Clinicians should implement lifestyle interventions as the primary treatment for older adults with diabetes. This may complement drug therapy and improve quality of life.
“Although lifelong interventions are recommended as a cornerstone of diabetes management, this recommendation is not recommended in older adults because of the belief that it is too late to change lifelong habits and that dieting may be harmful for this population. It’s not always protected,” explains Dennis T. Villareal. , MD. “As a result, many older adults with diabetes are treated with drugs and exposed to side effects without first fully considering the benefits of an intensive lifestyle intervention (ILI) program.”
About the research published in diabetes care, Dr. Villareal and colleagues sought to establish whether lifestyle interventions improve glycemic control and age-related outcomes in older adults with diabetes and comorbidities. A cohort of 100 older adults with diabetes was randomly assigned to her ILI or Healthy Lifestyle (HL) group for 1 year. The ILI consisted of a diet and exercise program that began at the facility and moved to community fitness centers and homes. Changes in A1C were the primary outcome, and secondary outcomes included changes in physical function, body composition, glycemic regulation, and quality of life.
Improvement observed across the ILI cohort
The research team observed significant weight loss in the ILI group (-8.4 ± 0.6 kg), but not in the HL group (-0.3 ± 0.6 kg; shape), and the ILI group experienced greater reductions in visceral fat and body weight compared with the HL group. were correlated.
Compared with the HL group, the ILI had significantly improved physical performance test scores and improved VO.2 peaks. Gait, muscle strength, and 36-item short-form survey (SF-36) body component summary scores were also more improved in the ILI group. Finally, total insulin dose was reduced by 19.8 ± 4.4 units per day in the ILI group.
It’s never too late to start making lifestyle interventions
“It’s never too late to start lifestyle interventions for older people with diabetes,” says Dr. Villarreal. “Clinicians should consider implementing lifestyle interventions as the primary treatment in this patient population that may complement diabetes pharmacotherapy and improve quality of life.”
The study authors acknowledge some limitations of the study related to exclusion criteria. “Because participants were able to physically participate in the lifestyle program, it may not be fully representative of the general population of older adults with diabetes,” they wrote. was limited to years, so longer-term adherence and beneficial effects of lifestyle interventions could reduce health care costs associated with diabetes complications or prevent institutionalization of older adults with diabetes. Additional research is needed to determine whether
Older adults are highly motivated to change lifelong habits
For future research, Dr. Villareal and colleagues hope that the lifestyle intervention protocol in this study will be evaluated for widespread implementation in real-world settings. For example, he hopes that seniors with diabetes will be able to take advantage of Medicare Part B coverage for medical nutrition therapy and other Medicare plans with coverage for senior fitness center attendance. increase.
Older people are particularly vulnerable to diabetes, Dr. Villarreal notes. “As we age, we need fewer calories, but many people continue to eat the same as when they were younger, resulting in weight gain,” T2D. “However, we found that older adults with diabetes were highly motivated to change their habits for life. Did.”