OR33: Preservation of Lean Mass Upon Combined Lifestyle Intervention in Older Adults with Obesity and Type 2 Diabetes During 6-Months Follow-Up After RCT (Probe Study)

2019 ◽  
Vol 38 ◽  
pp. S16-S17
Author(s):  
R.G. Memelink ◽  
A. Bongers ◽  
W.J. Pasman ◽  
M.J. van Rijmenam ◽  
S. Wopereis ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Older Adults ◽  
Lifestyle Intervention ◽  
Lean Mass

scholarly journals Preservation of Lean Mass upon Combined Lifestyle Intervention in Older Adults with Obesity and Type 2 Diabetes During 6-Months Follow-Up After RCT (PROBE Study)

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 53-53
Author(s):  
Robert Memelink ◽  
Anke Bongers ◽  
Wilrike Pasman ◽  
Mariëtte van Rijmenam ◽  
Suzan Wopereis ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Older Adults ◽  
Vitamin D ◽  
G Protein ◽  
Whey Protein ◽  
Muscle Mass ◽  
Lifestyle Intervention ◽  
Lean Mass

Abstract Objectives Weight loss is a key element in the treatment of obesity and type 2 diabetes (T2D), but also a risk factor for lean mass (LM) loss in older adults. We evaluated whether a whey protein drink enriched with leucine and vitamin D preserved LM during 3-month lifestyle intervention and whether effects sustained during 6 months follow-up after intervention (FU). Methods 123 older adults (66 ± 6 y) with obesity (BMI 34 ± 4 kg/m2) and T2D participated in a 3-month lifestyle intervention with dietary advice (−600 kcal/d) and resistance exercise (3×/wk). In this double-blind RCT (PROBE) subjects were randomised to receive 10×/wk a test (21 g protein) or isocaloric control (0 g protein) drink. LM, appendicular muscle mass (AMM), leg muscle mass (LMM), and fat mass (FM) were assessed with DXA. Mixed linear model analysis was used with baseline value in the outcome vector and adjustment for stratification factors sex and SU-derivate use. Data represent EMM ± SE (within group) or 95% CI (between groups). Results 105 subjects completed intervention and 76 subjects participated in FU. At 3 months, body weight (−2.2 ± 0.4 kg, P < 0.001, test; −2.9 ± 0.4 kg, P < 0.001, control) and FM (−2.6 ± 0.4 kg, P < 0.001, test; −2.5 ± 0.4 kg, P < 0.001, control) were reduced without differences between groups. LM and AMM were increased in test (+0.57 ± 0.27 kg, P = 0.03; +0.39 ± 0.13 kg, P < 0.01) and unchanged in control (−0.35 ± 0.26 kg, P = 0.18; +0.03 ± 0.12 kg, P = 0.80), with significant difference between groups (+0.92 kg, 95% CI 0.19–1.65, P = 0.015; +0.36 kg, 95% CI 0.01–0.71, P = 0.047). At FU (without test or control drink), the difference in LM and AMM between groups had disappeared while both groups still had significantly improved body composition compared to baseline, as reflected by decreased FM (−2.4 ± 0.4 kg, < 0.001, test; −2.6 ± 0.4 kg, < 0.001, control) and increased or preserved LM (+0.88 ± 0.32 kg, 0.007; +0.54 ± 0.32 kg, 0.09) and AMM (+0.46 ± 0.15 kg, 0.002; +0.31 ± 0.15 kg, 0.03). Conclusions Use of a whey protein drink enriched with leucine and vitamin D during a combined lifestyle intervention showed beneficial effects on lean mass in older adults with obesity and type 2 diabetes. Preservation of lean mass was sustained after 6 months follow-up, without differences between treatment groups. Funding Sources Grant: Topsector Agri & Food, The Netherlands. Financial support for study conduct: Danone Nutricia Research.

scholarly journals Type 2 Diabetes Reduces the Muscle Anabolic Effect of Resistance Exercise Training in Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 529-529
Author(s):  
Amanda Randolph ◽  
Tatiana Moro ◽  
Adetutu Odejimi ◽  
Blake Rasmussen ◽  
Elena Volpi
Keyword(s):  
Type 2 Diabetes ◽  
Older Adults ◽  
Muscle Strength ◽  
Exercise Training ◽  
Resistance Exercise ◽  
Lean Mass ◽  
Synthesis Rate ◽  
Resistance Exercise Training ◽  
Appendicular Lean Mass

Abstract Type 2 Diabetes Mellitus (T2DM) accelerates the incidence and increases the prevalence of sarcopenia in older adults. This suggests an urgent need for identifying effective sarcopenia treatments for older adults with T2DM. It is unknown whether traditional approaches, such as progressive resistance exercise training (PRET), can effectively counteract sarcopenia in older patients with T2DM. To test the efficacy of PRET for the treatment of sarcopenia in older adults with T2DM, 30 subjects (15 T2DM and 15 age- and sex- matched controls) underwent metabolic testing with muscle biopsies before and after a 13-week full-body PRET program. Primary outcome measures included changes in appendicular lean mass, muscle strength, and mixed muscle fractional synthesis rate (FSR). Before PRET, BMI-adjusted appendicular lean mass was significantly lower in the T2DM group (0.7095±0.0381 versus 0.8151±0.0439, p<0.0001). As a result of PRET, appendicular lean mass adjusted for BMI and muscle strength increased significantly in both groups, but to a lesser extent for the T2DM group (p=0.0009) . Preliminary results for FSR (n=25) indicate that subjects with T2DM had lower basal FSR prior to PRET (p=0.0197) . Basal FSR increased significantly in the control group after PRET (p=0.0196), while it did not change in the T2DM group (p=0.3537). These results suggest that in older adults the positive effect of PRET on muscle anabolism and strength is reduced by T2DM . Thus, older adults with T2DM may require more intensive, multimodal and targeted sarcopenia treatment. Funded by NIH R01AG049611 and P30AG024832.

scholarly journals FRAILTY AND THE COMPARATIVE EFFECTIVENESS AND SAFETY OF SGLT2I AND SULFONYLUREA IN OLDER ADULTS WITH TYPE 2 DIABETES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S581-S581
Author(s):  
Ajinkya Pawar ◽  
elisabetta Patorno ◽  
Dae Kim
Keyword(s):  
Type 2 Diabetes ◽  
Older Adults ◽  
Cohort Study ◽  
Comparative Effectiveness ◽  
Retrospective Cohort ◽  
Severe Hypoglycemia ◽  
Medicare Data ◽  
Cardiovascular Endpoint

Abstract We conducted a 1:1 propensity score-matched retrospective cohort study of 70,826 patients with type 2 diabetes (mean age, 71.4 years [standard deviation, 5.0]) initiating a SGLT2i or a second-generation sulfonylurea in Medicare data. We estimated HRs (95% CIs) for a composite cardiovascular endpoint and severe hypoglycemia comparing the two treatments in the entire population and by the CFI-based frailty subgroups. Compared with sulfonylureas, SGLT2is were associated with lower rates of the composite cardiovascular endpoint (HR, 0.68 [95% CI, 0.62-0.75]) and severe hypoglycemia (0.43 [0.35-0.53]) over a mean follow-up of 9.5 months. The lower rate of composite cardiovascular endpoint for SGLT2i vs sulfonylureas was observed in pre-frail (0.68 [0.61-0.77]) and frail (0.64 [0.53-0.77]) subgroups, but not in non-frail subgroup (0.95 [0.59-1.54]). The rate of severe hypoglycemia was consistently lower for SGLT2i vs sulfonylureas across frailty subgroups (non-frail, 0.37 [0.12-1.16]; pre-frail, 0.45 [0.35-0.59]; frail, 0.40 [0.28-0.58]).

scholarly journals Can the Onset of Type 2 Diabetes Be Delayed by a Group-Based Lifestyle Intervention in Women with Prediabetes following Gestational Diabetes Mellitus (GDM)? Findings from a Randomized Control Mixed Methods Trial

2015 ◽  
Vol 2015 ◽  
pp. 1-11 ◽  
Author(s):  
Angela O’Dea ◽  
Marie Tierney ◽  
Brian E. McGuire ◽  
John Newell ◽  
Liam G. Glynn ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Mixed Methods ◽  
Gestational Diabetes ◽  
Lifestyle Intervention ◽  
Intervention Group ◽  
Outcome Variable ◽  
Control Group ◽  
One Year

Objective. To evaluate a 12-week group-based lifestyle intervention programme for women with prediabetes following gestational diabetes (GDM).Design. A two-group, mixed methods randomized controlled trial in which 50 women with a history of GDM and abnormal glucose tolerance postpartum were randomly assigned to intervention (n=24) or wait control (n=26) and postintervention qualitative interviews with participants.Main Outcome Measures. Modifiable biochemical, anthropometric, behavioural, and psychosocial risk factors associated with the development of type 2 diabetes. The primary outcome variable was the change in fasting plasma glucose (FPG) from study entry to one-year follow-up.Results. At one-year follow-up, the intervention group showed significant improvements over the wait control group on stress, diet self-efficacy, and quality of life. There was no evidence of an effect of the intervention on measures of biochemistry or anthropometry; the effect on one health behaviour, diet adherence, was close to significance.Conclusions. Prevention programmes must tackle the barriers to participation faced by this population; home-based interventions should be investigated. Strategies for promoting long-term health self-management need to be developed and tested.

Sustained reduction in the incidence of type 2 diabetes by lifestyle intervention: follow-up of the Finnish Diabetes Prevention Study

The Lancet ◽  
2006 ◽  
Vol 368 (9548) ◽  
pp. 1673-1679 ◽  
Author(s):  
Jaana Lindström ◽  
Pirjo Ilanne-Parikka ◽  
Markku Peltonen ◽  
Sirkka Aunola ◽  
Johan G Eriksson ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Lifestyle Intervention ◽  
Diabetes Prevention ◽  
Prevention Study ◽  
Diabetes Prevention Study ◽  
Sustained Reduction

scholarly journals Association of Baseline and Longitudinal Changes in Body Composition Measures With Risk of Heart Failure and Myocardial Infarction in Type 2 Diabetes

Circulation ◽  
2020 ◽  
Vol 142 (25) ◽  
pp. 2420-2430
Author(s):  
Kershaw V. Patel ◽  
Judy L. Bahnson ◽  
Sarah A. Gaussoin ◽  
Karen C. Johnson ◽  
Xavier Pi-Sunyer ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Type 2 Diabetes ◽  
Body Composition ◽  
Lifestyle Intervention ◽  
Lower Risk ◽  
Hazard Ratio ◽  
Longitudinal Changes

Background: Intentional weight loss is associated with lower risk of heart failure (HF) and atherosclerotic cardiovascular disease among patients with type 2 diabetes. However, the contribution of baseline measures and longitudinal changes in fat mass (FM), lean mass (LM), and waist circumference (WC) to the risk of HF and myocardial infarction (MI) in type 2 diabetes is not well established. Methods: Adults from the Look AHEAD trial (Action for Health in Diabetes) without prevalent HF were included. FM and LM were predicted using validated equations and compared with dual-energy x-ray absorptiometry measurements in a subgroup. Adjusted Cox models were used to evaluate the associations of baseline and longitudinal changes in FM, LM, and WC over 1- and 4-year follow-up with risk of overall HF, HF with preserved ejection fraction (EF; EF ≥50%), HF with reduced EF (EF <50%), and MI. Results: Among 5103 participants, there were 257 incident HF events over 12.4 years of follow-up. Predicted and measured FM/LM were highly correlated ( R 2 =0.87–0.90; n=1369). FM and LM decreased over 4-year follow-up with greater declines in the intensive lifestyle intervention arm. In adjusted analysis, baseline body composition measures were not significantly associated with HF risk. Decline in FM and WC, but not LM, over 1 year were each significantly associated with lower risk of overall HF (adjusted hazard ratio per 10% decrease in FM, 0.80 [95% CI, 0.68–0.95]; adjusted hazard ratio per 10% decrease in WC, 0.77 [95% CI, 0.62–0.95]). Decline in FM was significantly associated with lower risk of both HF subtypes. In contrast, decline in WC was significantly associated with lower risk of HF with preserved EF but not HF with reduced EF. Similar patterns of association were observed for 4-year changes in body composition and HF risk. Longitudinal changes in body composition were not significantly associated with risk of MI. Conclusions: In adults with type 2 diabetes, a lifestyle intervention is associated with significant loss of FM and LM. Declines in FM and WC, but not LM, were each significantly associated with lower risk of HF but not MI. Furthermore, decline in WC was significantly associated with lower risk of HF with preserved EF but not HF with reduced EF. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT00017953.

scholarly journals Physical Function Following a Long-Term Lifestyle Intervention Among Middle Aged and Older Adults With Type 2 Diabetes: The Look AHEAD Study

2017 ◽  
Vol 73 (11) ◽  
pp. 1552-1559 ◽  
Author(s):  
Denise K Houston ◽  
Rebecca H Neiberg ◽  
Michael E Miller ◽  
James O Hill ◽  
John M Jakicic ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Older Adults ◽  
Physical Function ◽  
Lifestyle Intervention ◽  
Middle Aged ◽  
Look Ahead ◽  
The Look

scholarly journals FRAILTY AND THE COMPARATIVE EFFECTIVENESS AND SAFETY OF SGLT2I AND DPP4I IN OLDER ADULTS WITH TYPE 2 DIABETES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S582-S582
Author(s):  
Dae H Kim ◽  
Ajinkya Pawar ◽  
Seoyoung Kim ◽  
Elisabetta Patorno
Keyword(s):  
Type 2 Diabetes ◽  
Older Adults ◽  
Comparative Effectiveness ◽  
Retrospective Cohort ◽  
Severe Hypoglycemia ◽  
Similar Rate ◽  
Medicare Data ◽  
Cardiovascular Endpoint

Abstract We conducted a 1:1 propensity score-matched retrospective cohort study of 83,432 patients with type 2 diabetes (mean age, 71.5 years [standard deviation, 5.0]) initiating a SGLT2i or a DPP4i in Medicare data. We estimated HRs (95% CIs) for a composite cardiovascular endpoint and severe hypoglycemia comparing the two treatments in the entire population and by the CFI-based frailty subgroups. Compared with DPP4i, SGLT2i were associated with a lower rate of the composite cardiovascular endpoint (HR, 0.70 [95% CI, 0.64-0.77]) and a similar rate of severe hypoglycemia (0.88 [0.71-1.07]) over a mean follow-up of 8.8 months. The rate of composite cardiovascular endpoint for SGLT2i vs DPP4i was consistently lower in pre-frail (0.71 [0.64-0.79]) and frail (0.67 [0.55-0.80]) subjects, but not in non-frail patients (0.98 [0.62-1.54]). The rate of severe hypoglycemia was not meaningfully different between SGLT2i and DPP4i (non-frail, 0.39 [0.12-1.16]; pre-frail, 0.83 [0.65-1.07]; frail, 1.13 [0.78-1.64]).

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