DIABETES

Develop more effective

treatment and prevention strategies

Why is body composition analysis

an effective tool for diabetes programs?

It is already known that obesity, especially visceral fat, is a major risk factor for diabetes.​
Besides, quantified body fat, muscle and extracellular water for each body segment enables to identify visceral fat, sarcopenia, changes in leg muscles, and edema in leg extremities. It provide basic data for drug prescriptions, insulin dose, exercise / diet program, and complication management. ​

In particular, in pediatric patients whose growth and development are important, accurate body composition measurement is to guide proper growth and
development, and is essential for accurately diagnosing the type of diabetes.

  • Obtain objective measurements of muscle, fat, and visceral fat to assess disease risk and obesity.
  • Measure leg muscles and monitor the outcomes of interventions aimed to improve insulin resistance, and the maximization of the effectiveness of drugs.
  • Detect the onset of diabetic complications such as diabetic kidney disease by monitoring fluid imbalance with ECW Ratio
MUSCLE-FAT ANALYSIS, SEGMENTAL LEAN ANALYSIS, VISCERAL FAT AREA

Diabetes and fat, muscles.

Besides obesity, sarcopenia is another independent risk factor for diabetes. 80% of the glucose uptake occurs in the Skeletal Muscle Mass (SMM), and especially the leg muscle takes up about 60% of total SMM. Muscle level can be evaluated by Skeletal Muscle Mass Index (SMI) or Muscle ratio (Muscle/Fat) which is to predict metabolic syndrome, sarcopenia in risk group, and insulin resistance. It is also used to assess the (side) effects of SGLT-2 inhibitors and GLP-1 receptor agonists.

SEGMENTAL ECW RATIO ANALYSIS

Managing Diabetic Complications

Often the severity of the diabetes is overlooked because it is considered as lifestyle disease without hospitalization. However, diabetes is one of the most severe disease as high blood glucose causes complications such as cardiovascular disease, and kidney failure. Treatment can be done in three phases: Pre-screen the causes, early detect the onset of complications, and properly manage after obtaining complications. ​

With body compositions, muscle increase prevents cardiovascular disease, Extracellular Water Ratio (ECW Ratio) may detect vascular stenosis and kidney failure. For Diabetic Kidney Disease (DKD) patients, ECW Ratio is used to set proper dry weight which contributes to the proper dialysis and extends the longevity. Besides, it also shows the diuretic effect of the SGLT-2 inhibitors in DKD patients. To conclude, the body compositions are the indicators to be monitored in regards of diabetic complications.​

MUSCLE-FAT ANALYSIS IN CHILDREN

Pediatric Diabetes

In children, growth and development are the most important health indicator. However, onset of diabetes causes metabolic disorders which may lead to abnormal growth and development. Traditionally, weight by height or BMI are used as growth indicators, but it limitedly reflect the adiposity level. In this background, measuring body compositions in pediatric patients is essential to provide accurate information about the growth. ​

It helps distinguish newly diagnosed diabetic patients or atypical cases such as non-obese patient with T2DM. It is also used to detect double diabetes who has characteristics of both type 1 and 2 diabetes. The body compositions can guide normal growth and development and can be used as a base information when selecting diabetes treatment for the pediatric patients. ​

BODY COMPOSITION HISTORY

Track changes in muscle, fat, and fluid balance to chart progress

The best way to prevent or reverse diabetes is by making healthy-focused behavioral and lifestyle changes. However, health professionals often have a hard time keeping patients engaged in a diet and exercise regimen. With a comprehensive body composition report, InBody devices show patients the changes that ordinary weight scales are incapable of showing and provide an educational outline to start a discussion towards lifestyle change. In addition, patients and providers can use the Body Composition History section to chart their progress throughout interventions and make adjustments to optimize results and health outcomes. ​

ACTUAL CASE

Case 1

Tall : 153cm

Age : 57 years old

Weight : 50.4kg

Gender : Female

Note: This female in her 50s had weight, SMM, body fat mass all in the normal range, but had relatively low SMM. She had slight imbalance between upper/lower limb due to low muscle development in the lower limb compared to the upper limb.​

Out of all the muscles in the human body, the thigh muscle is known to use the most glucose in the blood. This female has been on diabetes medication for 5 years and by this we can figure that low leg muscle is related to diabetes.​

Her SMI is 5.8kg/m2 which isn’t diagnosed as sarcopenia, but because it is close to the cut-off value it is important to regularly monitor the appendicular muscle mass so it doesn’t lead to sarcopenia.

ACTUAL CASE

Case 2

Tall : 174cm

Age : 76 years old

Weight : 74.2kg

Gender : Male

This male in his 70s looks healthy compared to his age because weight, SMM and body fat mass is all in the normal range. However, his ECW Ratio is 0.402 which means edema.​

This male has been diagnosed as diabetes for 20 years and is also suffering from hypertension and prostatic hypertrophy. Also due to angiosis and other complications, the ECW ratio is over the normal range.​

Muscle status looks okay according to SMI of 8.4kg/m2. However, severe lower limb edema due to complications should be taken care of that it doesn’t proceed.

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