Background: Long-term associations between type 2 diabetes, prediabetes, and muscle strength are obscure in older adults. The aim of this study was to examine type 2 diabetes as a predictor of handgrip strength decline during an 11-year follow-up among men and women aged 55 years. Methods: We used Finnish population-based Health 2000 Survey and its follow-up measurements in 2011. The study population consisted of 1,200 individuals, aged 55–86 years at baseline. Baseline fasting glucose level or use of diabetes medication was used to categorize the participants into diabetes (≥7.0 mmol/L), prediabetes (≥6.1 mmol/L but <7.0 mmol/L), and nondiabetes (<6.1 mmol/L) groups. Handgrip strength was measured at baseline and during 11-year follow-up. Results: Mean handgrip strength at baseline did not differ between diabetes groups in men or women. Among men during the 11-year follow-up, decline in muscle strength was significantly greater among diabetes group (−131.5 Newtons [N], 95% confidence interval (CI) −182.7 to −80.4) than nondiabetes group (−98.9 N, 95% CI −139.5 to −58.3) after adjusting for age, education, lifestyle factors, chronic conditions, and diabetes status at follow-up. Among women, muscle strength decline did not differ between diabetes, prediabetes, or nondiabetes groups after adjusting for all potential covariates, the results being −45.0 N (95% CI −73.2 to −16.7), −29.4 N (95% CI −59.7 to 0.9), and −42.3 N (95% CI −70.5 to −14.1), respectively. Conclusions: The presence of type 2 diabetes was associated with greater muscle strength decline among older men but not among older women.

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