
AU  - Yin GP
AD  - Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, 
      Nanjing, Jiangsu, China.
FAU - Shao, Zi-Yue
AU  - Shao ZY
AD  - Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, 
      Nanjing, Jiangsu, China.
FAU - Zhu, Jian
AU  - Zhu J
AUID- ORCID: 0000-0002-4629-9883
AD  - Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, 
      Nanjing, Jiangsu, China.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20230720
PL  - United States
TA  - PeerJ
JT  - PeerJ
JID - 101603425
RN  - 0 (Insulin)
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Glycated Hemoglobin)
RN  - 0 (Blood Glucose)
RN  - 0 (Insulin, Regular, Human)
SB  - IM
MH  - Humans
MH  - *Insulin/therapeutic use
MH  - *Diabetes Mellitus, Type 2/drug therapy
MH  - Hypoglycemic Agents/therapeutic use
MH  - Blood Glucose Self-Monitoring
MH  - Cross-Sectional Studies
MH  - Glycated Hemoglobin
MH  - Hand Strength
MH  - Blood Glucose/metabolism
MH  - Insulin, Regular, Human/therapeutic use
PMC - PMC10363338
OTO - NOTNLM
OT  - Hand grip strength
OT  - Total daily insulin dose
OT  - Type 2 diabetes mellitus
COIS- The authors declare that they have no competing interests.
EDAT- 2023/07/25 06:43
MHDA- 2023/07/27 06:42
PMCR- 2023/07/20
CRDT- 2023/07/25 03:36
PHST- 2022/05/10 00:00 [received]
PHST- 2023/06/27 00:00 [accepted]
PHST- 2023/07/27 06:42 [medline]
PHST- 2023/07/25 06:43 [pubmed]
PHST- 2023/07/25 03:36 [entrez]
PHST- 2023/07/20 00:00 [pmc-release]
AID - 15761 [pii]
AID - 10.7717/peerj.15761 [doi]
PST - epublish
SO  - PeerJ. 2023 Jul 20;11:e15761. doi: 10.7717/peerj.15761. eCollection 2023.