Patients With Type 2 Diabetes Show a Greater Decline in Muscle Mass, Muscle Strength, and Functional Capacity With Aging

doi:10.1016/j.jamda.2013.02.006

Journal of the American Medical Directors Association

Volume 14, Issue 8, August 2013, Pages 585-592

https://doi.org/10.1016/j.jamda.2013.02.006 Get rights and content

Abstract

Background

The loss of muscle mass with aging reduces muscle strength, impairs functional capacity, and increases the risk of developing chronic metabolic disease. It has been suggested that the development of type 2 diabetes results in a more rapid decline in muscle mass, strength, and functional capacity.

Objective

To investigate the impact of type 2 diabetes on muscle mass, strength, and functional capacity in an older population.

Methods

Muscle mass (DXA and muscle biopsies), strength (1-repetition maximum), functional capacity (sit-to-stand test and handgrip strength), and reaction time performance (computer task) were compared between 60 older men with type 2 diabetes (71 ± 1 years) and 32 age-matched normoglycemic controls (70 ± 1 years). Data were analyzed using ANCOVA to adjust for several potential confounders.

Results

Leg lean mass and appendicular skeletal muscle mass were significantly lower in older men with type 2 diabetes (19.1 ± 0.3 and 25.9 ± 0.4 kg, respectively) compared with normoglycemic controls (19.7 ± 0.3 and 26.7 ± 0.5 kg, respectively). Additionally, leg extension strength was significantly lower in the group with type 2 diabetes (84 ± 2 vs 91 ± 2 kg, respectively). In agreement, functional performance was impaired in the men with type 2 diabetes, with longer sit-to-stand time (9.1 ± 0.4 vs 7.8 ± 0.3 seconds) and lower handgrip strength (39.5 ± 5.8 vs 44.6 ± 6.1 kg) when compared with normoglycemic controls. However, muscle fiber size and reaction time performance did not differ between groups.

Conclusion

Older patients with type 2 diabetes show an accelerated decline in leg lean mass, muscle strength, and functional capacity when compared with normoglycemic controls. Exercise intervention programs should be individualized to specifically target muscle mass, strength, and functional capacity in the older population with type 2 diabetes.

Section snippets

Subjects

Ninety-two older men were included in the present study: 60 with type 2 diabetes (71 ± 1 years) and 32 age-matched normoglycemic controls (70 ± 1 years). All subjects were community dwelling and still living independently. All subjects were recruited through advertisements in local newspapers. Medical history of all subjects was evaluated and an oral glucose tolerance test and resting and exercise electrocardiogram were performed before inclusion. Exclusion criteria included a recent history or

Subjects

Subjects’ characteristics are provided in Table 1. In total, 60 elderly men with type 2 diabetes and 32 normoglycemic age-matched controls were included in the study. Both groups showed no differences for age, body weight, height, BMI, HOMA, and ISI. The group with type 2 diabetes presented significantly higher basal plasma glucose and HbA1c values and lower basal plasma insulin concentrations when compared with the normoglycemic group.

Dietary Intake and Physical Activity

A significant difference was observed in total energy

Discussion

The present study shows that both leg lean mass and ASM are lower in older patients with type 2 diabetes when compared with age-matched normoglycemic controls. Additionally, leg muscle strength and functional capacity are reduced in older individuals suffering from type 2 diabetes. Reduced muscle strength and impairments in functional capacity are strongly correlated with type II muscle fiber atrophy in both normoglycemic elderly individuals and those with type 2 diabetes.

Aging is accompanied

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: None of the authors have any conflicts of interest.

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Original StudyPatients With Type 2 Diabetes Show a Greater Decline in Muscle Mass, Muscle Strength, and Functional Capacity With Aging

Abstract

Background

Objective

Methods

Results

Conclusion

Section snippets

Subjects

Subjects

Dietary Intake and Physical Activity

Discussion

Nutrition

Am J Clin Nutr

J Am Med Dir Assoc

Prev Med

Cogn Psychol

Am J Clin Nutr

Gait Posture

Functional and metabolic consequences of sarcopenia

J Nutr

Decreased muscle strength and quality in older adults with type 2 diabetes: The health, aging, and body composition study

Diabetes

Excessive loss of skeletal muscle mass in older adults with type 2 diabetes

Diabetes Care

Insulin resistance: A contributing factor to age-related muscle mass loss?

Diabetes Metab

Insulin resistance of protein metabolism in type 2 diabetes

Diabetes

Muscle strength and speed of movement in relation to age and muscle morphology

J Appl Physiol

Age and gender comparisons of muscle strength in 654 women and men aged 20–93 yr

J Appl Physiol

Accelerated loss of skeletal muscle strength in older adults with type 2 diabetes: The health, aging, and body composition study

Diabetes Care

Diminished performance on response-selection tasks in Type 2 diabetes

Percept Mot Skills

Cognitive function and information processing in type 2 diabetes

Diabet Med

The relationship between impaired glucose tolerance, type 2 diabetes, and cognitive function

J Clin Exp Neuropsychol

Early diabetic neuropathy: Triggers and mechanisms

World J Gastroenterol

Compendium of physical activities: An update of activity codes and MET intensities

Med Sci Sports Exerc

Original Study
Patients With Type 2 Diabetes Show a Greater Decline in Muscle Mass, Muscle Strength, and Functional Capacity With Aging