scholarly journals Effect of an Enriched Protein Drink on Muscle Mass and Glycemic Control during Combined Lifestyle Intervention in Older Adults with Obesity and Type 2 Diabetes: A Double-Blind RCT

Nutrients ◽  
2020 ◽  
Vol 13 (1) ◽  
pp. 64
Author(s):  
Robert G. Memelink ◽  
Wilrike J. Pasman ◽  
Anke Bongers ◽  
Anita Tump ◽  
Annemieke van Ginkel ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Older Adults ◽  
Glycemic Control ◽  
Muscle Mass ◽  
Lifestyle Intervention ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Dietary Advice ◽  
Oral Glucose

Background: Weight loss is key to treatment of older adults with obesity and type 2 diabetes, but also a risk for muscle mass loss. This study investigated whether a whey protein drink enriched with leucine and vitamin D could preserve muscle mass and improve glycemic control during combined lifestyle intervention in this population. Methods: 123 older adults with obesity and type 2 diabetes were randomized into a 13-week lifestyle intervention with dietary advice and exercise, receiving either the enriched protein drink (test) or an isocaloric control (control). Muscle mass was assessed with dual-energy X-ray absorptiometry and glycemic control by oral glucose tolerance test. Statistical analyses were performed using a linear mixed model. Results: There was a nonsignificant increase in leg muscle mass (+0.28 kg; 95% CI, −0.01 to 0.56) and a significant increase in appendicular muscle mass (+0.36 kg; 95% CI, 0.005 to 0.71) and total lean mass (+0.92 kg; 95% CI, 0.19 to 1.65) in test vs. control. Insulin sensitivity (Matsuda index) also increased in test vs. control (+0.52; 95% CI, 0.07 to 0.97). Conclusions: Use of an enriched protein drink during combined lifestyle intervention shows beneficial effects on muscle mass and glycemic control in older adults with obesity and type 2 diabetes.

scholarly journals Obese Older Type 2 Diabetes Mellitus Patients with Muscle Insulin Resistance Benefit from an Enriched Protein Drink during Combined Lifestyle Intervention: The PROBE Study

Nutrients ◽  
2020 ◽  
Vol 12 (10) ◽  
pp. 2979 ◽  
Author(s):  
Wilrike J. Pasman ◽  
Robert G. Memelink ◽  
Johan de Vogel-Van den Bosch ◽  
Mark P. V. Begieneman ◽  
Willem J. van den Brink ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Muscle Mass ◽  
Lifestyle Intervention ◽  
Tolerance Test ◽  
Whole Body ◽  
Physiological Data ◽  
Oral Glucose ◽  
Before And After

(1) Background: Recent research showed that subtypes of patients with type 2 diabetes may differ in response to lifestyle interventions based on their organ-specific insulin resistance (IR). (2) Methods: 123 Subjects with type 2 diabetes were randomized into 13-week lifestyle intervention, receiving either an enriched protein drink (protein+) or an isocaloric control drink (control). Before and after the intervention, anthropometrical and physiological data was collected. An oral glucose tolerance test was used to calculate indices representing organ insulin resistance (muscle, liver, and adipose tissue) and β-cell functioning. In 82 study-compliant subjects (per-protocol), we retrospectively examined the intervention effect in patients with muscle IR (MIR, n = 42) and without MIR (no-MIR, n = 40). (3) Results: Only in patients from the MIR subgroup that received protein+ drink, fasting plasma glucose and insulin, whole body, liver and adipose IR, and appendicular skeletal muscle mass improved versus control. Lifestyle intervention improved body weight and fat mass in both subgroups. Furthermore, for the MIR subgroup decreased systolic blood pressure and increased VO2peak and for the no-MIR subgroup, a decreased 2-h glucose concentration was found. (4) Conclusions: Enriched protein drink during combined lifestyle intervention seems to be especially effective on increasing muscle mass and improving insulin resistance in obese older, type 2 diabetes patients with muscle IR.

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 Muscle strength, an independent determinant of glycemic control in older adults with long-standing type 2 diabetes: a prospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bo Kyung Koo ◽  
Seoil Moon ◽  
Min Kyong Moon
Keyword(s):  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Older Adults ◽  
Glycemic Control ◽  
Muscle Mass ◽  
Older Patients ◽  
Primary Outcome ◽  
Muscle Quality

Abstract Background Although the proportion of older patients with type 2 diabetes mellitus (T2DM) has increased, few studies have reported the factors affecting glucose levels in older patients with long-standing T2DM. This study assessed the determinants of glycemic control in older adults with T2DM of a duration of ≥10 years, including muscle mass, muscle quality, and β-cell function. Methods This was a prospective study of older patients aged ≥60 years with a T2DM duration of ≥10 years. The Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) index, handgrip strength (HGS), and body composition through bioelectrical impedance analysis were assessed. The primary outcome was a composite of: (i) increment of glycated hemoglobin (HbA1c) from the baseline ≥0.6% and (ii) HbA1c ≥ 9% at any time point during the follow-up period. To find the predicting determinants of the outcome, we performed the Cox proportional hazard analysis. Results Among 100 patients (mean age, 64.0 ± 8.6 years; median duration of diabetes, 20 [interquartile range (IQR), 17–23] years; median HbA1c at baseline, 7.1 [IQR, 6.7–7.4] %), the primary outcome was observed in 40 (40.0%) patients during 4.0 (IQR 2.3–5.0) years of follow-up. A Cox proportional hazards model adjusted for age, sex, baseline HbA1c, obesity, duration of DM and anti-diabetic medication at baseline showed that low HGS and insulin resistance at the baseline were independent determinants of the primary outcome (hazard ratio [HR] = 2.23 [95% confidence interval (CI), 1.06–4.72] and 2.39 [95% CI, 1.18–4.83], respectively). Sex stratification confirmed that HGS and muscle mass were independent determinants of the primary outcome only in women (HR per quartile, 0.58 [95% CI, 0.37–0.93] and 0.46 [95% CI, 0.25–0.85], respectively). `. Conclusions Low HGS and insulin resistance were independent risk factors for aggravated glycemic control among older patients with long standing T2DM.

1890-P: Glycemic Control and Ultrasonic Measures of Muscle Mass in Older Adults with Type 2 Diabetes

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 1890-P
Author(s):  
KENNETH M. MADDEN ◽  
BORIS FELDMAN ◽  
SHANE ARISHENKOFF ◽  
SARAH SY ◽  
GRAYDON S. MENEILLY
Keyword(s):  
Type 2 Diabetes ◽  
Older Adults ◽  
Glycemic Control ◽  
Muscle Mass

scholarly journals Effects of low-intensity resistance training on muscular function and glycemic control in older adults with type 2 diabetes

2018 ◽  
Vol 10 (2) ◽  
pp. 331-338 ◽  
Author(s):  
Eri Takenami ◽  
ShinMin Iwamoto ◽  
Noriko Shiraishi ◽  
Akiko Kato ◽  
Yuichi Watanabe ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Older Adults ◽  
Resistance Training ◽  
Glycemic Control ◽  
Low Intensity ◽  
Muscular Function

Decreased Serum Growth Differentiation Factor 15 Levels After Lifestyle Intervention in Patients With Newly Diagnosed Type 2 Diabetes Mellitus

2020 ◽  
Author(s):  
Xingxing He ◽  
Jiaorong Su ◽  
Xiaojing Ma ◽  
Jingyi Lu ◽  
Yufei Wang ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Lifestyle Intervention ◽  
Enzyme Linked Immunosorbent Assay ◽  
Oral Glucose ◽  
Model Assessment ◽  
Newly Diagnosed ◽  
Serum Samples ◽  
Growth Differentiation Factor 15 ◽  
Differentiation Factor

Abstract Background: Recent studies noted that circulating growth differentiation factor 15 (GDF15) were closely related to metabolic states. The study aimed to explore the changes of GDF15 levels and their influencing factors after 4 weeks of lifestyle intervention (LI) or LI combined with breakfast meal replacement (LI+MR) in newly diagnosed type 2 diabetes patients. Methods: A total of 84 patients with available serum samples at both baseline and Week 4 were enrolled in this biomarker substudy. All subjects underwent a 2-hour 75g oral glucose tolerance test at baseline and Week 4. Serum GDF15 levels were determined by a sandwich enzyme-linked immunosorbent assay. Results: After 4-weeks of LI, GDF15 levels overall significantly decreased compared with baseline (P<0.05). ∆GDF15 levels were significantly and negatively associated with baseline GDF15 levels (r=–0.450, P<0.001). The optimal cut-off point of baseline GDF15 levels for predicting a GDF15 decrease after 4-weeks of LI was 904.57 pg/ml, with an area under curve of 0.699. Based on the cut-off point of 900 pg/ml, patients with baseline GDF15 ≥900 pg/ml had significantly decreased GDF15 levels after LI, while those <900 pg/ml had no significant changes. Regression models showed that baseline GDF15 level was an independent positive factor for the improvement of fasting plasma glucose and homeostasis model assessment for insulin resistance only in patients with baseline GDF15 levels ≥900 pg/ml. Conclusions: LI led to significantly decreased GDF15 levels among patients with newly diagnosed type 2 diabetes and its effect was more significant among patients with baseline GDF15 levels ≥900 pg/ml.Trial registration: ClinicalTrials.gov, NCT02248714. Registered 25 September 2014 - Retrospectively registered, https://www.clinicaltrials.gov/ct2/show/NCT02248714?term=NCT02248714&draw=2&rank=1

scholarly journals Glycemic Control and Insulin Improve Muscle Mass and Gait Speed in Type 2 Diabetes: The MUSCLES-DM Study

2020 ◽  
Author(s):  
Ken Sugimoto ◽  
Hiroshi Ikegami ◽  
Yasunori Takata ◽  
Tomohiro Katsuya ◽  
Masahiro Fukuda ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Muscle Mass ◽  
Gait Speed

scholarly journals Decreased Appetite is Associated with Sarcopenia-Related Outcomes in Acute Hospitalized Older Adults

Nutrients ◽  
2019 ◽  
Vol 11 (4) ◽  
pp. 932 ◽  
Author(s):  
Carliene van Dronkelaar ◽  
Michael Tieland ◽  
Jesse Aarden ◽  
Lucienne Reichardt ◽  
Rosanne van Seben ◽  
...  
Keyword(s):  
Older Adults ◽  
Muscle Mass ◽  
Physical Performance ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Handgrip Strength ◽  
Post Discharge ◽  
Hospitalized Older Adults ◽  
Multicenter Prospective Cohort Study ◽  
Mobility Skills

Decreased appetite is one of the main risk factors of malnutrition. Little is known on how appetite changes during hospitalization and after discharge and how it relates with sarcopenia-related outcomes. We analyzed data of the Hospital-ADL study, a multicenter prospective cohort study that followed 400 acutely hospitalized older adults (≥70 year). Appetite (SNAQ), handgrip strength (Jamar), muscle mass (BIA), mobility (DEMMI), and physical performance (SPPB) were assessed within 48 h of admission, at discharge, and at one and three months post-discharge. The course of decreased appetite was analysed by Generalised Estimating Equations. Linear Mixed Model was used to analyse the associations between decreased appetite and the sarcopenia-related outcomes. Decreased appetite was reported by 51% at hospital admission, 34% at discharge, 28% one month post-discharge, and 17% three months post-discharge. Overall, decreased appetite was associated with lower muscle strength (β = −1.089, p = 0.001), lower mobility skills (β = −3.893, p < 0.001), and lower physical performance (β = −0.706, p < 0.001) but not with muscle mass (β = −0.023, p = 0.920). In conclusion, decreased appetite was highly prevalent among acute hospitalized older adults and remained prevalent, although less, after discharge. Decreased appetite was significantly associated with negative sarcopenia-related outcomes, which underlines the need for assessment and monitoring of decreased appetite during and post hospitalization.

scholarly journals Low muscle mass and risk of type 2 diabetes in middle-aged and older adults: findings from the KoGES

Diabetologia ◽  
2017 ◽  
Vol 60 (5) ◽  
pp. 865-872 ◽  
Author(s):  
Jang Won Son ◽  
Seong Su Lee ◽  
Sung Rae Kim ◽  
Soon Jib Yoo ◽  
Bong Yun Cha ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Older Adults ◽  
Muscle Mass ◽  
Middle Aged
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