Diabetic sarcopenia in clinical practice: expert consensus and usability evaluation of a novel screening and diagnostic algorithm.

Abstract

Introduction: Recently, an expert panel developed an algorithm for the screening, diagnosis, and staging of diabetic sarcopenia, a clinically relevant condition in the progression of diabetes. Sarcopenia is associated with an increased risk of falls, physical disability, reduced quality of life, and increased mortality.

Methods: A qualitative study, with quantitative aspects, was conducted to assess medical specialists' opinions on the applicability of the proposed algorithm. Data was collected using a questionnaire that included information relating to user experience, a usability questionnaire, a survey of healthcare professionals' opinions and a consensus form administered using the Delphi method.

Results: The questionnaire was completed by 299 doctors (65.9% were women, mean age 39.1 (SD 8.5) years and with a mean of 10.4 (SD 8) years' experience). Most respondents indicated that screening for sarcopenia should be prioritised in patients with recent hospitalisations, major surgery, prolonged immobilisation and malignancies (Median 9, IQ0) and should be repeated annually in high-risk patients without a confirmed diagnosis (Median 8, IQ2). The algorithm was considered suitable for muscle assessment in people with diabetes. 90% of participants considered the tool to be easy to use, requiring no specialist staff (70%), and taking less than 7 min to apply (88%). For most respondents, use of the algorithm has changed the approach to decision-making regarding sarcopenia in patients with type 2 diabetes.

Conclusion: The findings highlight the importance of systematic screening, diagnosis, and staging of diabetic sarcopenia, and demonstrate high levels of perceived applicability and usability of the proposed algorithm in routine clinical practice.