Assessment of lower extremity muscle mass, muscle strength, and exercise therapy in elderly patients with diabetes mellitus

Nomura, Takuo; Kawae, Toshihiro; Kataoka, Hironao; Ikeda, Yukio

doi:10.1186/s12199-018-0710-7

Cited by 46 publications

(46 citation statements)

References 55 publications

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“…Skeletal muscle dysfunction and poor exercise tolerance are hallmarks of end-stage renal disease. Intensive physical therapy intervention should be provided to diabetic patients with a loss of muscle strength 35) .…”

Section: Resultsmentioning

confidence: 99%

Aging, physical activity, and diabetic complications related to loss of muscle strength in patients with type 2 diabetes

et al. 2018

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Patients with type 2 diabetes may have motor dysfunctions such as loss of muscle strength. Compared with non-diabetic subjects, patients with diabetes show decreased lower extremity muscle strength. The aim of this review was to describe the influence of factors associated with loss of muscle strength in patients with type 2 diabetes. Aging promotes an accelerated loss of muscle strength in patients with diabetes. Physical inactivity may cause a decline in muscle strength in patients with diabetes. Gradual loss of muscle strength is related to the presence and severity of diabetic neuropathy. Diabetic nephropathy may be a factor contributing to loss of muscle strength, because decrease in skeletal muscle mass is a hallmark of end-stage renal disease. Resistance exercise is an essential component of diabetes treatment regimens and also plays a role in the prevention and management of sarcopenia. Intensive physical therapy intervention should be provided to patients with diabetes having decreased muscle strength.

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Section: Resultsmentioning

confidence: 99%

Aging, physical activity, and diabetic complications related to loss of muscle strength in patients with type 2 diabetes

et al. 2018

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“…Third, there was no adjustment for confounding factors such as physical activity or dietary intake in the analyses. Not only these factors but also muscle mass or muscle strength has been found to be associated with diabetes mellitus [25], and these factors might have affected the results through motor or nutritional dysfunction. Fourth, it was thought that a generalized form of linear regression analysis, but not non-linear analyses (for example, a model including quadratic terms), would be better to assess longitudinal changes in these factors.…”

Section: Discussionmentioning

confidence: 99%

Hemoglobin A1c and 10-year information processing speed in Japanese community dwellers

Otsuka

Nishita

Tange

et al. 2019

Environ Health Prev Med

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Background Hyperglycemia is believed to be a risk factor for cognitive decline, but the longitudinal relationship between hyperglycemia and cognitive decline in the Japanese population is unclear. The present study aimed to clarify the association between blood glucose levels and information processing ability in middle-aged and older adults. Methods The subjects were 866 men and 815 women aged 40–79 years not taking medication for diabetes who participated in the first study wave (1997–2000) and then participated at least once in the subsequent six study waves (2000–2012) of the National Institute for Longevity Sciences—Longitudinal Study of Aging, Japan. Hemoglobin A1c (HbA1c) levels were categorized into four groups (< 5.6, 5.6 to < 6.0, 6.0 to < 6.5, ≥ 6.5%), and a mixed-effects model was used to evaluate the effects of the HbA1c level (four groups) on repeated measures of information processing speed. The models also included baseline age, body mass index, ethanol intake, smoking status, educational level, family income, and history of stroke, hypertension, heart disease, and dyslipidemia as covariates. Results Mean (standard deviation) HbA1c and follow-up time in participants were 5.2 (0.5) % and 10.0 (3.6) years, respectively. A linear mixed model showed that the main effect of the four HbA1c groups on information processing ability was not significant in either men or women, but the interaction of HbA1c and time with information processing speed in the higher HbA1c level groups (≥ 6.5% group in men, 6.0 to < 6.5% and ≥ 6.5% groups in women) was significant compared to the lower HbA1c level (< 5.6%) group ( P < 0.05). When the slope of information processing speed by HbA1c level at baseline was examined, the slope of information processing speed in the higher HbA1c level (≥ 6.5%) group was higher than in the lower HbA1c level (< 5.6%) group, both in men (− 0.31/year) and in women (− 0.30/year), as well as in women with an HbA1c level of 6.0 to < 6.5% (− 0.40/year). Conclusions Higher baseline HbA1c was associated with greater subsequent decline in information processing ability in Japanese community dwellers, even with the pre-clinical HbA1c level (6.0 to < 6.5%) in women. The results suggest that good glycemic control or prevention of hyperglycemia may contribute to maintaining information processing ability. Electronic supplementary material The online version of this article (10.1186/s12199-019-0778-8) contains supplementary material, which is available to authorized users.

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“…Ageing is a well-known nonmodifiable factor for the development of diabetes and lower muscle strength [50]. BMI has a negative impact on muscle strength in a population with insulin resistance (prediabetic situation) and diabetes type 2, which will manifest itself as a decrease of absolute and relative peak torque [56, 57]. Concerning physical activity, low levels have a negative impact on the development of diabetes and on lower muscle strength [57].…”

Section: Discussionmentioning

confidence: 99%

“…BMI has a negative impact on muscle strength in a population with insulin resistance (prediabetic situation) and diabetes type 2, which will manifest itself as a decrease of absolute and relative peak torque [56, 57]. Concerning physical activity, low levels have a negative impact on the development of diabetes and on lower muscle strength [57]. In our ANCOVA we encountered this barrier by adding age, BMI, and physical activity to add them as covariates.…”

Section: Discussionmentioning

confidence: 99%

The Influence of Clinically Diagnosed Neuropathy on Respiratory Muscle Strength in Type 2 Diabetes Mellitus

Eetvelde

Cambier

Wyngaert

et al. 2018

Journal of Diabetes Research

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Objectives This cross-sectional study investigated the influence of clinically diagnosed neuropathy (cdNP) on respiratory muscle strength in patients with type 2 diabetes mellitus (T2DM). Methods 110 T2DM patients and 35 nondiabetic healthy controls (≥60 years) were allocated to one of three groups depending on the presence of cdNP: T2DM without cdNP (D−; n = 28), T2DM with cdNP (D+; n = 82), and controls without cdNP (C; n = 35). Clinical neurological diagnostic examination consisted of Vibration Perception Threshold and Diabetic Neuropathy Symptom score. Respiratory muscle strength was registered by maximal Inspiratory and Expiratory Pressures (PImax and PEmax), and respiratory function by Peak Expiratory Flow (PEF). Isometric Handgrip Strength and Short Physical Performance Battery were used to evaluate peripheral skeletal muscle strength and physical performance. Univariate analysis of covariance was used with age, level of physical activity, and body mass index as covariates. Results PImax, PEmax, and PEF were higher in C compared to D− and D+. Exploring more in detail, PImax, PEmax, and PEF were significantly lower in D+ compared to C. PEmax and PEF were also significantly lower in D− versus C. Measures of peripheral muscle strength and physical performance showed less associations with cdNP and T2DM. Conclusions The presence of cdNP affects respiratory muscle strength in T2DM patients compared to healthy controls. Both cdNP and diabetes in themselves showed a distinctive impact on respiratory muscle strength and function; however, an accumulating effect could not be ascertained in this study. As commonly used measures of peripheral muscle strength and physical performance seemed to be less affected at the given time, the integration of PImax, PEmax, and PEF measurements in the assessment of respiratory muscle weakness could be of added value in the (early) screening for neuropathy in patients with T2DM.

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Assessment of lower extremity muscle mass, muscle strength, and exercise therapy in elderly patients with diabetes mellitus

Cited by 46 publications

References 55 publications

Aging, physical activity, and diabetic complications related to loss of muscle strength in patients with type 2 diabetes

Aging, physical activity, and diabetic complications related to loss of muscle strength in patients with type 2 diabetes

Hemoglobin A1c and 10-year information processing speed in Japanese community dwellers

The Influence of Clinically Diagnosed Neuropathy on Respiratory Muscle Strength in Type 2 Diabetes Mellitus

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