Abstract

With the progressive aging of the global population, the comorbidity of type 2 diabetes mellitus (T2DM) and sarcopenia has emerged as a critical public‑health challenge among older adults. Sarcopenia is characterized by progressive and generalized loss of skeletal‑muscle mass, strength, and physical performance, which substantially increases risks of falls, frailty, disability, hospital admission, and all‑cause mortality in older patients with T2DM. Bidirectional interactions exist between T2DM and sarcopenia: insulin resistance, chronic low‑grade inflammation, oxidative stress, hormonal dysregulation, and nutritional deficiency jointly accelerate skeletal muscle deterioration, while sarcopenia in turn worsens glycemic homeostasis and amplifies diabetic‑related complications. This review aims to summarize current evidence regarding pathogenesis, modifiable and non‑modifiable risk factors, as well as multi‑modal intervention approaches for sarcopenia in older adults living with T2DM. Limitations of existing studies and directions for future clinical research are also discussed, hoping to provide reference for early screening and comprehensive clinical management of this comorbid condition.

Keywords: older adults; type 2 diabetes mellitus; sarcopenia; insulin resistance; risk factor; intervention

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