Frailty syndrome and type 2 diabetes – relationships and risks
Authors:
Pavel Weber 1,3; Dana Weberová 4,2; Hana Meluzínová 3,2; Vlasta Polcarová 1; Katarína Bieláková 1
Authors‘ workplace:
Všeobecná interní klinika Lékařské fakulty Masarykovy univerzity a Fakultní nemocnice Brno
1; Klinika interní, geriatrie a praktického lékařství Lékařské fakulty Masarykovy univerzity a Fakultní nemocnice Brno
2; DIASTOP, diabetologická a interní ambulance, U Pošty 14, Brno
3; Interní gastroenterologická klinika Lékařské fakulty Masarykovy univerzity a Fakultní nemocnice Brno
4
Published in:
Geriatrie a Gerontologie 2026, 15, č. 2: 55-59
Category:
Original Article
doi:
https://doi.org/10.61568/geri/50-6739/20260506/143563
Overview
Introduction: Dysregulation of physiological systems during aging is considered a key feature of frailty syndrome (FS), although no single specific cause has been identified. Diabetes mellitus (DM) and FS are two major geriatric challenges that often overlap in older adults and negatively influence each other. The aim of this study was to highlight selected aspects of the relationship between FS and DM over the period 1995–2022.
Methods: This retrospective study included patients from two time periods (1995–2010 and 2011–2022) who were admitted to our clinic. A total of 28,594 individuals aged 65–105 years were analyzed. Of these, 17,752 were women (mean age 81.7 ± 7.7 years) and 10,842 were men (mean age 79.0 ± 7.6 years). Women were almost 3 years older than men (p < 0.01). The prevalence of DM was 33.7% in men and 33.0% in women. FS and pre-frailty (PF) were present in 46.7% and 33.6% of men, and in 50.7% and 36.3% of women, respectively.
Results: The prevalence of FS and pre-frailty (PF) was consistently higher in patients with DM by 1–1.5 % across all time periods and in both sexes. Similarly, the age at which FS and PF occurred was lower in patients with DM by 2–2.2 years. Mortality occurred earlier in patients with DM and FS (or PF) compared with non-diabetic individuals by 1–1.5 years. Our results demonstrate temporal trends in several aspects of the relationship between DM and FS across the two study periods. During this time, median life expectancy increased by 1.3–2.1 years.
Conclusion: The presence of FS as an unfavorable prognostic factor should substantially influence diagnostic and therapeutic strategies, including preventive approaches. Older frail patients with DM are particularly at risk of polypharmacy, cognitive impairment, and falls. Effective management of FS and DM in older adults includes: (A) nutritional support aimed at preventing malnutrition and sarcopenia; (B) regular physical activity; (C) optimization of pharmacotherapy; and (D) comprehensive geriatric assessment (CGA), including regular evaluation of frailty, cognition, depression, and fall risk.
Keywords:
geriatrization of medicine – mortality – diabetes mellitus – comorbidities – frailty syndrome – acute hospitalization of older adults
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Geriatrics and Gerontology
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