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World J Diabetes. Oct 15, 2026; 17(10): 124847
Published online Oct 15, 2026. doi: 10.4239/wjd.124847
Published online Oct 15, 2026. doi: 10.4239/wjd.124847
Pathophysiological mechanisms and risk factors linking type 2 diabetes mellitus and sarcopenia: A narrative review
Xiu-Li Xie, School of Pharmaceutical Sciences, Xiamen University, Xiamen 361102, Fujian Province, China
Hai-Yan Cao, Zhong-Yu Han, School of Medicine, Southeast University, Nanjing 210009, Jiangsu Province, China
Zi-Tong Wang, Department of Acupuncture and Tuina, Changchun University of Chinese Medicine, Changchun 130117, Jilin Province, China
Hao-Ran Chen, Li-Sui Zhou, Chengdu Xinhua Hospital Affiliated to North Sichuan Medical College, Chengdu Xinhua Hospital, Chengdu 610055, Sichuan Province, China
Tao Qian, Department of Thyroid and Breast Surgery, Nanjing University of Chinese Medicine, Nanjing 210009, Jiangsu Province, China
Co-first authors: Xiu-Li Xie and Hai-Yan Cao.
Co-corresponding authors: Tao Qian and Zhong-Yu Han.
Author contributions: Xie XL and Cao HY prepared the first draft of the manuscript as co-first authors; Xie XL, Cao HY, Wang ZT, Chen HR, and Zhou LS were involved in writing the article; Qian T and Han ZY were involved in the conception of the study as co-corresponding authors; all authors read and approved the final manuscript.
AI contribution statement: The authors take full responsibility and accountability for all content of this manuscript, including any portions for which AI tools were used as assistive technologies. All AI-assisted outputs were carefully reviewed, validated, and approved by the authors. AI tools were not used to generate original scientific data, perform independent scientific analyses, or draw scientific conclusions.
Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.
Corresponding author: Zhong-Yu Han, Academic Fellow, School of Medicine, Southeast University, No. 2 Southeast University Road, Jiangning District, Nanjing 210009, Jiangsu Province, China. hzyczy1997@163.com
Received: June 25, 2026
Revised: July 30, 2026
Accepted: September 9, 2026
Published online: October 15, 2026
Processing time: 109 Days and 15.5 Hours
Revised: July 30, 2026
Accepted: September 9, 2026
Published online: October 15, 2026
Processing time: 109 Days and 15.5 Hours
Core Tip
Core Tip: Type 2 diabetes mellitus significantly accelerates skeletal muscle decline and is an independent risk factor for sarcopenia, particularly in older adults. This review highlights key interconnected mechanisms – including insulin resistance, chronic inflammation, mitochondrial dysfunction, and altered protein metabolism – that drive muscle loss in type 2 diabetes mellitus. Given the high and often underrecognized prevalence of sarcopenia in diabetic populations, early screening and integrated management are essential. Multimodal strategies combining glycaemic control, resistance exercise, adequate nutrition, and muscle-protective pharmacotherapy may effectively mitigate functional decline and improve patient outcomes.