Type 1 diabetes (T1D) is often described as a state of accelerated aging, although comparative data on physical performance measures between individuals with T1D and the general population are limited. We compared gait speed and handgrip strength of middle-aged adults with T1D with published normative data and further assessed correlates of physical function in T1D. Participants of the EDC study of childhood onset T1D who attended the 25-yr exam - when handgrip strength and gait speed were first assessed - were selected for study (n=204; 53.9% women; mean age, 51 (range, 30-69) years and duration, 43 (32-63) years). Within each decile of age, mean handgrip strength (kg) obtained from the dominant hand was lower in T1D compared with adults participating in the NIH Toolbox Study in both sexes (all p-values <0.03). In contrast, both usual and maximum gait speed (m/s) were generally higher in T1D except in 60-69 year olds, where speeds were similar by diabetes status. Within individuals with T1D, diabetes duration, female sex, macroalbuminuria, and confirmed distal symmetric polyneuropathy were all inversely, and total lean mass and physical activity were positively related to handgrip strength and explained 62% of its variability. In addition, body mass index and smoking status, inversely, and physical activity positively related to gait speed and explained 23% of the variability in usual gait speed and 17% of the variability in maximum gait speed. No associations were seen with HbA1c.
In conclusion, although no differences were seen in gait speed, we observed reduced handgrip strength among middle-aged adults with long duration T1D compared with published normative values. Microvascular complications, body fatness and participation in physical activity explained and the vast majority of the variability in handgrip strength, pointing to the importance of healthy lifestyle choices in maintaining physical function in individuals with T1D in mid-life and early old age.
T. Costacou: None. E.S. Strotmeyer: None. T.J. Orchard: None.
National Institutes of Health (DK34818)