This article, titled “Bibliometric mapping of diabetes mellitus and sarcopenia research: hotspots and emerging trends” by Wang, M., Zhou, Q., Guo, X., Cui, X., Tang, Z., Ou, T., Zhao, X., Liang, C., Xu, P., Dai, X., Yao, J., Ji, G., and Li, Y., published in Frontiers in Medicine in 2025, presents a pioneering bibliometric analysis of the scientific literature on diabetes mellitus and sarcopenia.
Background and Purpose: The study addresses the increasing scientific attention on the interrelationship between diabetes mellitus and sarcopenia, two chronic metabolic disorders that frequently coexist and interact bidirectionally. The authors highlight that the interrelationship between these conditions is of critical importance due to their synergistic worsening of metabolic dysregulation, elevated cardiovascular and all-cause mortality risks, and substantial economic burdens on healthcare systems. Despite existing research, a systematic bibliometric analysis was previously lacking. Therefore, the primary aim of this study was to systematically investigate their association by mapping the knowledge structure, evolutionary trajectories, current foci, and emerging frontiers within this research area. By offering a novel perspective, the findings aim to provide actionable insights for clinical decision-making and advance investigative efforts.
Methodology: The researchers retrieved 2,773 publications from the Web of Science Core Collection (WOSCC) from its inception until December 26, 2024. This extensive dataset was then subjected to visual and quantitative analyses using a combination of specialized bibliometric tools, including CiteSpace, VOSviewer, R (with the Bibliometrix package), and Microsoft Excel. The analysis encompassed various aspects, such as disciplinary distributions, publication outputs, national/regional contributions, institutional collaborations, authorship networks, journal profiles, references, and keywords. Data collection and filtering were rigorously conducted by two independent authors to ensure methodological rigor.
Key Findings and Insights:
- Publication Growth and Impact: The field has demonstrated sustained annual growth, with a notable acceleration after 2014, coinciding with the adoption of standardized sarcopenia diagnostic criteria. A peak of 394 publications was recorded in 2024 (up to December 26). The total citation count for these publications reached 100,355, with an average of 36.19 citations per article, and an h-index of 141, reflecting substantial productivity and sustained academic influence.
- Geographical and Institutional Dominance: The United States dominates scholarly contributions, leading in both publication volume (578 papers) and total citation frequency (43,305 citations). China follows with 478 papers. Together, the U.S. and China account for approximately one-third of all publications, reflecting significant national investment and alignment with high prevalence of diabetes-sarcopenia comorbidity in their aging populations. Harvard University ranked first globally among institutions with 62 publications, and six of the top ten institutions were based in the U.S..
- Key Authors: Fukui Michiaki emerged as the most prolific author, contributing 42 publications with 750 total citations, demonstrating exceptional consistency and productivity.
- Interdisciplinary Nature and Key Journals: Research in diabetes and sarcopenia exhibits marked interdisciplinary integration, spanning fields such as endocrinology, geriatrics, nutrition, biochemistry, and clinical medicine. Nutrients ranked first in publication volume (82 articles), while PloS One was the most co-cited journal (1,316 co-citations), followed by Diabetes Care (1,295 co-citations).
- Core Literature: The most frequently co-cited reference was the 2019 article “Sarcopenia: Revised European Consensus on Definition and Diagnosis” by Cruz-Jentoft et al., which updated the EWGSOP definition, emphasizing low muscle strength and providing diagnostic thresholds. The review “Sarcopenia and Type 2 Diabetes Mellitus: A Bidirectional Relationship” was also highly co-cited, underscoring the growing recognition of the reciprocal causal link between T2DM and sarcopenia mediated by insulin resistance, chronic inflammation, and mitochondrial dysfunction.
- Research Hotspots and Trends: Current research hotspots include:
- Shared pathological mechanisms such as insulin resistance, chronic low-grade inflammation, oxidative stress, mitochondrial dysfunction, and adipose-muscle crosstalk. Mechanistic exploration is identified as a primary driver of domain advancement.
- Clinical characterization of specific subtypes, particularly sarcopenic obesity (SO), defined as the co-existence of excess adiposity and low muscle mass/function. Research focuses on its epidemiological characteristics, risk factors, and prognostic indicators.
- Imaging-based assessment of muscle dysfunction in diabetes, utilizing advanced technologies like dual-energy X-ray absorptiometry (DXA), computed tomography (CT), and magnetic resonance imaging (MRI) for qualitative and quantitative muscle evaluation.
- Therapeutic efficacy of exercise as an intervention. Exercise-based strategies, including resistance training and multimodal exercise, play an important role in the clinical management of diabetic sarcopenia.
- Evolution of Research Focus: The research trajectory has evolved from early studies centered on “diabetes mellitus” and “insulin resistance” to a deeper exploration of “muscle atrophy” and “body composition” between 2000 and 2010. From 2010 to 2020, “sarcopenic obesity,” “oxidative stress,” and “handgrip strength” gained prominence. Since 2020, there has been a shift towards cross-disciplinary terms like “metabolic syndrome,” “frailty,” and “cardiovascular disease,” emphasizing multi-system joint assessments and the synergistic impact of diabetes and sarcopenia on overall health outcomes. The overall trajectory indicates an evolution from mechanistic exploration to clinical integration, advancing toward multidimensional precision interventions.
Conclusion and Future Directions: The field has evolved from theoretical frameworks to clinical applications, emphasizing the importance of uncovering common pathophysiological mechanisms and pinpointing potential therapeutic targets. While most research has focused on the relationship between T2DM and sarcopenia, studies examining sarcopenia in Type 1 Diabetes Mellitus (T1DM) remain limited, representing a significant research gap. Future priorities include refining screening and diagnostic protocols, optimizing preventive strategies, and developing personalized interventions. Cross-disciplinary innovations integrating multi-omics and precision medicine, along with AI-driven digital biomarkers and community-based ultrasound AI screening, are poised to reshape this research landscape and enhance health outcomes for patients.
Limitations: The authors acknowledge limitations, including the emphasis on quantitative trends over qualitative validity, the exclusive use of the WOSCC database (potentially omitting studies from other sources), and the exclusion of non-English publications, which may introduce selection bias.
Reference: Wang, M., Zhou, Q., Guo, X., Cui, X., Tang, Z., Ou, T., Zhao, X., Liang, C., Xu, P., Dai, X., Yao, J., Ji, G., & Li, Y. (2025). Bibliometric mapping of diabetes mellitus and sarcopenia research: hotspots and emerging trends. Frontiers in Medicine, 12, 1586308. https://doi.org/10.3389/fmed.2025.1586308.
