Mapping High-Impact Publications in Diabetes and Sarcopenia Research: A Bibliometric Analysis (2003-2024)

Abstract

Background and Aims:

This bibliometric study investigates high-impact publications (HCPs) in Diabetes and Sarcopenia research from 2003 to 2024. The primary aim is to map the scholarly landscape by identifying influential works, key authors, institutions, and emerging trends in the literature, highlighting the interrelationships between diabetes and sarcopenia.

Methods:

A systematic search was conducted in the Scopus database in October 2024 using a combination of keywords related to diabetes and sarcopenia. An initial 2,499 publications were screened, resulting in 151 papers with 100 or more citations. Key bibliographic details, citation counts, author information, and thematic focus areas were extracted and analysed. VOSviewer software was employed for network analysis and visualisation of relationships among authors, institutions and keywords.

Results:

The analysis revealed that the 151 highly cited papers collectively garnered over 15,000 citations, indicating a strong scholarly impact. Key contributors included prominent authors and institutions primarily from the United States and Europe. Major themes identified encompassed the pathophysiological connections between diabetes and sarcopenia, alongside interventions for muscle preservation in people with diabetes. The network analysis highlighted significant collaborations, emphasising the interdisciplinary nature of this research. The study identifies overarching trends and highlights the need for collaborative efforts to address the complexities of diabetes and sarcopenia.

Conclusions:

This research provides a comprehensive overview of influential works and their contributions to the understanding of diabetes and sarcopenia. It establishes a foundation for future research and underscores the critical need for ongoing investigation in this area to improve patient management and outcomes.

Keywords

Diabetes sarcopenia bibliometric study VOSviewer high-impact publications citation analysis

Introduction

Diabetes and sarcopenia research are critical areas of study focusing on the relationship between diabetes and the degenerative loss of skeletal muscle mass, that is, sarcopenia.^[1-3] With the global rise in diabetes and musculoskeletal disorders,^[4-6] mapping high-impact publications (HCPs) in these fields is essential for advancing research and clinical practice.^[7]

This study employs bibliometric analysis using the Scopus database from 2003 to 2024 to identify influential works, key authors, and significant collaborations in diabetes and sarcopenia research. Over the past two decades, advancements in this field have been marked by numerous scholarly contributions. By examining the most cited papers, this study aims to highlight trends, research gaps, and areas of impact in diabetes and musculoskeletal health.^[8-12] Tools like VOSviewer facilitate the visualisation of networks among authors, institutions, and keywords, providing insights into collaborations that drive HCPs.

Previous reviews have covered the diabetes–sarcopenia connection, noting trends and future directions.^[13-19] Recent bibliometric studies examined related topics, revealing the maturation of established subjects such as ‘resistance exercise’ and promising growth in areas like ‘cancer’. However, these studies often lacked comprehensive coverage, primarily using the Web of Science instead of the broader Scopus database.^[20]

Consequently, this study aims to provide a complete analysis of literature and citations over the last two decades, investigating productivity and impact among key contributors in this vital research area.

Material and Methods

Search Strategy

In conducting this study, a systematic search was executed on Scopus, Elsevier’s abstract and citation database, in October 2024, to retrieve relevant data from the period spanning 2003 to 2024. The research strategy employed a combination of keywords related to diabetes including terms such as (diabet* OR ‘Type 1 diabet*’ OR ‘Type 2 diabet*’) and sarcopenia involving phrases like (‘sarcopenia’ OR ‘Skeletal muscle mass’ OR ‘patients with Sarcopenia’). The search query was designed to retrieve publications with publication years between 2003 and 2024, resulting in 2,499 initial search results which were then sorted by the number of citations in ascending order. From these results, a total of 151 documents that garnered 100 or more citations were selected for further analysis, encompassing details such as citation count, title, author information (including name, authorship position, and country), publication year, journal title, study design, and thematic focus areas.

Data Analysis

The subsequent analysis involved extracting keywords from the identified 151 HCPs, followed by a statistical examination of the collected data. This in-depth evaluation of highly cited papers served as a critical step in identifying and understanding the most influential articles that contribute significantly to decision-making processes within the field. To facilitate the exploration of connections among authors, institutions, keywords, and publications, specialised software for bibliometric network analysis and visualisation, VOSviewer 1.6.20 was utilised.^[21]

Statistical Methods

Through this comprehensive analysis, productive authors were identified based on their output exceeding the average productivity of all authors, while impactful organisations were distinguished by a higher citation per paper (CPP) compared to the average CPP of all organisations. Countries with substantial publication output, high CPP, and Relative Citation Index were recognised as the most productive in terms of citation impact. Leveraging the capabilities of the Scopus database and the functionalities of VOSviewer 1.6.20,^[22] a detailed network analysis was conducted, exploring co-authorship, co-occurrence, citation, and co-citation patterns within the realm of non-union fracture research. By constructing networks for authors, institutions, countries, journals (co-citation), and keywords (co-occurrence), VOSviewer is a software tool for constructing and visualising bibliometric networks and provides insights into the intricate relationships among authors, affiliations, geographic regions, publications, and thematic content areas.

Results

Overall Publications

The analysis of HCPs in diabetes and sarcopenia research from 2003 to 2024 reveals significant insights into scholarly impact and collaboration trends [Table 1]. A total of 151 papers published during this period received 57,696 citations, resulting in a CPP of 382.09. The average number of authors per paper is 8.31, indicating a strong emphasis on collaborative research. Funding played a role, with 83 of the papers receiving financial support, and a 54.97% International Collaborative Papers (ICP) rate highlighting the importance of global partnerships. Citation metrics showed substantial growth from 2014 to 2024, with notable variations across the years.

Table 1.

Yearly growth of highly cited papers and citations in diabetes and sarcopenia from 2003 to 2024

Year	TP	TC	CPP	AU	APP	FP	ICP	%ICP	RCI	TC Range
2003	2	487	243.50	9	4.50	1			0.64	212–275
2004	2	996	498.00	7	3.50	1			1.30	269–727
2005	1	102	102.00	5	5.00				0.27	102
2006	1	1,062	1,062.00	1	1.00	1			2.78	1,062
2007	1	127	127.00	3	3.00	1	1	100.00	0.33	127
2008	2	1,126	563.00	12	6.00	1	1	50.00	1.47	188–938
2009	1	100	100.00	6	6.00	1			0.26	100
2010	3	1,036	345.33	23	7.67	1	1	33.33	0.90	130–457
2012	4	1,178	294.50	32	8.00		1	25.00	0.77	136–668
2013	11	2,634	239.45	58	5.27	3	3	27.27	0.63	102–675
2014	21	6,030	287.14	106	5.05	8	6	28.57	0.75	103–1,918
2015	5	1,016	203.20	34	6.80	1	1	20.00	0.53	108–287
2016	16	18,604	1,162.75	203	12.69	7	5	31.25	3.04	100–10,552
2017	14	4,744	338.86	111	7.93	8	4	28.57	0.89	116–1,134
2018	20	7,779	388.95	114	5.70	10	7	35.00	1.02	101–2,753
2019	8	1,366	170.75	48	6.00	5	2	25.00	0.45	105–305
2020	16	3,271	204.44	113	7.06	12	9	56.25	0.54	114–523
2021	18	3,859	214.39	202	11.22	17	6	33.33	0.56	102–664
2022	4	1,924	481.00	141	35.25	4	4	100.00	1.26	196–1,141
2024	1	255	255.00	27	27.00	1	1	100.00	0.67	225
2003–13	28	8,848	316.00	156	5.71	10	7	25.00	0.83	100–1,062
2014–24	123	48,848	397.14	1,099	8.93	73	45	36.59	1.04	100–10,552
Total	151	57,696	382.09	1,255	8.31	83	52	54.97	1.00	100–10,552

Note: TP-Total Papers; TC-Total Citations; CPP-Citations per Paper; AU-Author; AAPP-Average Author per Paper; FP-Funded Papers; ICP-International Collaborative Papers; RCI-Relative Citation Index.

Most HCPs were reviews (81) and original research articles (61), with the majority (94%) authored by multiple institutions. Of the 151 HCPs, 83 (55%) had external funding, accumulating 25,810 citations, averaging 310.96 CPP. Major funding agencies, such as the National Institutes of Health (NIA) and the U.S. Department of Health and Human Services, demonstrated significant contributions to the field, shaping the scientific landscape and advancing research efforts.

Top Most Publishing Countries

Authors from 67 countries contributed to publications, with distribution skewed across different countries. Fifty countries had authors publishing 1-5 papers, while seven countries saw 6-9 papers from their authors. Another nine countries contributed 10-25 papers, with one country standing out with over 66 papers. The United States led in publications, followed by Italy and the UK, representing 18.08%, 6.85%, and 6.30% of the total publication share, respectively [Table 2]. Four of the top 10 countries had CPP and RCI values exceeding global averages of 1,218.84 and 1.43, respectively. Researchers from all the top 10 countries had one-to-one collaborative linkages among themselves and these linkages varied from 18 to 59.

Table 2.

Top 10 most productive countries on diabetes and sarcopenia research

Sl. No.	Country	TP	TC	CPP	FP	%FP	ICP	%ICP	RCI	TLS	Links
1	USA	66	36,492	552.91	46	69.70	29	43.94	0.29	152	59
2	Italy	25	26,164	1,046.56	13	52.00	17	68.00	0.49	143	58
3	UK	23	21,456	932.87	12	52.17	17	73.91	0.46	154	59
4	Spain	19	23,158	1,218.84	12	63.16	14	73.68	1.43	132	57
5	South Korea	16	3,901	243.81	6	37.50	6	37.50	0.11	34	25
6	Germany	14	19,192	1,370.86	8	57.14	11	78.57	0.82	144	57
7	Japan	14	8,258	589.86	10	71.43	6	42.86	0.20	52	34
8	Netherlands	12	19,595	1,632.92	6	50.00	10	83.33	0.58	115	50
9	China	11	1,966	178.73	9	81.82	6	54.55	1.19	22	18
10	Canada	10	8,207	820.70	8	80.00	6	60.00	0.23	45	27
Top 10 Countries		210	1,68,389	801.85	130	61.90	122	58.10	2.59	993	444
World		365	8,68,531	1,880.91	178	84.76	261	71.51	1.00	4,831	2,648

Note: TP-Total Papers; TC-Total Citations; CPP-Citations per Paper; FP-Funded Papers;

ICP-International Collaborative Papers; RCI-Relative Citation Index; TLS-Total Link Strength.

The largest number of collaborative linkages were between researchers from the USA and Italy, followed by the USA and Spain with 12 papers each, the USA and the UK, and the UK and Spain with 10 papers each, highlighting the dominance of developed nations in fostering international collaboration through the co-authorship network. A VOSviewer analysis showcased four distinct collaboration clusters among authors and countries. With 1,324 co-authorship links and a total link strength of 1,919, Cluster 1, marked in red, comprised authors from 31 countries, followed by 20 countries in Cluster 2 (blue), 15 countries in Cluster 3 (green), and a single country, Ireland, in Cluster 4 (yellow). This analysis unveils intricate patterns in collaborative networks within the academic realm of the research field under scrutiny as illustrated in Figure 1.

Figure 1.

Visualisation of co-authorship networks and clusters among 67 countries

Top Most Productive Authors

Out of 1108 authors who participated in 151 HCPs on Diabetes and Sarcopenia research, the majority of authors, accounting for 1,022, published one paper. Moreover, 64 authors contributed to two papers, while 15 authors produced three papers. Furthermore, seven authors were responsible for four or more publications. The research productivity of the top 10 most prolific authors ranged from 3 to 8 articles. Collectively, these 10 authors, who account for 3.73% (n = 46) of the publications, made significant contributions to the field [Table 3].

Table 3.

Top 10 most productive authors on diabetes and sarcopenia research

Name of the Author	Affiliation of the Author	TP	TC	CPP	FP	ICP	%ICP	RCI	TC Range	TLS	Links
Morley J.E.	Saint Louis University, USA	8	2,559	319.88	2	4	50.00	0.24	102–727	60	50
Ferrucci L.	National Institute on Aging, USA	6	3,469	578.17	5	4	66.67	0.44	100–1,892	110	108
Rodriguez Manas l.	Getafe University Hospital, Spain	6	1,285	214.17	3	5	83.33	0.16	109–505	116	107
Anker S.D.	Charité Universitätsmedizin Berlin, Germany	5	17,733	3,546.60	2	5	100.00	2.69	135–10,552	259	216
Malmstrom T.K.	Saint Louis University, USA	4	1,125	281.25	1	1	25.00	0.21	102–675	6	4
Kim S.G.	Soonchunhyang University Bucheon Hospital, South Korea	4	1,112	278.00	1	0	0.00	0.21	170–460	50	44
Choi K.M.	Korea University College of Medicine, South Korea	4	1,053	263.25	0	0	0.00	0.20	167–457	26	19
Cleland J.G.F.	University of Glasgow, UK	3	17,114	5,704.67	1	3	100.00	4.32	1,141–10,552	222	180
Coats A.J.S.	University of Warwick, UK	3	17,114	5,704.67	1	3	100.00	4.32	1,141–10,552	222	180
Falk V.	German Centre for Cardiovascular Research, Germany	3	17,114	5,704.67	1	3	100.00	4.32	1,141–10,552	222	180
Total of Top 10 authors		46	79,678	1,732.13	17	28	60.86	1.31	100–10,552	1,293	1,088
Global Total		1,232	1,463,226	1,187.68
Share of top 10 authors in global total		3.73	5.45

Note: TP-Total Papers; TC-Total Citations; CPP-Citations per Paper; FP-Funded Papers; ICP-International Collaborative Papers; RCI-Relative Citation Index; TLS-Total Link Strength.

VOSviewer analysis was conducted to examine collaborations between authors through co-authorship analysis, identifying eight distinct clusters of authors. These clusters are represented by links totalling 11,742, with a TLS of 12,230. Out of the 1,108 authors studied, all 1,108 met the specified thresholds, and significantly, 357 authors exhibited the most extensive connections within the network map. The size of each circle in the visualisation is determined by the number of documents authored by the respective author. At the same time, the thickness of the connecting lines indicates the strength of collaborations between them as shown in Figure 2.

Figure 2.

Visualisation of 357 author’s collaborations in the co-authorship analysis using VOSviewer

Top 10 Most Productive Institutions

Out of 580 institutions that participated in 151 HCPs on Diabetes and Sarcopenia research, the majority of institutions, accounting for 438, published one paper. Moreover, 109 institutions contributed to two papers, while 20 institutions produced three papers. Furthermore, 13 institutions were responsible for four or more publications. The research productivity of the top 10 most prolific institutions ranged from 4 to 11 articles. Collectively, these 10 institutions, which account for 6.90% (n = 54) of the publications, made significant contributions to the field. These institutions, among the 580 examined, stand out for their noteworthy contributions to the field of research. Figure 3 presents the visualisation of collaborations among the top 33 organisations, each having at least three papers, generated through the VOSviewer tool. In the figure, colours are utilised to differentiate various clusters, with Cluster 8 being specifically highlighted, comprising 120 links and a total link strength of 171. The size of each node corresponds to the number of publications, with larger nodes indicating a higher publication count. Furthermore, the top 10 most productive organisations collaborating in the realm of HCPs demonstrate one-to-one collaborative linkages, as illustrated in Table 4.

Figure 3.

Visualisation of the representation of the highlighted institutions in cluster 8, showcasing their contributions to scholarly research

Table 4.

Top 10 most productive institutions on diabetes and sarcopenia research

Institutions	TP	TC	CPP	FP	ICP	%ICP	RCI	TC Range	TLS	Links
Saint Louis University School of Medicine	11	3,688	335.27	4	6	54.55	0.27	102–804	96	73
National Institute on Ageing	6	4,009	668.17	6	4	66.67	0.53	101–1,948	64	59
University Hospital of Getafe	6	1,275	212.50	3	5	83.33	0.17	103–515	114	105
Mayo Clinic	5	1,436	287.20	2	1	20.00	0.23	120–676	18	16
Harvard Medical School	5	1,373	274.60	3	3	60.00	0.22	103–804	91	72
University of Padova	5	1,076	215.20	2	5	100.00	0.17	124–428	57	56
University of Florida College of Medicine	4	1,568	392.00	2	4	100.00	0.31	115–804	78	60
Yale University School of Medicine	4	1,432	358.00	1	2	50.00	0.28	115–804	38	21
Stanford University School of Medicine	4	1,398	349.50	3	4	100.00	0.28	103–676	67	66
Johns Hopkins University School of Medicine	4	1,115	278.75	4	2	50.00	0.22	101–782	57	54
Total of Top 10 authors	54	18,370	340.19	30	36	66.67	0.27	101–1,948	680	582
Global Total	782	983,029	1,257.07
Share of top 10 authors in global total	6.90	1.86

Note: TP-Total Papers; TC-Total Citations; CPP-Citations per Paper; FP-Funded Papers; ICP-International Collaborative Papers; RCI-Relative Citation Index; TLS-Total Link Strength.

Significant Keywords

Out of the 890 keywords analysed, these terms are highlighted as pivotal areas of interest and investigation in the research domain, clustering into four distinct clusters with 730 links and a total link strength of 5,974, as illustrated in Table 5 and Figure 4. Among the top keywords in the study, ‘Sarcopenia’ emerges as the most frequently occurring term, mentioned 150 times, indicating its significant importance in the research landscape. Following closely is ‘Diabetes Mellitus’ with 89 mentions and ‘Non-Insulin Dependent Diabetes Mellitus’ with 74 mentions, Suggesting a focus on the relationship between these medical conditions. The keywords ‘Obesity’ and ‘Aging’ are also prominent, appearing 72 and 66 times, respectively, in the scholarly literature. Additionally, ‘Muscle Mass’ is referenced 53 times, emphasising its relevance to the study.

Table 5.

List of top 40 signiﬁcant keywords

Sl. No.	Keyword	Occ	TLS	Sl. No.	Keyword	Occ	TLS
1	Sarcopenia	150	1,185	21	Osteoporosis	24	213
2	Diabetes mellitus	89	701	22	Muscle atrophy	24	203
3	Non-insulin dependent diabetes mellitus	74	649	23	Metabolic syndrome x	23	224
4	Obesity	72	646	24	Depression	22	197
5	Aging	66	585	25	Adipose tissue	19	195
6	Muscle mass	53	488	26	Chronic disease	19	174
7	Cardiovascular disease	45	422	27	Malignant neoplasm	18	167
8	Muscle strength	42	359	28	Atherosclerosis	17	142
9	Skeletal muscle	42	357	29	Grip strength	17	134
10	Hypertension	41	333	30	Non-alcoholic fatty liver	15	159
11	Inflammation	39	396	31	Muscle function	15	151
12	Disease association	39	357	32	Body weight	15	131
13	Insulin resistance	38	398	33	Malnutrition	15	120
14	Nonhuman	37	316	34	Sarcopenic obesity	14	164
15	Pathophysiology	35	322	35	Glucose	14	150
16	Exercise	33	304	36	Insulin	14	145
17	Physiology	30	281	37	Diet therapy	14	111
18	Body mass	28	235	38	Muscle weakness	13	126
19	Diabetes mellitus, type 2	27	242	39	Genetics	13	124
20	Quality of life	24	237	40	Neoplasm	13	105

Note: Occ.-Number of Occurrences; TLS-Total Link Strength.

Figure 4.

Visualisation of the four distinct clusters of keywords in the study

Top Most Medium of Research Communication

Through an examination of 106 sources, these 151 publications have played a pivotal role in shaping the research landscape within the domains of Diabetes and Sarcopenia. These top 15 journals are dispersed across six distinct coloured clusters, with 15 links and 20 total link strengths, as illustrated in Table 6 and Figure 5. The top 10 impactful journals collectively contributed 40 papers with a total citation count of 16,406, showcasing a CPP average of 410.15. Among these journals, there were 20 funded papers and 16 ICPs, indicating a significant global impact within the research community. Journals such as ‘Nutrients’, with seven publications and 1018 citations, and ‘Clinical Nutrition’, with six publications and 1441 citations, have demonstrated their impact on scholarly discourse. ‘The International Journal of Molecular Sciences’ and the ‘Journal of the American Medical Directors Association’, each contributing five publications and accumulating 697 and 1,394 citations, respectively, have also shown significant influence in academic discussions of Diabetes and Sarcopenia.

Table 6.

Bibliometric profile of top 10 impactful journals

Source Title	TP	TC	CPP	FP	ICP	%ICP	RCI	TC Range	TLS	Links
Nutrients	7	1,018	145.43	5	2	28.57	0.38	103–248	687	1,723
Clinical Nutrition	6	1,441	240.17	2	3	50.00	0.63	116–668	490	69
International Journal of Molecular Sciences	5	697	139.40	4		0.00	0.36	105–182	319	74
Journal of the American Medical Directors Association	4	1,394	348.50	1	1	25.00	0.91	121–675	560	73
PLoS ONE	4	895	223.75	2	1	25.00	0.59	107–449	290	56
American Journal of Clinical Nutrition	3	2,287	762.33	2	2	66.67	2.00	287–1,062	99	44
Menopause	3	1,187	395.67	1	3	100.00	1.04	111–794	2	1
Journal of Cachexia, Sarcopenia and Muscle	3	524	174.67	2	2	66.67	0.46	135–229	131	53
Geriatrics and Gerontology International	3	401	133.67			0.00	0.35	121–141	492	64
European Journal of Heart Failure	2	6,562	3,281.00	1	2	100.00	8.59	1141–5,421	111	3
Total of Top 10 Source Title	40	16,406	410.15	20	16	40.00	1.07	103–5,421	3,181	2,160
Global Total	151	57,696	382.09	83	52	34.44	1.00	100–10,552
Share of top 10 Source Title in global total	3.77	3.52

Note: TP-Total Papers; TC-Total Citations; CPP-Citations per Paper; FP-Funded Papers; ICP-International Collaborative Papers; RCI-Relative Citation Index; TLS-Total Link Strength.

Figure 5.

Visualisation of the distribution of the top 15 journals across coloured clusters in the analysis of scholarly discourse

Top 10 Highly Cited Papers

The most focused areas of research in Diabetes and Sarcopenia encompass various key themes as shown in Table 7. Ponikowski (2016), Ponikowski (2016a), and McDonagh (2022) contributed significantly to the field with their papers on the diagnosis and treatment of acute and chronic heart failure, accumulating citations of 10,554, 5,421, and 1,141, respectively, thereby establishing foundational concepts. Further studies by Liguori (2018), Ferrucci (2018), Houston (2008), and Kalyani (2014) emphasised the association between Diabetes and Sarcopenia with ageing and its related implications, garnering citations ranging from 2,573 to 764. Furthermore, the exploration of senescence studies by Muñoz-Espín (2014), He (2017), and McHugh (2018) shed light on the physiological, pathological, and therapeutic aspects of senescence in health, disease, and ageing, with citations reflecting their impact. Lastly, Baumgartner (2004), Malmstrom (2013), and Landi (2012) investigated the adverse outcomes of Sarcopenia in the elderly, particularly concerning disability in daily activities and the heightened risk of falls, each paper receiving citations within the academic community.

Table 7.

Details of the top 10 highly cited publications

Author, Year, Journal	DOI	TC	TC per Year	Normalised TC
Ponikowski P, 2016, Eur Heart J	10.1093/eurheartj/ehw128	10,552	1,172.44	53.14
Ponikowski P, 2016, Eur J Heart Fail	10.1002/ejhf.592	5,421	602.33	27.30
Liguori I, 2018, Clin Interventions Ageing	10.2147/CIA.S158513	2,573	367.57	31.48
Muñoz-Espín D, 2014, Nat Rev Mol Cell Biol	10.1038/nrm3823	1,918	174.36	17.52
Ferrucci L, 2018, Nat Rev Cardiol	10.1038/s41569-018-0064-2	1,892	270.29	23.15
Mcdonagh TA, 2022, Eur J Heart Fail	10.1002/ejhf.2333	1,141	380.33	79.06
He S, 2017, Cell	10.1016/j.cell.2017.05.015	1,134	141.75	16.22
Wolfe RR, 2006, Am J Clin Nutr	10.1093/ajcn/84.3.475	1,062	55.89	3.52
Houston DK, 2008, Am J Clin Nutr	10.1093/ajcn/87.1.150	938	55.18	3.76
Pinkerton JV, 2017, Menopause	10.1097/GME.0000000000000921	794	99.25	11.35

An analysis of the 151 HCPs was conducted to calculate the citation links and determine their interconnections. It was noted that among these HCPs, 98 papers (65%) remained unconnected to one another. Further analysis revealed a subset of 53 (35%) connected HCPs forming 11 distinct clusters with a total of 75 links. The clustering pattern indicated that Cluster 1 comprised 7 HCPs, Clusters 2 to 4 each contained 6 HCPs, followed by Clusters 5 to 7 with 5 HCPs each. Additionally, Cluster 8 included 4 HCPs, and Clusters 9 to 11 consisted of 3 HCPs each, as illustrated in Figure 6. This clustering analysis sheds light on the varying degrees of interconnectivity among the HCPs, highlighting the presence of cohesive clusters within the network of highly cited documents.

Figure 6.

Visualisation of the 11 distinct clusters of connected hcps in the analysis of citation links

Discussion

The results of this bibliometric study illuminate the evolving landscape of research at the intersection of diabetes and sarcopenia, highlighting the significant contributions of various scholars and institutions over the years from 2003 to 2024. The focus on HCPs allows us to identify key trends and themes that have emerged within the literature and to assess the scholarly impact of these contributions.

The finding of 151 HCPs among the initial 2,499 search results underlines the concentration of academic interest and discourse surrounding the interplay between diabetes and sarcopenia. This selection criteria based on citation counts emphasises the relevance and influence of these works on the academic community and underscores the growing recognition of the complications associated with diabetes, particularly in elderly populations and those with musculoskeletal deterioration.

Through the keyword analysis and VOSviewer network visualisation, we were able to discern patterns in research focus and collaboration. The common keywords identified reveal an increasing emphasis on diagnostics, treatment modalities, and the pathophysiological mechanisms connecting diabetes and sarcopenia.^[5,23-25] This aligns with the clinical understanding of how insulin resistance and metabolic dysfunction in diabetes may exacerbate muscle wasting,^[26,27] suggesting a burgeoning area for future research and interdisciplinary collaboration that integrates endocrinology, geriatrics, and rehabilitation medicine.^[28-30]

The statistical metrics acquired not only highlight prolific authors and leading institutions but also reflect a broader international effort in examining these interrelated conditions. Countries with high publication output often correlate with advanced healthcare systems and funding opportunities, enhancing research quality and scope. The identification of these countries sheds light on global disparities in funding, resources, and research infrastructure that may affect scholarly impact in less affluent regions.

Additionally, the study spotlights the importance of interdisciplinary research, as a significant number of publications intertwine aspects of endocrinology, gerontology, nutrition, and exercise science. Future studies could potentially benefit from collaborative frameworks that leverage insights from these diverse fields to develop holistic interventions aimed at mitigating the adverse effects of diabetes on muscle health.^[31-33]

The synthesis of findings from this bibliometric review provides a foundational understanding of current trends, yet also points toward areas that warrant further exploration. There is a clear need for ongoing research to delve deeper into the causal relationships between diabetes and sarcopenia, including the role of lifestyle interventions and pharmacological therapies. Furthermore, as the global population ages and the incidence of diabetes continues to rise, strategies aimed at preventing or managing sarcopenia in people with diabetes will be crucial.

Strengths and Limitations of the Study

The study utilises the Scopus database, one of the largest and most comprehensive citation resources, ensuring extensive coverage of literature on diabetes and sarcopenia research. By focusing on HCPs, the study aims to highlight influential research that can inform future studies and funding priorities.

However, relying solely on Scopus may overlook significant contributions from other databases like PubMed, potentially missing relevant studies. Additionally, using citation counts as a measure of impact may not fully reflect the quality or applicability of research, as some valuable studies may have low citation counts due to niche topics or their novelty. The study does not evaluate the quality of the publications, which can vary significantly, and high citation counts do not necessarily imply methodological rigour or validity of findings.^[34-37]

Major Contribution of the Study and Future Scope of Work

The study offers significant insights into diabetes and sarcopenia research by mapping HCPs and identifying key authors, institutions, and countries that influence the field. It highlights major research trends, particularly the connections between diabetes and muscle health, which can guide future research agendas.

Future research could benefit from including additional databases like PubMed or Web of Science for a more comprehensive dataset.^[38,39] Qualitative analyses of highly cited papers could uncover specific findings and methodologies, while longitudinal studies might track the evolving landscape of the field. Interdisciplinary approaches could yield innovative solutions for managing diabetes and sarcopenia. Additionally, examining the influence of HCPs on clinical guidelines and healthcare policies could demonstrate how research informs practice. Investigating global disparities in research output and funding may highlight areas needing support, encouraging contributions from underrepresented regions. Overall, these avenues aim to build on the study’s foundation to enhance knowledge and improve patient care outcomes.

Conclusion

This bibliometric study highlights the significant contributions and evolving landscape of research at the intersection of diabetes and sarcopenia from 2003 to 2024. A total of 151 highly cited publications were identified, revealing critical trends and thematic focuses within the literature, particularly regarding the relationship between metabolic dysfunction and muscle deterioration. The analysis demonstrates the collaborative efforts of key authors and institutions, showcasing the global nature of this research domain. Utilising VOSviewer for network analysis provided valuable insights into the connections among researchers and the thematic areas of focus. This study not only informs current understanding but also outlines future research directions essential for addressing the complexities of managing diabetes and sarcopenia. Ultimately, the findings serve as a foundation for advancing knowledge and improving patient care in this critical area of healthcare.

Footnotes

Declaration of conflicting interests

The authors declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

Funding

The authors received no financial support for the research, authorship and/or publication of this article.

Institutional Ethical Committee Approval Number

Not required for such bibliometric study.

Informed consent

No informed consent is needed for this bibliometric study since it does not involve any human data or intervention and is based solely on the published literature.

Credit author statement

GMNM: Data Curation and Analysis, Literature Search, Manuscript writing, editing, and final approval.

BMG: Conceptualization, Data Analysis, Literature Search, Manuscript writing, editing and final approval.

MNA: Data Curation and Analysis, Literature Search, Manuscript writing, editing, and final approval.

AKS: Literature search, Data analysis, Manuscript writing, editing, and final approval.

AV: Literature search, Data analysis, Manuscript writing, editing, and final approval.

RV: Conceptualization, Literature search, Data analysis, Manuscript writing, editing, and final approval.

Data availability

The raw data is available with the corresponding author.

Use of artificial intelligence

The manuscript’s English and readability were enhanced with the assistance of Grammarly. However, it is important to note that all content, including figures and tables, is original and has not been derived from external sources. The authors have diligently reviewed the manuscript in its entirety and assume full responsibility for its contents.

Key highlights

The study highlights 151 highly cited papers in diabetes and sarcopenia research, collectively amassing over 15,000 citations, demonstrating significant scholarly influence in the field.

Major themes identified include the pathophysiological links between diabetes and sarcopenia, and the analysis emphasises significant interdisciplinary collaborations among leading authors and institutions primarily from the United States and Europe.

The findings establish a comprehensive overview of influential works, underscoring the critical need for continued investigation in diabetes and sarcopenia to enhance patient management and treatment outcomes.

References

Rajan

, Anwar

, Jain

, Khan

, Dey

. Serum sestrins: potential predictive molecule in human sarcopenia. Aging Clin Exp Res. 2021;33(5):1315–24. doi:10.1007/s40520-020-01642-9

Chen

, Huang

, Dong

, Wen

, Zhou

, Yuan

. The association between sarcopenia and diabetes: from pathophysiology mechanism to therapeutic strategy. DMSO. 2023; 16:1541–54. doi:10.2147/DMSO.S410834

Sravya

, Swain

, Sahoo

, . Sarcopenia in type 2 diabetes mellitus: study of the modifiable risk factors involved. JCM. 2023;12(17):5499. doi:10.3390/jcm12175499

Sozen

, Calik

Basaran N

, Turkey

, . Musculoskeletal problems in diabetes mellitus. Eur J Rheumatol. 2018;5(4):258–65. doi:10.5152/eurjrheum.2018.18044

Marcotte-Chénard

, Oliveira

, Little

, Candow

. Sarcopenia and type 2 diabetes: Pathophysiology and potential therapeutic lifestyle interventions. Diabetes Metab Syndr. 2023;17(9):102835. doi:10.1016/j.dsx.2023.102835

Liu

, Guo

, Zheng

. Type 2 diabetes mellitus related sarcopenia: a type of muscle loss distinct from sarcopenia and disuse muscle atrophy. Front Endocrinol. 2024;15:1375610. doi:10.3389/fendo.2024.1375610

Meena

, Taneja

, Tandon

, . Home-based intensive nutrition therapy improves frailty and sarcopenia in patients with decompensated cirrhosis: a randomized clinical trial. J Gastro Hepatol. 2023;38(2): 210–8. doi:10.1111/jgh.16035

Alahmari

, Reddy

. Knee proprioception, muscle strength, and stability in type 2 diabetes mellitus: a cross-sectional study. Heliyon. 2024;10(20):e39270. doi:10.1016/j.heliyon.2024.e39270

Csonka

, Varjú

, Lendvay

. Diabetes mellitus-related musculoskeletal disorders: unveiling the cluster of diseases. Primary Care Diabetes. 2023; 17(6):548–53. doi:10.1016/j.pcd.2023.08.003

10.

Gupta

, Ezhilarasan

Santhi SS

, Ravi

, Ramanan

. Rheumatological and Musculoskeletal complications in diabetes patients. J Endocrinol Metab. 2022;12(4–5):117–24. doi:10.14740/jem811

11.

Inaba

, ed. Musculoskeletal Disease Associated with Diabetes Mellitus. Japan: Springer; 2016. doi:10.1007/978-4-431-55720-3

12.

Kim

, Edelman

, Kim

. Musculoskeletal complications of diabetes mellitus. Clin Diabetes. 2001;19(3):132–5. doi:10.2337/diaclin.19.3.132

13.

Tang

, Lian

, Li

, Jiang

, Yang

. Landscape and research trends of sarcopenic obesity research: a bibliometric analysis. Heliyon. 2024;10(2):e24696. doi:10.1016/j.heliyon.2024.e24696

14.

Chen

, Wang

, Zhang

, Su

. Evolutionary overview of sarcopenia—bibliometric study on the Web of Science: a review. Medicine. 2023;102(30):e34500. doi:10.1097/MD.0000000000034500

15.

Jishi

, Fang

, Li

. A bibliometric analysis and visualization of research on heart failure complicated with malnutrition. Front Nurs. 2023;10(4):413–26. doi:10.2478/fon-2023-0044

16.

Long

, Chen

, Huang

, Zhou

. Analyzing global sarcopenia research: revealing trends and hotspots through bibliometric analysis and visualization (1997-2022). J Nutr Health Aging. 2023;27(11): 1147–8. doi:10.1007/s12603-023-2016-8

17.

Vaishya

, Gupta

, Singh

, Vaish

. Covid-19 and sarcopenia: a bibliometric analysis. Iberoam J Sci Meas Commun. 2023;3(2). doi:10.47909/ijsmc.49

18.

Vaishya

, Gupta

, Misra

, Mamdapur

, Vaish

. Global research in sarcopenia: high-cited papers, research institutions, funding agencies and collaborations, 1993–2022. Diabetes Metab Syndr. 2022;16(11):102654. doi:10.1016/j.dsx.2022.102654

19.

Shafiee

, Aletaha

, Maleki

Birjandi S

, Jabbari

, Heshmat

, Larijani

. Past, present and future trends of sarcopenia research in endocrinology & metabolism research institute: a scientometric study. J Diabetes Metab Disord. Published online January 6, 2021. doi:10.1007/s40200-020-00691-1

20.

Vaishya

, Gupta

, Kappi

, Mamdapur

GMN

, Ali

, Vaish

. Scientometric analysis of global research on delayed and nonunion of fractures (2004–2023): insights from the Web of Science core collections. Injury. 2024;55(11):111882. doi:10.1016/j.injury.2024.111882

21.

Van Eck

, Waltman

. Software survey: VOSviewer, a computer program for bibliometric mapping. Scientometrics. 2010;84(2): 523–38. doi:10.1007/s11192-009-0146-3

22.

Leiden University. VOSviewer - Visualizing scientific landscapes. VOSviewer. https://www.vosviewer.com//; 2024. Accessed November 26, 2024.

23.

Hou

, Xiang

, Wang

, . Pathogenesis and comprehensive treatment strategies of sarcopenia in elderly patients with type 2 diabetes mellitus. Front Endocrinol. 2024;14:1263650. doi:10.3389/fendo.2023.1263650

24.

Wang

, Tan

, Shi

, Wang

, Liao

, Wei

. Diabetes and sarcopenic obesity: pathogenesis, diagnosis, and treatments. Front Endocrinol. 2020;11:568. doi:10.3389/fendo.2020.00568

25.

Lim

, Kang

. Exercise therapy for sarcopenia and diabetes. World J Diabetes. 2023;14(5):565–72. doi:10.4239/wjd.v14.i5.565

26.

Mesinovic

, Fyfe

, Talevski

, . Type 2 diabetes mellitus and sarcopenia as comorbid chronic diseases in older adults: established and emerging treatments and therapies. Diabetes Metab J. 2023; 47(6):719–42. doi:10.4093/dmj.2023.0112

27.

Nishikawa

, Asai

, Fukunishi

, Nishiguchi

, Higuchi

. Metabolic syndrome and sarcopenia. Nutrients. 2021;13(10):3519. doi:10.3390/nu13103519

28.

Purnamasari

, Tetrasiwi

, Kartiko

, Astrella

, Husam

, Laksmi

. Sarcopenia and chronic complications of type 2 diabetes mellitus. Rev Diabet Stud. 2022;18(3):157–65. doi:10.1900/RDS.2022.18.157

29.

De Luis Román

, Gómez

, García-Almeida

, . Diabetic sarcopenia. A proposed muscle screening protocol in people with diabetes: expert document. Rev Endocr Metab Disord. 2024;25(4): 651–61. doi:10.1007/s11154-023-09871-9

30.

Dionyssiotis

, Athanassiou

, Papathanasiou

, . Sarcopenia in patients with diabetes mellitus. FM. 2022;64(4):596–601. doi:10.3897/folmed.64.e63530

31.

Vishwanathan

, Kambhampati

Srinivas BS

, Vaishya

. Top 100 cited articles on diabetes mellitus and Covid-19: a bibliometric analysis. Diabetes Metab Syndr. 2021;15(4):102160. doi:10.1016/j.dsx.2021.05.033

32.

Dayal

, Gupta

, Mamdapur

, Rohilla

, Nanda

. Stem cell therapy for type 1 diabetes: a scientometric assessment of global research during the twenty-first century. J Diabetes Metab Disord. 2022;21(2):1679–87. doi:10.1007/s40200-022-01120-1

33.

Ulugerger

Avci G

. A bibliometric perspective to the most cited diabetes articles. J Diabetes Metab Disord. 2023;22(1):763–73. doi:10.1007/s40200-023-01199-0

34.

Gupta

, Dhawan

, Singh

, . A scientometric analysis of highly cited papers of Pakistan in COVID-19 research 2020–2023. J Data Sci Informetr Cit Stud. 2024;3(3):1–15.

35.

Gupta

, Mamdapur

GMN

, Vaish

, Vaishya

. COVID-19 research output from South Asia: a scientometric analysis of highly cited papers. Apollo Med. Published online April 16, 2024:09760016241245854. doi:10.1177/09760016241245854

36.

Vaishya

, Gupta

, Mamdapur

GMN

, Vaish

. Multiligamentous knee injury: a scientometric assessment of global publications during 2008–2023. JOIO. Published online April 27, 2024. doi:10.1007/s43465-024-01149-9

37.

Vaishya

, Gupta

, Mamdapur

GMN

, Vaish

, Bhadani

, Mukhopadhaya

. Highly-cited papers on fracture non-union: a bibliometric analysis of the global literature (1990–2023). JOIO. Published online May 13, 2024. doi:10.1007/s43465-024-01176-6

38.

Vaishya

, Gupta

, Kappi

, Mamdapur

GMN

, Vaish

. Global research output and highly-cited publications on prosthetic joint infections: a bibliometric analysis (2003–2022). J Clin Orthop Trauma. 2024;50:102373. doi:10.1016/j.jcot.2024.102373

39.

Vaishya

, Gupta

, Mamdapur

GMN

, Vaish

, Migliorini

. Scientometric analysis of highly cited papers on avascular necrosis of the femoral head from 1991 to 2022. J Orthop Traumatol. 2023; 24(1):27. doi:10.1186/s10195-023-00709-3