Risk of Sarcopenia and Associated Factors in Older Adults with Type 2 Diabetes: An Exploratory Cross-Sectional Study

Whey Protein Supplementation in Older Adults With Type 2 Diabetes Undergoing a Resistance Training Program: A Double-Blind Randomized Controlled Trial

BACKGROUND/OBJECTIVE

This study aims to analyze the effect of whey protein (WP) supplementation on glycemic control, muscle strength, quality of life, and body composition in older adults with non-insulin-dependent diabetes undergoing a resistance training program.

METHODS

A double-blind, placebo-controlled, randomized study was carried out with older adults with Type 2 diabetes. Body composition, food intake, muscle strength, glycemic profile, markers of renal function, cardiopulmonary capacity, and quality of life were evaluated. Older adults were randomized into a supplementation group with 33 g of WP consumed twice a week on days of resistance training for 12 weeks supplemented group and a placebo group.

RESULTS

In total, 39 older adults were randomized into two groups, 19 in the supplement group and 20 in the placebo group. Both groups showed improvement in muscle strength, with the WP group failing to exceed that of the control group. WP supplementation slightly increased blood urea compared with the placebo group (p = .05), but values remained within normal limits. The group that used WP showed a small improvement in mental health, according to the 12-Item Short-Form Health Survey questionnaire, but without clinically important improvements.

CONCLUSION

Both groups showed improvements in muscle strength and mass, regardless of supplementation, showing that resistance exercises performed twice a week can contribute to the nonprogression of sarcopenia in older adults with Type 2 diabetes. More studies are needed to determine the safe and effective amount of supplementation to improve muscle strength without renal impairment in older adults with diabetes.

Increased ectodysplasin-A2-receptor EDA2R is a ubiquitous hallmark of aging and mediates parainflammatory responses

Intensive efforts have been made to identify features that could serve as biomarkers of aging. Yet, drug-based interventions aimed at lessening the detrimental effects of getting older are lacking. This is largely attributable to tissue-specificity, sex-related differences, and to the difficulty of identifying actionable targets, which continues to pose a significant challenge. Here, we implement a bioinformatics approach revealing that aging-associated increase of the transmembrane Ectodysplasin-A2-Receptor is a prominent tissue-independent alteration occurring in humans and other species, and is particularly pronounced in models of accelerated aging. We show that strengthening of the Ectodysplasin-A2-Receptor signalling axis in myogenic precursors and differentiated myotubes suffices to trigger potent parainflammatory responses, mirroring aspects of aging-driven sarcopenia. Intriguingly, obesity, insulin-resistance, and aging-related comorbidities, such as type-2-diabetes, result in heightened levels of the Ectodysplasin-A2 ligand. Our findings suggest that targeting the Ectodysplasin-A2 surface receptor represents a promising pharmacological strategy to mitigate the development of aging-associated phenotypes.

Association between Sarcopenia and Poor Glycemic Control in Older Adults with Type 2 Diabetes Mellitus

BACKGROUND

Aging is associated with a decrease in muscle mass. Insulin resistance and hyperglycemia accelerate muscle loss, leading to a deterioration in strength, muscle mass, and physical capacity in older adults. This study was conducted to determine the association between sarcopenia and poor glycemic control in older adults with type 2 diabetes mellitus (T2D).

METHODS

A cross-sectional study was carried out in older adults with T2D in geriatric outpatient clinics. Sarcopenia was diagnosed as per the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) criteria. According to glycosylated hemoglobin (HbA1c) levels, participants were classified into glycemic control (HbA1c ≤ 7.5%) and poor glycemic control (HbA1c ≥ 7.5%) groups.

RESULTS

Older adults with sarcopenia were found to have poor glycemic control compared to adults without sarcopenia (62.3% vs. 47.9%, p = 0.007). Logistic regression analysis showed an association between poor glycemic control and the presence of sarcopenia (odds ratio (OR): 1.79, 95% confidence interval (CI): 1.17-2.75) and low muscle mass (OR: 1.73, 95% CI: 1.07-2.73).

CONCLUSIONS

Poor glycemic control is associated with the presence of sarcopenia and low muscle mass, which highlights the need to implement better treatment strategies in order to reduce the loss of muscle mass.