Assessment of hand grip strength may be used as a simple tool to easily identify adults at increased risk for type 2 diabetes (T2D), according to study results published in the American Journal of Preventive Medicine.

Previous studies reported that low muscular strength and quality are associated with increased risk for T2D in adults. Recently, hand grip cut points for detecting T2D risk have been established in US adults. The goal of the current study was to explore the age- and sex-specific thresholds of muscular strength for assessment of prediabetes and T2D risk categorization among healthy, normotensive adults.

The study included data on 5108 individuals aged 20 to 80 years from the National Health and Nutrition Examination Survey (NHANES) in 2011 to 2012 and 2013 to 2014. Most included individuals (68.6%) were aged 20 to 50 years (1813 men; 1692 women) and the remainder were aged 50 to 80 years (813 men; 790 women).

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Muscular strength was assessed using a handgrip dynamometer and normalized by adjusting for body weight. Risk for T2D was determined using American Diabetes Association diagnostic criteria.

The study findings supported that normalized grip strength was an appropriate screening tool for the detection of T2D, as low muscular strength was associated with increased risk for T2D, but not for prediabetes. Based on these data, the researchers established normalized grip strength cut points for the risk in adults.

The cut points for T2D risk in the younger group were 0.78 for men and 0.57 for women. In the older group, the cut points were 0.68 for men and 0.49 for women. The risk percentages for T2D in the younger group were 6.84 (95% CI, 5.32-8.36) and 7.49 (95% CI, 5.87-9.10) among men and women, respectively. In the older group, the respective risk percentages were 5.76 (95% CI, 2.34-9.19) and 4.27 (95% CI, 2.44-6.10) for men and women. The normalized grip strength cut points were most accurate for T2D risk estimation in the older group.

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The study had several limitations, including cut points limited only to the 2 age categories included in the study, as well as possible limitations secondary to diurnal variations in muscular performance and inclusion of the nondominant hand value, which may have reduced the maximal strength assessment.

“In apparently healthy adults, low [muscular strength] is associated with increased risk of [T2D] after controlling for known covariates. Established [normalized grip strength cut points, such as the ones proposed in this study,] may be used in U.S. adults for the detection of increased risk of [T2D],” concluded the researchers.


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

This article originally appeared on Endocrinology Advisor