Dear Editor-in-Chief, We read with great interest the study by Fujimoto et al. 1, published in the Journal of Diabetes Investigation (2025, DOI: https://doi.org/10.1111/jdi.70224), examining the impact of diabetes mellitus and grip strength on postoperative outcomes in older patients undergoing gastrointestinal cancer surgery. This work makes a valuable contribution to geriatric oncology by emphasizing that reduced physical function, particularly weakened grip strength, emerges as a more significant independent predictor of adverse postoperative outcomes than current diabetes mellitus status in elderly surgical patients. We commend the authors' finding that current diabetes mellitus status does not independently predict postoperative survival when physical function is accounted for, a clinically reassuring result that challenges the traditional assumption of diabetes as a major independent surgical risk factor. This observation underscores the paramount importance of comprehensive geriatric assessment and targeted optimization of physical function in all older patients undergoing cancer surgery, regardless of glycemic status. This work was supported by the Yunnan Provincial Department of Education Science Research Fund (Grant No. 2024J2133) and the Yunnan Medical Health College University-level Research Project Fund (Grant No. 2024Y010). This manuscript is a commentary on a previously published article and does not involve any original research with human participants or animals. Therefore, ethical approval was not required for this work. Approval of the research protocol: Not applicable. This manuscript is a commentary on a previously published article and does not involve any original research with human participants. Informed consent: Not applicable. No human participants were involved in this work. Registry and the registration no. of the study/trial: Not applicable. This is a letter to the editor/commentary, not a clinical trial or registered study. Animal studies: Not applicable. No animal studies were conducted. Data sharing is not applicable to this article as no datasets were generated or analyzed during the current study.
Tian Ruan (2026) studied this question.