Patients with diabetes who have high grip strength have a lower risk for adverse health outcomes compared with patients with lower grip strength, according to a prospective study published in Diabetes Care.1
In this prospective cohort study, investigators evaluated 13,373 patients with diabetes who were included in the UK Biobank. Specifically, the investigators sought to determine the association between grip strength and all-cause mortality and the incidence of cardiovascular disease (CVD)/mortality. At 4.9-year follow-up, a total of 4301 patients had developed CVD, and 594 had died due to CVD complications.
CVD mortality was significantly lower (P <.05) in patients with high (hazard ratio [HR] 1.46; 95% CI 0.87-2.46) vs low (HR 4.05; 95% CI 2.72-5.80) grip strength. In addition, the investigators found similar significant associations between diabetes and grip strength with regard to all-cause mortality (P =.020), incidence of CVD (P =.041), and CVD mortality (P =.016).
Patients with low grip strength and diabetes had a significantly greater risk for all-cause mortality compared with patients with high grip strength without diabetes (HR 2.79; 95% CI 2.41-3.23]; P <.0001). Also, patients with high grip strength and diabetes featured a greater risk for all-cause mortality (HR 1.36; 95% CI 1.15-1.61]; P <.0001) but not CVD mortality (HR 1.46; 95% CI 0.87-2.46) compared with high-grip-strength patients without diabetes.
One limitation of this analysis was data bias, since the investigators only evaluated outcomes in patients with diabetes who had survived long enough to be recruited into the study. Also, there was the potential for incomplete ascertainment of diabetes diagnosis, as all diagnoses were obtained via self-reported data.
In addition to low grip strength being a predictive tool for detecting high-risk patients with diabetes, the investigators suggest the introduction of “interventions such as resistance exercise to people with low grip strength” for increasing clinical effectiveness of therapy.
Celis-Morales CA, Petermann F, Hui L, et al. Associations between diabetes and both cardiovascular disease and all-cause mortality are modified by grip strength: evidence from UK Biobank, a prospective population-based cohort study [published online October 6, 2017]. Diabetes Care. doi:10.2337/dc17-0921