Session: OR12-Fresh Thoughts on Diabetes Treatment
Room 210 (BCEC)
Methods/design: We present preliminary results of an ongoing randomized controlled trial (RCT) designed to comprehensively examine the effect of a lifestyle intervention strategy (behavioral diet therapy for weight loss and exercise training) in older (age: 65-85 yrs.) overweight/obese (BMI ≥ 27 kg/m2) adults with T2D. Main outcomes for this RCT included changes in: a) glycemic metabolic control (HbA1c), b) body weight and body composition (lean body mass, fat mass and visceral fat mass using DXA), c) physical function (Physical Performance Test [PPT], aerobic capacity [VO2peak]), and d) bone mineral density (BMD) and bone quality (trabecular bone score, TBS). Subjects were randomized to intensive lifestyle intervention (LI group) or healthy-lifestyle control (HL group) for 6 months.
Results: To date, 17 subjects (age: 70.2±3.8 yrs., BMI: 35.3±6.0 kg/m2, HbA1c: 7.3±1.2%) have been enrolled and 13 subjects (76.5%) have completed the interventions. There were no significant differences in age and baseline BMI and HbA1c between the LI (n=10) and HL (n=7) groups. After 6 months, HbA1c significantly improved in the LI group compared with HL (-0.7±0.2 vs 0.2±0.4%; p<0.001). Body weight tended to decrease in the LI relative to HL (-8.1±3.2 vs. -1.9±7.7 kg; p=0.08) associated with significant decreases in fat mass (-4.6±6.6 vs. -2.1±6.6 kg, p=0.02) and visceral fat mass (-0.2±0.2 vs 0.0±0.1 kg; p=0.04) but relative preservation of lean body mass (0.3±3.4 vs. 0.9±5.1 kg; p=0.80). In addition, PPT (3.3±1.6 vs. 1.2±6.5) and VO2peak (2.7±1.1 vs. 0.4±1.5) also significantly improved in LI compared to HL. Finally, although there were no significant changes in BMD, TBS significantly improved in the LI group but not in the HL group (0.09±0.0 vs -0.02; p=0.04).
Conclusion: These preliminary findings suggest that an intensive lifestyle intervention is not only feasible but importantly confers beneficial effects on glucose control, body composition, and physical function in older adults with T2D. Further, they provide evidence that bone quality may improve independent of changes in BMD in response to lifestyle intervention. Long-term studies involving a larger sample are needed to follow up on these encouraging results and examine underlying mechanisms.
Nothing to Disclose: AC, DB, YB, GC, RCV, DTV
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