The association between time in range with sarcopenia and its components in older patients with type 2 diabetes mellitus

Time in range (TIR) is a new marker for blood glucose management, but its relationship with sarcopenia and its components requires further investigation. This study aims to investigate the association between TIR and sarcopenia and its components in older patients with type 2 diabetes mellitus (T2DM). This cross-sectional study included 310 hospitalized patients aged ≥ 60 years with T2DM. Continuous glucose monitoring (CGM) was used to assess TIR, and sarcopenia was diagnosed according to the 2019 criteria of the Asian Working Group on Sarcopenia, including indicators such as skeletal muscle mass index (SMI), handgrip strength, and physical performance. The relationships between TIR and sarcopenia and its components were analyzed using a logistic regression model, a linear regression model, and a restricted cubic spline model. The prevalence of sarcopenia was 32.3%. After adjusting for multiple factors, each 10% increase in TIR was associated with a 17% reduction in sarcopenia risk (odds ratio [OR] and 95% confidence interval [CI] = 0.83 [0.74–0.93], P = 0.001). Patients with TIR ≥ 70% had a 62% lower risk of sarcopenia compared to those with TIR < 50% (OR and 95%CI: 0.38 [0.19–0.74], P = 0.005). TIR showed a linear positive correlation with SMI and a nonlinear correlation with handgrip strength; however, it was not significantly associated with physical performance. Higher TIR is associated with higher muscle mass and handgrip strength, as well as a lower incidence of sarcopenia. For older adults with type 2 diabetes who have a low TIR, caution should be exercised regarding their elevated risk of developing sarcopenia.