Abstract

Objective

Children with type 1 diabetes mellitus (T1DM) are at risk for reduced muscle mass and strength, which may be influenced by insulin deficiency. Although insulin is known to regulate muscle metabolism, data on its effects in newly diagnosed pediatric patients are limited. The aim was to describe changes in muscle mass and muscle strength after insulin treatment in children newly diagnosed with T1DM.

Methods

This was a prospective analysis of 36 hospitalized children with newly diagnosed T1DM and 43 age, sex-matched outpatient healthy controls at Akdeniz University Faculty of Medicine Hospital Pediatric Endocrinology Clinic between 2020 and 2021. The primary outcome was muscle strength, muscle mass measured at diagnosis, 3 months and 6 months after insulin initiation in patients with type 1 diabetes, compared with age- and sex-matched healthy controls. Total body muscle mass were assessed using bioelectrical impedance analysis and muscle strength was measured by handgrip dynamometry.

Results

Baseline muscle mass did not differ significantly between T1DM patients and controls (p = 0.73), but muscle strength was significantly lower in the T1DM group (p = 0.001). Following insulin therapy, both muscle mass and strength significantly increased in the T1DM group (p < 0.001 for both). No significant correlations were found between muscle parameters and biochemical markers.

Conclusion

Insulin treatment in children with newly diagnosed T1DM is associated with improvements in muscle mass and strength during early follow-up. Regular glycemic control and insulin therapy may contribute to delaying or mitigating complications related to impaired muscle development. Longitudinal studies are warranted to explore the long-term musculoskeletal outcomes of insulin therapy in pediatric T1DM.