Elise Brown, PhD, on Grip Strength as a Predictor of Diabetes

In order to help prevent vascular complications of type 2 diabetes, there is a need for early detection screening tools. While aerobic fitness has been used as a risk indicator in the past, various methods are available for assessment, making cross-study comparisons difficult.

In a recent study, a research team sought to establish low muscular strength cut off points using inexpensive, easy-to-use handgrip dynamometers.

They found that normalized grip strength was significantly associated with risk of diabetes, with cut points for detecting diabetes risk including 0.78 (young male participants), 0.57 (young female participants), 0.68 (older male participants), and 0.49 (older female participants).

Consultant360 reached out to study author Elise Brown, PhD, assistant professor of Wellness & Health Promotion at Oakland University, to find out more about their research.

Consultant360: How did you decide on grip strength as the metric you would use to measure muscular strength in your study?

Elise Brown: Grip strength was chosen as a measure of muscular strength because hand dynamometers, which are used to measure grip strength, are affordable, transportable, time-efficient, and require minimal training. These factors are important for practicality in terms of clinical use. Additionally, grip strength is a way of estimating total muscular strength in adults and older adults.

C360: Why was it important to focus your study on patients who were free from common diabetes comorbidities?

EB: Undiagnosed and untreated diabetes comprises a large proportion of type 2 diabetes cases. Type 2 diabetes does not present symptoms when initially developing but may still cause damage to blood vessels even in early stages of the disease. The cut points were established to screen for diabetes early in those who may not be presenting any signs or symptoms of the disease. Thus, excluding participants with known diabetes comorbidities increases the likelihood that the cut points are accurately predicting diabetes rather than a disease or condition that commonly manifests alongside diabetes. Increased screening efforts in patients without symptoms may aid in early diabetes detection, and reduce complications associated with the disease.

C360: You found that normalized grip strength was a significant predictor of diabetes risk. What do these results mean for clinical practice?

EB: Muscular weakness that commonly accompanies diabetes is evident in early stages of the disease, and a patient’s normalized grip strength may predict their risk of having this disease. Medical practitioners could implement grip strength assessment as a routine preventative clinical measure, and when patients are classified as high risk, further diagnostic testing could be prompted. Grip strength is just another noninvasive, easy to implement tool that could be used to identify those at high risk and in more need of lifestyle intervention and further testing.

C360: What knowledge gaps still exist in this area of medicine?

EB: The establishment of normalized grip strength cut points was the first step in developing a new screening tool for early diabetes detection. These cut points were significant predictors of type 2 diabetes in a nationally representative sample, and the cut points should now be evaluated to determine how well they identify diabetes in apparently healthy, normotensive individuals. There is a need for prospective studies to investigate how well the cut points identify those at risk in diverse populations, and this tool could be incorporated into routine clinical check-ups.

Reference:
Brown EC, Buchan DS, Madi SA, Gordon BN, Drignei D. grip strength cut points for diabetes risk among apparently healthy US adults [published online April 6, 2020]. Am J Prev Med. doi:10.1016/j.amepre.2020.01.016