OBJECTIVE -To evaluate the influence of a twice-weekly progressive resistance training (PRT) program, without a concomitant weight loss diet, on abdominal fat and insulin sensitivity in older men with type 2 diabetes.RESEARCH DESIGN AND METHODS -Nine older men (aged 66.6 Ϯ 3.1) with type 2 diabetes participated in a 16-week PRT supervised program (50 -80% of the one repetition maximum), for all main muscle groups. Basal glycemia, HbA 1c , diet, habitual physical activity, body composition, and upper/lower maximal strength were measured. Insulin sensitivity was determined according to Bergman's minimal model procedure and abdominal fat was obtained by computed tomography. The measurements were taken 4 weeks before training (Ϫ4), immediately before training (0), and at 8-week intervals (i.e., weeks 8 and 16) during the 16-week training period.RESULTS -No significant variation was observed in any of the above selected parameters during the 4-week control period. After PRT, both leg and arm maximal strength increased significantly by 17.1 and 18.2%, respectively. Visceral and subcutaneous abdominal fat decreased significantly by 10.3% (from 249.5 Ϯ 97.9 to 225.6 Ϯ 96.6 cm 3 , P Ͻ 0.01) and by 11.2% (from 356.0 Ϯ 127.5 to 308.6 Ϯ 118.8 cm 3 , P Ͻ 0.01), respectively, while no changes were observed in body mass. PRT significantly increased insulin sensitivity by 46.3% (from 2.0 Ϯ 1.2 to 2.8 Ϯ 1.6 ⅐ 10 4 ⅐ min Ϫ1 ⅐ U Ϫ1 ⅐ ml Ϫ1 , P Ͻ 0.01), whereas it significantly decreased (Ϫ7.1%, P Ͻ 0.05) fasting blood glucose (from 146.6 Ϯ 28.3 to 135.0 Ϯ 29.3 mg/dl). Finally, a 15.5% increase in energy intake (from 2,287.1 Ϯ 354.7 to 2,619.0 Ϯ 472.1 kcal/day, P Ͻ 0.05) was observed.CONCLUSIONS -Two sessions per week of PRT, without a concomitant weight loss diet, significantly improves insulin sensitivity and fasting glycemia and decreases abdominal fat in older men with type 2 diabetes. Diabetes Care 28:662-667, 2005

Summary Aims To evaluate in a real‐world setting the effectiveness and tolerability of available GLP‐1 RA drugs in patients with type 2 diabetes after a prolonged follow‐up. Materials and methods Observational, retrospective, single‐centre study in patients starting GLP‐1 RA therapy. Change in HbA1c, fasting plasma glucose (FPG) and body mass index (BMI) along with gastrointestinal (GI) adverse events and withdrawal from GLP‐1 RA therapy were evaluated. Lack of efficacy of GLP‐1 RA therapy according to prespecified goals was also measured. Results A total of 735 patients were included, mean age 59.7 years, duration of diabetes 9.01 years, HbA1c 8.18% and BMI 38.56 kg/m 2 . Average follow‐up was 18.97 months (range 4.2‐39.09). All HbA1c (0.93%; P < 0.01), FPG (24 mg/dL; P < 0.01) and BMI (1.55 kg/m 2 ; P < 0.05) were significantly reduced from baseline and maintained throughout follow‐up, regardless of prescribed GLP‐1 RA. GI adverse events were present in 13.81% of patients at first follow‐up visit, 37.07% of patients discontinued GLP‐1 RA treatment, and 38.63% did not meet efficacy goals. Conclusions In a real‐world setting, GLP‐1 RA therapy is largely prescribed in severely obese patients with a long‐standing and poorly controlled diabetes. All prescribed GLP‐1 RAs significantly decreased HbA1c, FPG and BMI. GI adverse events affected a low proportion of patients. Inversely, a high proportion of patients did not meet efficacy goals and/or discontinued GLP‐1 RA treatment. Baseline characteristics of patients and lack of adherence may represent important issues underlying differences in effectiveness in real‐world studies versus randomized trials.

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