Type 2 diabetes does not exacerbate body heat storage in older adults during brief, extreme passive heat exposure

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.

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Predictors of frailty among Chinese community-dwelling older adults with type 2 diabetes: a cross-sectional survey

BMJ Open ◽

10.1136/bmjopen-2020-041578 ◽

2021 ◽

Vol 11 (3) ◽

pp. e041578

Author(s):

Linglin Kong ◽

Huimin Zhao ◽

Junyao Fan ◽

Quan Wang ◽

Jie Li ◽

...

Keyword(s):

Type 2 Diabetes ◽

Older Adults ◽

Depressive Symptoms ◽

Community Health ◽

Community Dwelling ◽

Central China ◽

Chinese Community ◽

Cross Sectional ◽

Community Dwelling Older Adults

ObjectivesTo assess the prevalence of frailty and identify predictors of frailty among Chinese community-dwelling older adults with type 2 diabetes.DesignA cross-sectional design.SettingTwo community health centres in central China.Participants291 community-dwelling older adults aged ≥65 years with type 2 diabetes.Main outcome measuresData were collected via face-to-face interviews, anthropometric measurements, laboratory tests and community health files. The main outcome measure was frailty, as assessed by the frailty phenotype criteria. The multivariate logistic regression model was used to identify the predictors of frailty.ResultsThe prevalence of prefrailty and frailty were 51.5% and 19.2%, respectively. The significant predictors of frailty included alcohol drinking (ex-drinker) (OR 4.461, 95% CI 1.079 to 18.438), glycated haemoglobin (OR 1.434, 95% CI 1.045 to 1.968), nutritional status (malnutrition risk/malnutrition) (OR 8.062, 95% CI 2.470 to 26.317), depressive symptoms (OR 1.438, 95% CI 1.166 to 1.773) and exercise behaviour (OR 0.796, 95% CI 0.716 to 0.884).ConclusionsA high prevalence of frailty was found among older adults with type 2 diabetes in the Chinese community. Frailty identification and multifaceted interventions should be developed for this population, taking into consideration proper glycaemic control, nutritional instruction, depressive symptoms improvement and enhancement of self-care behaviours.

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The status of frailty in poor older adults with type 2 diabetes mellitus or hypertension: the case of Mexico

International Journal of Diabetes in Developing Countries ◽

10.1007/s13410-019-00774-7 ◽

2019 ◽

Vol 40 (2) ◽

pp. 303-309

Author(s):

Javier E. García-de-Alba-García ◽

Ana L. Salcedo-Rocha ◽

Susana De-la-Rosa-Hernández

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Older Adults ◽

Type 2 Diabetes Mellitus ◽

The Status

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Sex-specific association of BMI change with stroke in middle-aged and older adults with type 2 diabetes

Nutrition Metabolism and Cardiovascular Diseases ◽

10.1016/j.numecd.2021.07.007 ◽

2021 ◽

Author(s):

Cancan Cui ◽

Zhiyuan Wu ◽

Yunke Shi ◽

Zhonghang Xu ◽

Bing Zhao ◽

...

Keyword(s):

Type 2 Diabetes ◽

Older Adults ◽

Middle Aged ◽

Specific Association

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Effect of Advanced Glycation End Products on Cognition in Older Adults with Type 2 Diabetes: Results from a Pilot Clinical Trial

Journal of Alzheimer s Disease ◽

10.3233/jad-210131 ◽

2021 ◽

pp. 1-11

Author(s):

Roni Lotan ◽

Ithamar Ganmore ◽

Abigail Livny ◽

Nofar Itzhaki ◽

Mark Waserman ◽

...

Keyword(s):

Type 2 Diabetes ◽

Older Adults ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Pilot Trial ◽

Advanced Glycation ◽

Glycation End Products ◽

End Products ◽

Global Cognition

Background: Dietary advanced glycation end-products (AGEs) are linked to cognitive decline. However, clinical trials have not tested the effect of AGEs on cognition in older adults. Objective: The aim of the current pilot trial was to examine the feasibility of an intervention to reduce dietary AGEs on cognition and on cerebral blood flow (CBF). Methods: The design is a pilot randomized controlled trial of dietary AGEs reduction in older adults with type 2 diabetes. Seventy-five participants were randomized to two arms. The control arm received standard of care (SOC) guidelines for good glycemic control; the intervention arm, in addition to SOC guidelines, were instructed to reduce their dietary AGEs intake. Global cognition and CBF were assessed at baseline and after 6 months of intervention. Results: At baseline, we found a reverse association between AGEs and cognitive functioning, possibly reflecting the long-term toxicity of AGEs on the brain. There was a significant improvement in global cognition at 6 months in both the intervention and SOC groups which was more prominent in participants with mild cognitive impairment. We also found that at baseline, higher AGEs were associated with increased CBF in the left inferior parietal cortex; however, 6 months of the AGEs lowering intervention did not affect CBF levels, despite lowering AGEs exposure in blood. Conclusion: The current pilot trial focused on the feasibility and methodology of intervening through diet to reduce AGEs in older adults with type 2 diabetes. Our results suggest that participants with mild cognitive impairment may benefit from an intensive dietary intervention.

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