Clinicians should implement lifestyle intervention as a primary therapy for older adults with diabetes, which can complement medical therapy and improve QOL.
“Although lifelong intervention is recommended as a cornerstone of diabetes management, this recommendation is not always followed in older adults due to the belief that it is too late to change lifelong habits and that diet may be harmful in this population,” explains Dennis T. Villa real estate. , MD. “As a result, many older adults with diabetes are treated with medications and exposed to side effects without first exploring the full benefit of an intensive lifestyle intervention (ILI) program.
For a study published in Diabetes Care, Dr. Villareal and colleagues sought to determine whether lifestyle intervention would improve glycemic control and age-relevant outcomes in older adults with diabetes and comorbidities. A cohort of 100 older adults with diabetes were randomly assigned to a 1-year ILI or healthy lifestyle (HL) group. ILI consisted of a diet and exercise program that began at a facility and moved into community exercise centers and homes. Change in A1C was the primary outcome, while secondary outcomes included changes in physical function, body composition, glucose regulation and QOL.
Improvements Observed Across the Board in the ILI Cohort
The study team observed a significant reduction in body weight in the ILI group (-8.4 ± 0.6 kg) but not the HL group (-0.3 ± 0.6 kg; figure), and the ILI group experienced a greater reduction in visceral fat and body weight compared to the HL group. In addition, A1C improvement was greater in the ILI cohort than the HL cohort and correlated with improved insulin sensitivity and disposition indices.
Greater improvements on physical performance test scores were seen in the ILI compared to the HL group, as well as VO2peak. Gait, strength and 36-item short form examination (SF-36) physical component summary scores also improved in the ILI group. This may interest you : Type-2 diabetes in children: 5 symptoms of lifestyle disorders in children. Finally, total insulin dose was reduced in the ILI group by 19.8 ± 4.4 units per day.
Never Too Late to Start Lifestyle Intervention
“For older adults with diabetes, it’s never too late to start lifestyle intervention,” says Dr. Villareal. “Clinicians should consider implementing lifestyle intervention as a primary therapy for this patient population, which can complement medical treatment for diabetes and improve QOL.”
The study authors acknowledge some limitations of the study related to the exclusion criteria. “Participants were physically able to participate in a lifestyle program and therefore may not be fully representative of the general population of older adults with diabetes,” they wrote. Read also : Lifestyle Interventions or Treatments for Type 2 Diabetes?. “Our study was limited to 1 year duration, so further studies are needed to determine long-term compliance and whether the beneficial effects of lifestyle intervention therapy can reduce diabetes complications and associated medical costs or prevent institutionalization of older adults with diabetes.”
Older Adults Very Motivated to Change Lifelong Habits
For future research, Dr. Villareal and colleagues would like to see the lifestyle intervention protocol in this study evaluated for widespread implementation in a practical setting. To see also : Lifestyle is now top priority for expats when considering moving abroad, survey finds. For example, he would like to see older adults with diabetes benefit from Medicare Part B coverage for medical nutrition therapy and other Medicare plans for coverage of gym participation among older adults.
Elderly people are particularly susceptible to diabetes, points out Dr. Villareal. “As people get older, they need fewer calories, but many continue to eat the same way they did when they were younger, resulting in weight gain,” he says, adding that older people tend to exercise less, which is another risk factor for T2D. “However, we found that older adults with diabetes are highly motivated to change lifelong habits. They had excellent adherence to the intervention, showed significant weight loss, and improved A1C.