Elucidating Prevalence and Risk Determinants of Sarcopenia in Type 2 Diabetes Mellitus [SARC-T2DM]

This is a prospective cross-sectional study designed to determine the prevalence and risk determinants of sarcopenia among Indian adults aged 60 years or above with type 2 diabetes mellitus. The study will recruit 260 participants from the Endocrinology outpatient department at Kasturba Hospital, Manipal, using consecutive sampling. Sarcopenia will be diagnosed using the Asian Working Group for Sarcopenia 2019 criteria, which is validated for Asian populations and considered the gold standard. Assessment will be conducted through a single visit lasting 45 to 60 minutes, including handgrip dynamometry for muscle strength, dual energy X-ray absorptiometry scan for muscle mass measurement, physical performance tests including 5-time chair stand or 6-meter walk test, and quality of life assessment using the sarcopenia-specific SarQoL questionnaire and generic EQ-5D-5L instrument in English or Kannada versions. A nested case-control component will include 30 sarcopenic and 30 non-sarcopenic participants matched by propensity scores for metabolomic profiling using gas chromatography-mass spectrometry to identify dysregulated metabolic pathways and novel biomarkers. This will be the first Indian study to perform metabolic profiling in sarcopenic type 2 diabetes patients. The study aims to identify modifiable clinical and demographic risk factors, assess quality of life deficits, and contribute evidence for integrating sarcopenia screening into national diabetes management guidelines. Data will be analyzed using descriptive statistics, binary logistic regression for risk factor analysis, Mann-Whitney U tests for quality of life comparisons, and propensity score matching for metabolomic case-control analysis. The estimated study duration is 2 years and 6 months.