Intensive lifestyle intervention improves cardiometabolic profile, bone quality in older adults with type 2 diabetes

BOSTON — Older adults with overweight or obesity and type 2 diabetes saw improved glucose control, body composition, physical function and bone quality when assigned to an intensive diet and exercise training program, according to preliminary results from an ongoing randomized trial presented here.

“Weight loss therapy is still controversial among an elderly population because of the potential exacerbation of sarcopenia and frailty,” Alessandra Celli, MS, a research dietitian and predoctoral fellow in endocrinology at Baylor College of Medicine in Houston, told Endocrine Today “But our preliminary results of an ongoing clinical train on older diabetic patients showed that lifestyle intervention (made with weight loss and regular exercise training) in the elderly is not only doable, but may confer a beneficial effect on glucose, metabolic control, physical function, body composition and bone quality.”

Alessandra Celli

Celli and colleagues analyzed data from 17 adults aged 65 to 85 years with overweight or obesity and type 2 diabetes randomly assigned to lifestyle intervention (n = 10; behavioral diet therapy for weight loss and exercise training) or a healthy lifestyle control group (n = 7) for 6 months (mean age, 70 years; mean BMI, 35.3 kg/m²; mean HbA1c, 7.3%). Main outcomes included changes in HbA1c, body weight, body composition (lean body mass, fat mass and visceral fat mass via DXA), physical function (physical performance test and aerobic capacity), and BMD and bone quality (trabecular bone score).

At 6 months, researchers found that HbA1c improved in the lifestyle intervention group vs. controls (–0.7% vs. 0.2%; P < .001). Intervention group participants lost more body weight than controls (–8.1 kg vs. –1.9 kg; P = .08), including decreases in fat mass (–4.6 kg vs. –2.1 kg, P = .02) and visceral fat mass (–0.2 kg vs. 0 kg; P = .04) while lean body mass was preserved (0.3 kg vs. 0.9 kg; P = .80). Participants in the intervention group also performed better on the physical performance test (3.3 vs. 1.2) and had greater aerobic capacity (VO_2peak_,2.7 vs. 0.4).

Researchers also observed improvements in trabecular bone score for intervention participants (0.09 vs. –0.02; P = .04).

“If our results are confirmed, these encouraging findings may be used to formulate concrete recommendations about healthy lifestyle changes in older diabetic patients,” Celli said. “Long-term studies involving a larger sample are needed to follow-up on these results and examine underlying mechanisms.” – by Regina Schaffer

Reference :

Celli A, et al. OR12-4. Presented at: The Endocrine Society Annual Meeting; April 1-4, 2016; Boston.

Disclosure: The American Diabetes Association and the Michael E. DeBakey Veterans Affairs Medical Center supported this research. Celli reports no relevant financial disclosures.