New grip strength thresholds identify diabetes risk

New guidelines align grip strength measurements with the early onset of type 2 diabetes.

Early stage type 2 diabetes may not produce obvious symptoms, making detection difficult and often leading to cardiovascular issues.

It is known, however, that the onset of type 2 diabetes may reveal itself through muscular weakness, which a reduction in the strength of a person’s grip can indicate.

This loss of grip strength can be an important diagnostic clue for the disease in adults who appear healthy otherwise. Until now, though, specific grip strength values that signify type 2 diabetes have not been available.

However, the researchers behind a new study have now identified specific grip strength cut points that indicate type 2 diabetes, making it possible for doctors to perform quick, easy testing for diabetes.

“Our study identifies the levels of handgrip strength/weakness that correlate with [type 2 diabetes] in otherwise healthy men and women, according to their body weights and ages,” says lead investigator Elise C. Brown, Ph.D., of Oakland University, Rochester, MI.

Scientists from Oakland University worked in collaboration with the University of West Scotland, which has campuses in southwestern Scotland and London, United Kingdom, to conduct this research.

The study appears in the American Journal of Preventive Medicine.

The type 2 diabetes problem

More than 34 million people in the United States currently have diabetes, according to the Centers for Disease Control and Prevention (CDC). Of these individuals, 90–95% have type 2 diabetes, which is associated with an increased risk of cardiovascular morbidity and mortality.

Although type 2 primarily affects adults over the age of 45, it is now appearing in an increasing number of younger adults, teenagers, and children.

The costs associated with undiagnosed prediabetes and diabetes in 2017 in the U.S. — $43.4 billion and $31.7 billion, respectively — reflect the impact of the disease on people’s lives.

People can manage diabetes, and early diagnosis can often make it possible to prevent or delay the development of cardiovascular problems, such as retinopathy, neuropathy, and kidney disease (nephropathy).

“As the type 2 diabetes patient population continues to increase in the United States, diagnosing this disease in its early stages is becoming increasingly more important for preventing complications caused by blood vessel damage associated with diabetes.”

— Elise C. Brown, first author of the study

The study

The authors of the study analyzed grip strength data from the 2011–2012 and 2013–2014 National Health and Nutrition Examination Surveys to arrive at the cut points that indicate type 2 diabetes.

The data that the researchers studied came from grip strength tests that assessed 5,108 individuals’ muscle strength using inexpensive handgrip dynamometer devices.

The team excluded potential survey participants whom they assessed as having hypertension or other diabetes comorbidities. The data came from people who ranged in age from 20 to 80 years.

A dynamometer captures the combined grip strength of an individual’s left and right hands as a kilogram value. Dividing this number by the person’s weight in kilograms gives the person’s normalized grip strength.

In parsing the data from the survey, the researchers applied controls for:

• sociodemographics, including sex, age, race, ethnicity, poverty, and education
• lifestyle factors, including activity level, alcohol use, and smoking
• waist circumference

Their analysis allowed them to identify the grip strength cut points below which the presence of type 2 diabetes is indicated.

The study’s cut points take into account sex, age, and body weight, allowing diagnosticians to determine quickly and inexpensively a specific individual’s risk of type 2 diabetes — including that of apparently healthy adults — and the need for further, more in-depth testing.

Getting a head start on the disease

Lead author Brown explains the significance of the study.

She says, “Given the low cost, minimal training requirement and quickness of the assessment, the use of the normalized grip strength cut points in this paper could be used in routine health screenings to identify at-risk patients and improve diagnosis and outcomes.”

The study marks a significant change in the early diagnosis of type 2 diabetes, says Brown. “Healthcare providers now have a reliable test to detect it early before […] complications set in.”

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