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Wang WX, Kong LN, Zeng L, Chen L, Qiu J, Zhao Y. Exercise interventions for frail older adults with diabetes: A scoping review. Geriatr Nurs 2024; 58:200-207. [PMID: 38824882 DOI: 10.1016/j.gerinurse.2024.05.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 05/19/2024] [Accepted: 05/23/2024] [Indexed: 06/04/2024]
Abstract
There is a paucity of evidence on exercise interventions for frail older adults with diabetes. This scoping review aims to identify the scope of the current literature on the characteristics and effects of exercise interventions for frail older adults with diabetes. A search without time limitation was conducted in eight databases. 14 studies were finally included. Resistance exercise and multicomponent exercise were the most common types of exercise. There was considerable variation in the frequency, duration and intensity of exercise interventions. Studies reported improvements in frailty status, physical function, blood glucose and lipid levels and economic effectiveness. The most frequent combined interventions involved nutrition and education. Although evidence was limited, the potential benefits of exercise interventions for frail older adults with diabetes were substantial. Further high-quality studies are needed to explore the most effective and cost-saving exercise interventions for frail older adults with diabetes.
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Affiliation(s)
- Wen-Xin Wang
- School of Nursing, Chongqing Medical University, Chongqing, China
| | - Ling-Na Kong
- School of Nursing, Chongqing Medical University, Chongqing, China.
| | - Lin Zeng
- School of Nursing, Chongqing Medical University, Chongqing, China; Department of Cardiology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Lu Chen
- School of Nursing, Chongqing Medical University, Chongqing, China
| | - Ju Qiu
- School of Nursing, Chongqing Medical University, Chongqing, China; Department of Endocrinology and Breast Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yang Zhao
- School of Nursing, Chongqing Medical University, Chongqing, China
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2
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Omura T, Inami A, Sugimoto T, Kawashima S, Sakurai T, Tokuda H. Tirzepatide and Glycemic Control Metrics Using Continuous Glucose Monitoring in Older Patients with Type 2 Diabetes Mellitus: An Observational Pilot Study. Geriatrics (Basel) 2024; 9:27. [PMID: 38525744 PMCID: PMC10961786 DOI: 10.3390/geriatrics9020027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 02/22/2024] [Accepted: 02/24/2024] [Indexed: 03/26/2024] Open
Abstract
This observational pilot study aimed to investigate continuous glucose monitoring (CGM) metrics in older Japanese patients with type 2 diabetes mellitus (T2DM) using a CGM system (FreeStyle Libre Pro) during the first tirzepatide administration and compare the glycemic control measures before and after the initial injection. The four patients had a mean age of 79.5 years (standard deviation [SD]: 5.8), a mean body mass index of 24.6 kg/m2 (SD: 4.7), a mean glycated hemoglobin level of 9.1% (SD: 2.1), and a mean measurement period of 10.5 days (SD: 3.5). After the inclusion of tirzepatide treatment, the mean of time in range, time above range, and time below range changed from 53.2% to 78.9% (p = 0.041), 45.8% to 19.7% (p = 0.038), and 1.0% to 1.5% (p = 0.206), respectively. Improved hyperglycemia reduced the oral hypoglycemic medication in two cases and decreased the frequency of insulin injections in two cases. To elucidate the potential benefits of tirzepatide, future studies should investigate the long-term impact on functional prognosis, safety, and tolerability and distinguish between the use of other weekly agonists, especially in nonobese older Asian patients. However, tirzepatide-associated robust glycemic improvement may simplify diabetes treatment regimens in older patients with T2DM.
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Affiliation(s)
- Takuya Omura
- Department of Endocrinology and Metabolism, Hospital, National Center for Geriatrics and Gerontology, 7–430 Morioka-cho, Obu 474-8511, Aichi, Japan
- Department of Metabolic Research, Research Institute, National Center for Geriatrics and Gerontology, 7–430 Morioka-cho, Obu 474-8511, Aichi, Japan
| | - Akemi Inami
- Department of Metabolic Research, Research Institute, National Center for Geriatrics and Gerontology, 7–430 Morioka-cho, Obu 474-8511, Aichi, Japan
| | - Taiki Sugimoto
- Department of Prevention and Care Science, Research Institute, National Center for Geriatrics and Gerontology, 7–430 Morioka-cho, Obu 474-8511, Aichi, Japan
- Department of Medicine, University of Washington, Box 359780, 325 Ninth Avenue, Seattle, WA 98104, USA
| | - Shuji Kawashima
- Department of Endocrinology and Metabolism, Hospital, National Center for Geriatrics and Gerontology, 7–430 Morioka-cho, Obu 474-8511, Aichi, Japan
| | - Takashi Sakurai
- Department of Prevention and Care Science, Research Institute, National Center for Geriatrics and Gerontology, 7–430 Morioka-cho, Obu 474-8511, Aichi, Japan
| | - Haruhiko Tokuda
- Department of Endocrinology and Metabolism, Hospital, National Center for Geriatrics and Gerontology, 7–430 Morioka-cho, Obu 474-8511, Aichi, Japan
- Department of Metabolic Research, Research Institute, National Center for Geriatrics and Gerontology, 7–430 Morioka-cho, Obu 474-8511, Aichi, Japan
- Department of Clinical Laboratory, Hospital, National Center for Geriatrics and Gerontology, 7–430 Morioka-cho, Obu 474-8511, Aichi, Japan
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3
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Lopez-Pedrosa JM, Camprubi-Robles M, Guzman-Rolo G, Lopez-Gonzalez A, Garcia-Almeida JM, Sanz-Paris A, Rueda R. The Vicious Cycle of Type 2 Diabetes Mellitus and Skeletal Muscle Atrophy: Clinical, Biochemical, and Nutritional Bases. Nutrients 2024; 16:172. [PMID: 38202001 PMCID: PMC10780454 DOI: 10.3390/nu16010172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 12/30/2023] [Accepted: 12/30/2023] [Indexed: 01/12/2024] Open
Abstract
Today, type 2 diabetes mellitus (T2DM) and skeletal muscle atrophy (SMA) have become increasingly common occurrences. Whether the onset of T2DM increases the risk of SMA or vice versa has long been under investigation. Both conditions are associated with negative changes in skeletal muscle health, which can, in turn, lead to impaired physical function, a lowered quality of life, and an increased risk of mortality. Poor nutrition can exacerbate both T2DM and SMA. T2DM and SMA are linked by a vicious cycle of events that reinforce and worsen each other. Muscle insulin resistance appears to be the pathophysiological link between T2DM and SMA. To explore this association, our review (i) compiles evidence on the clinical association between T2DM and SMA, (ii) reviews mechanisms underlying biochemical changes in the muscles of people with or at risk of T2DM and SMA, and (iii) examines how nutritional therapy and increased physical activity as muscle-targeted treatments benefit this population. Based on the evidence, we conclude that effective treatment of patients with T2DM-SMA depends on the restoration and maintenance of muscle mass. We thus propose that regular intake of key functional nutrients, along with guidance for physical activity, can help maintain euglycemia and improve muscle status in all patients with T2DM and SMA.
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Affiliation(s)
| | | | | | | | - Jose Manuel Garcia-Almeida
- Department of Endocrinology and Nutrition, Virgen de la Victoria Hospital (IBIMA), Malaga University, 29010 Malaga, Spain;
| | - Alejandro Sanz-Paris
- Nutrition Unit, Universitary Hospital Miguel Servet, Isabel the Catholic 1-3, 50009 Zaragoza, Spain;
| | - Ricardo Rueda
- Abbott Nutrition R&D, 18004 Granada, Spain; (M.C.-R.); (A.L.-G.); (R.R.)
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4
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Omura T, Katsumi A, Kawashima S, Naya M, Tokuda H. Prolonged COVID-19 Infection in a Patient with Complete Remission from Follicular Lymphoma with Hyperosmolar Hyperglycemic Syndrome. Geriatrics (Basel) 2023; 8:110. [PMID: 37987470 PMCID: PMC10660512 DOI: 10.3390/geriatrics8060110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 10/31/2023] [Accepted: 11/09/2023] [Indexed: 11/22/2023] Open
Abstract
An 81-year-old woman undergoing B-cell depletion therapy developed COVID-19 and a hyperglycemic hyperosmotic state. She had a history of multiple vaccinations against coronaviruses but had persistent antigen positivity. Strategies to prevent the development of COVID-19 in immunosuppressed patients have not been established. Moreover, there is no standard treatment for prolonged antigen positivity. In this case, we were able to follow IgG antibodies during the course of treatment. The absence of N-IgG antibody titer elevation despite an effective immune response triggered by the vaccine is of great interest. The impaired humoral response observed in patients with lymphoma after anti-CD20 treatment implies the need for a justified different vaccination strategy for these patients. Furthermore, negative N-IgG titers in the immunosuppressed state may serve as an indicator of resistance to therapy.
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Affiliation(s)
- Takuya Omura
- Department of Endocrinology and Metabolism, National Center for Geriatrics and Gerontology, 7-430 Morioka-cho, Obu 474-8511, Aichi, Japan
- Department of Metabolic Research, Research Institute, National Center for Geriatrics and Gerontology, 7-430 Morioka-cho, Obu 474-8511, Aichi, Japan
| | - Akira Katsumi
- Department of Hematology, National Center for Geriatrics and Gerontology, 7-430 Morioka-cho, Obu 474-8511, Aichi, Japan
| | - Shuji Kawashima
- Department of Endocrinology and Metabolism, National Center for Geriatrics and Gerontology, 7-430 Morioka-cho, Obu 474-8511, Aichi, Japan
| | - Masahiro Naya
- Department of Clinical Laboratory, National Center for Geriatrics and Gerontology, 7-430 Morioka-cho, Obu 474-8511, Aichi, Japan
| | - Haruhiko Tokuda
- Department of Endocrinology and Metabolism, National Center for Geriatrics and Gerontology, 7-430 Morioka-cho, Obu 474-8511, Aichi, Japan
- Department of Metabolic Research, Research Institute, National Center for Geriatrics and Gerontology, 7-430 Morioka-cho, Obu 474-8511, Aichi, Japan
- Department of Clinical Laboratory, National Center for Geriatrics and Gerontology, 7-430 Morioka-cho, Obu 474-8511, Aichi, Japan
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5
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Chen Y, Yang L, Gao X, Tang A, He H, Xiong C, Xu F, Sun C. The Impact of Diabetes Mellitus on Patient-Reported Outcomes of Chronic Low Back Pain with Modic Changes at One Year: A Prospective Cohort Study. Global Spine J 2023:21925682231206962. [PMID: 37824194 DOI: 10.1177/21925682231206962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/13/2023] Open
Abstract
STUDY DESIGN Prospective cohort study. OBJECTIVES Diabetes mellitus (DM) is associated with unfavourable patient-reported outcomes after spine surgery. Chronic low back pain (CLBP) with Modic Changes (MCs) in the lumbar vertebrae, as observed on MRI, forms a specific subgroup. This study aims to investigate the potential influence of DM on CLBP with MCs. METHODS This study involved 259 patients with CLBP accompanied MCs. We recorded the patient-reported outcomes (visual analogue scale (VAS), Oswestry Disability Index (ODI), and Roland-Morris Disability Questionnaire (RMDQ)) at baseline, 3, 6, and 12 months. Multivariable linear regression analyses were performed to determine predictors of patient-reported outcomes. RESULTS 103 patients had DM. Patients with DM exhibited higher VAS (P < .05), ODI (P < .001), and RMDQ (P < .001) scores at 3, 6, and 12 months, while patients without DM experienced more significant improvements in the scores over time (P < .001). Patients with DM reported longer durations of physical exercise (P = .007). Additionally, patients without DM had a significantly higher patient satisfaction index (P < .001) and a lower prevalence of hypertension (P < .001). Notably, significant differences were observed in the distribution of MCs of lumbar vertebrae (P = .034) and Pfirrmann grades of intervertebral disc degeneration between two groups (P < .001). CONCLUSION Patients with DM demonstrated poorer patient-reported outcomes compared to those without DM in 1-year. DM emerged as an independent predictor of adverse patient-reported outcomes. It can be utilized to enhance the management and treatment of CLBP in patients with MCs.
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Affiliation(s)
- Yongkang Chen
- Department of Orthopedics, General Hospital of Central Theatre Command of PLA, Wuhan, China
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Lei Yang
- Department of Orthopedics, General Hospital of Central Theatre Command of PLA, Wuhan, China
| | - Xiaofeng Gao
- School of Basic Medical Sciences, Xianning Medical College, Hubei University of Science and Technology, Xianning, China
| | - Aolin Tang
- Department of Orthopedics, General Hospital of Central Theatre Command of PLA, Wuhan, China
| | - Hang He
- Department of Orthopedics, General Hospital of Central Theatre Command of PLA, Wuhan, China
| | - Chengjie Xiong
- Department of Orthopedics, General Hospital of Central Theatre Command of PLA, Wuhan, China
| | - Feng Xu
- Department of Orthopedics, General Hospital of Central Theatre Command of PLA, Wuhan, China
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Chao Sun
- Department of Orthopedics, General Hospital of Central Theatre Command of PLA, Wuhan, China
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6
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Armstrong M, Colberg SR, Sigal RJ. Where to Start? Physical Assessment, Readiness, and Exercise Recommendations for People With Type 1 or Type 2 Diabetes. Diabetes Spectr 2023; 36:105-113. [PMID: 37193205 PMCID: PMC10182968 DOI: 10.2337/dsi22-0016] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Exercise plays an important role in the management of diabetes and is associated with many benefits such as decreased morbidity and mortality. For people exhibiting signs and symptoms of cardiovascular disease, pre-exercise medical clearance is warranted; however, requiring broad screening requirements can lead to unnecessary barriers to initiating an exercise program. Robust evidence supports the promotion of both aerobic and resistance training, with evidence emerging on the importance of reducing sedentary time. For people with type 1 diabetes, there are special considerations, including hypoglycemia risk and prevention, exercise timing (including prandial status), and differences in glycemic responses based on biological sex.
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Affiliation(s)
- Marni Armstrong
- Medicine Strategic Clinical Network, Alberta Health Services, Alberta, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Sheri R. Colberg
- Human Movement Sciences Department, Old Dominion University, Norfolk, VA
| | - Ronald J. Sigal
- Departments of Medicine, Cardiac Sciences, and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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7
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Boaz M, Kaufman-Shriqui V. Systematic Review and Meta-Analysis: Malnutrition and In-Hospital Death in Adults Hospitalized with COVID-19. Nutrients 2023; 15:nu15051298. [PMID: 36904295 PMCID: PMC10005527 DOI: 10.3390/nu15051298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/02/2023] [Accepted: 03/04/2023] [Indexed: 03/09/2023] Open
Abstract
BACKGROUND Malnutrition and increased malnutrition risk are frequently identified in hospitalized adults. The increase in hospitalization rates during the COVID-19 pandemic was accompanied by the documentation of adverse hospitalization outcomes in the presence of certain co-morbidities, including obesity and type 2 diabetes. It was not clear whether the presence of malnutrition increased in-hospital death in patients hospitalized with COVID-19. OBJECTIVES To estimate the effect of malnutrition on in-hospital mortality in adults hospitalized with COVID-19; and secondarily, to estimate the prevalence of malnutrition in adults hospitalized with malnutrition during the COVID-19 pandemic. METHODS EMBASE, MEDLINE, PubMed, Google Scholar, and Cochrane Collaboration databases were queried using the search terms malnutrition and COVID-19 and hospitalized adults and mortality. Studies were reviewed using the 14-question Quality Assessment Tool for Studies with Diverse Designs (QATSDD) (questions appropriate for quantitative studies). Author names; date of publication; country; sample size; malnutrition prevalence; malnutrition screening/diagnostic method; number of deaths in malnourished patients; and number of deaths in adequately nourished patients were extracted. Data were analyzed using MedCalc software v20.210 (Ostend, Belgium). The Q and I2 tests were calculated; a forest plot was generated, and the pooled odds ratio (OR) with 95% confidence intervals (95%CI) were calculated using the random effects model. RESULTS Of the 90 studies identified, 12 were finally included in the meta-analysis. In the random effects model, malnutrition or increased malnutrition risk increased odds of in-hospital death by more than three-fold: OR 3.43 (95% CI 2.549-4.60), p < 0.001. The pooled prevalence estimate for malnutrition or increased malnutrition risk was 52.61% (95% CI 29.50-75.14%). DISCUSSION AND CONCLUSIONS It is clear that malnutrition is an ominous prognostic sign in patients hospitalized with COVID. This meta-analysis, which included studies from nine countries on four continents with data from 354,332 patients, is generalizable.
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Affiliation(s)
- Mona Boaz
- Correspondence: or ; Tel.: +972-50-212-9666
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8
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Abstract
Introduction Objectives: an expert report is presented on the situation of loss of muscle mass in people with type 2 diabetes mellitus (T2DM), with a proposal of what the clinical approach to this comorbidity should be, based on the evidence from the literature and clinical experience. Method: a qualitative expert opinion study was carried out using the nominal approach. A literature search on diabetes and muscle was made and submitted to a multidisciplinary group of 7 experts who through a face-to-face meeting discussed different aspects of the role of muscle mass in T2DM. Results: muscle mass must be taken into account in the clinical context of patients with T2DM. It has an enormous impact on patient function and quality of life, and is as important as adequate metabolic control of T2DM. Conclusions: in addition to drug therapy and diet adjustments, aerobic and strength activities are essential for maintaining muscle mass and function in diabetic patients. In concrete situations, artificial oral supplementation specific for muscle care could improve the situation of malnutrition and low muscle mass. Measures such as the walking speed test, chair test, or the SARC-F questionnaire, together with the Barthel index, constitute a first step to diagnose relevant impairment requiring intervention in patients with T2DM. This document seeks to answer some questions about the importance, assessment, and control of muscle mass in T2DM.
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9
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Muramatsu K, Nagasawa H, Takeuchi I, Jitsuiki K, Ohsaka H, Ishikawa K, Yanagawa Y. An analysis of patients with a chief complaint of difficulty moving. J Rural Med 2023; 18:36-41. [PMID: 36700130 PMCID: PMC9832309 DOI: 10.2185/jrm.2022-016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 10/20/2022] [Indexed: 01/06/2023] Open
Abstract
Objective: There have been few reports in English medical journals analyzing patients with difficulty moving. Herein, we conducted a retrospective survey of emergency patients admitted to our hospital with the chief complaint of difficulty moving, to clarify the clinical characteristics of the frequency, causative disease, and outcome in these patients. Patients and Methods: Between August 2017 and October 2021, we surveyed the patient database maintained by our department, covering cases in which the main complaint at the time of patient transport by ambulance to our hospital was difficulty moving. Results: In 111 cases, the patient's primary complaint was difficulty moving or adynamia. Patients included 59 males and 52 females, with a mean age of 76.3 years old. The most frequent diagnosis in these patients was rhabdomyolysis, followed by infection, body temperature abnormalities, electrolyte disorder, blood glucose abnormality, hypoxia, and renal failure. Trauma and various other diseases, such as stroke and malignancy, were also found to be causative diseases. After discharge from the hospital, the number of patients with a dependent status was greater than those with an independent status. Conclusion: Patients with difficulty moving were primarily elderly, and had a variety of causative diseases. Therefore, multiple approaches are required to manage these patients.
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Affiliation(s)
- Kenichi Muramatsu
- Department of Acute Critical Care Medicine, Shizuoka
Hospital, Juntendo University, Japan
| | - Hiroki Nagasawa
- Department of Acute Critical Care Medicine, Shizuoka
Hospital, Juntendo University, Japan
| | - Ikuto Takeuchi
- Department of Acute Critical Care Medicine, Shizuoka
Hospital, Juntendo University, Japan
| | - Kei Jitsuiki
- Department of Acute Critical Care Medicine, Shizuoka
Hospital, Juntendo University, Japan
| | - Hiromichi Ohsaka
- Department of Acute Critical Care Medicine, Shizuoka
Hospital, Juntendo University, Japan
| | - Kouhei Ishikawa
- Department of Acute Critical Care Medicine, Shizuoka
Hospital, Juntendo University, Japan
| | - Youichi Yanagawa
- Department of Acute Critical Care Medicine, Shizuoka
Hospital, Juntendo University, Japan
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10
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Mechanick JI, Christofides EA, Marchetti AE, Hoddy KK, Joachim J, Hegazi R, Hamdy O. The syndromic triad of COVID-19, type 2 diabetes, and malnutrition. Front Nutr 2023; 10:1122203. [PMID: 36895277 PMCID: PMC9988958 DOI: 10.3389/fnut.2023.1122203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 01/30/2023] [Indexed: 02/25/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic challenges our collective understanding of transmission, prevention, complications, and clinical management of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Risk factors for severe infection, morbidity, and mortality are associated with age, environment, socioeconomic status, comorbidities, and interventional timing. Clinical investigations report an intriguing association of COVID-19 with diabetes mellitus and malnutrition but incompletely describe the triphasic relationship, its mechanistic pathways, and potential therapeutic approaches to address each malady and their underlying metabolic disorders. This narrative review highlights common chronic disease states that interact epidemiologically and mechanistically with the COVID-19 to create a syndromic phenotype-the COVID-Related Cardiometabolic Syndrome-linking cardiometabolic-based chronic disease drivers with pre-, acute, and chronic/post-COVID-19 disease stages. Since the association of nutritional disorders with COVID-19 and cardiometabolic risk factors is well established, a syndromic triad of COVID-19, type 2 diabetes, and malnutrition is hypothesized that can direct, inform, and optimize care. In this review, each of the three edges of this network is uniquely summarized, nutritional therapies discussed, and a structure for early preventive care proposed. Concerted efforts to identify malnutrition in patients with COVID-19 and elevated metabolic risks are needed and can be followed by improved dietary management while simultaneously addressing dysglycemia-based chronic disease and malnutrition-based chronic disease.
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Affiliation(s)
- Jeffrey I Mechanick
- The Wiener Cardiovascular Institute/Marie-Josée and Henry R. Kravis Center for Cardiovascular Health at Mount Sinai Heart, New York, NY, United States.,Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | | | - Albert E Marchetti
- Medical Education and Research Alliance (Med-ERA, Inc.), New York, NY, United States.,Rutgers New Jersey Medical School, Newark, NJ, United States
| | | | - Jim Joachim
- Internal Medicine and Medical Nutrition, San Diego, CA, United States
| | | | - Osama Hamdy
- Joslin Diabetes Center, Boston, MA, United States.,Harvard Medical School, Boston, MA, United States
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11
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Alghanem L, Zhang X, Jaiswal R, Seyoum B, Mallisho A, Msallaty Z, Yi Z. Effect of Insulin and Pioglitazone on Protein Phosphatase 2A Interaction Partners in Primary Human Skeletal Muscle Cells Derived from Obese Insulin-Resistant Participants. ACS OMEGA 2022; 7:42763-42773. [PMID: 36467954 PMCID: PMC9713796 DOI: 10.1021/acsomega.2c04473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 11/01/2022] [Indexed: 05/16/2023]
Abstract
Skeletal muscle insulin resistance is a major contributor to type-2 diabetes (T2D). Pioglitazone is a potent insulin sensitizer of peripheral tissues by targeting peroxisome proliferator-activated receptor gamma. Pioglitazone has been reported to protect skeletal muscle cells from lipotoxicity by promoting fatty acid mobilization and insulin signaling. However, it is unclear whether pioglitazone increases insulin sensitivity through changes in protein-protein interactions involving protein phosphatase 2A (PP2A). PP2A regulates various cell signaling pathways such as insulin signaling. Interaction of the catalytic subunit of PP2A (PP2Ac) with protein partners is required for PP2A specificity and activity. Little is known about PP2Ac partners in primary human skeletal muscle cells derived from lean insulin-sensitive (Lean) and obese insulin-resistant (OIR) participants. We utilized a proteomics method to identify PP2Ac interaction partners in skeletal muscle cells derived from Lean and OIR participants, with or without insulin and pioglitazone treatments. In this study, 216 PP2Ac interaction partners were identified. Furthermore, 26 PP2Ac partners exhibited significant differences in their interaction with PP2Ac upon insulin treatments between the two groups. Multiple pathways and molecular functions are significantly enriched for these 26 interaction partners, such as nonsense-mediated decay, metabolism of RNA, RNA binding, and protein binding. Interestingly, pioglitazone restored some of these abnormalities. These results provide differential PP2Ac complexes in Lean and OIR in response to insulin/pioglitazone, which may help understand molecular mechanisms underpinning insulin resistance and the insulin-sensitizing effects of pioglitazone treatments, providing multiple targets in various pathways to reverse insulin resistance and prevent and/or manage T2D with less drug side effects.
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Affiliation(s)
- Lana Alghanem
- Department
of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan48201, United States
| | - Xiangmin Zhang
- Department
of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan48201, United States
| | - Ruchi Jaiswal
- Department
of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan48201, United States
| | - Berhane Seyoum
- Division
of Endocrinology, Wayne State University School of Medicine, Wayne State University, Detroit, Michigan48201, United States
| | - Abdullah Mallisho
- Division
of Endocrinology, Wayne State University School of Medicine, Wayne State University, Detroit, Michigan48201, United States
| | - Zaher Msallaty
- Division
of Endocrinology, Wayne State University School of Medicine, Wayne State University, Detroit, Michigan48201, United States
| | - Zhengping Yi
- Department
of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan48201, United States
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12
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Wannarong T, Sukpornchairak P, Naweera W, Geiger CD, Ungprasert P. Association between diabetic peripheral neuropathy and sarcopenia: A systematic review and meta‐analysis. Geriatr Gerontol Int 2022; 22:785-789. [DOI: 10.1111/ggi.14462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 07/24/2022] [Accepted: 07/27/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Thapat Wannarong
- Department of Neurology Neurological Institute, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine Cleveland Ohio USA
- Neuromuscular Division, Department of Neurology Duke University Hospital Durham North Carolina USA
| | - Persen Sukpornchairak
- Department of Neurology Neurological Institute, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine Cleveland Ohio USA
| | - Weerakit Naweera
- Nephrology Division, Department of Internal Medicine King Narai Hospital Lopburi Thailand
| | - Christopher D. Geiger
- Department of Neurology Neurological Institute, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine Cleveland Ohio USA
| | - Patompong Ungprasert
- Department of Rheumatic and Immunologic Diseases Cleveland Clinic Foundation Cleveland Ohio USA
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13
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González-Martos R, Aparicio-Ugarriza R, Alcazar J, Ramirez-Castillejo C, Reihmane D, Menéndez-Rey A, González-Gross M, Guadalupe-Grau A. Circulating Sestrins and Force Velocity Profiling in Older Adults with Type 2 Diabetes. Eur J Sport Sci 2022:1-10. [PMID: 35876123 DOI: 10.1080/17461391.2022.2106158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
ABSTRACTType 2 diabetes mellitus (T2DM) in old age affects the musculoskeletal system causing loss of muscle mass, strength, and physical function. Stress-inducible proteins named sestrins are potential novel biomarkers of muscle function due to their ability to suppress oxidative stress and prevent muscle degeneration. Our aim was to determine the association between different force-velocity (F-V) profiles with body composition, physical performance, and glucose control in older adults with T2DM. We also intended to determine the potential utility of sestrin 1 (Sesn1) and 2 (Sesn2) as biomarkers of physical functionality. Fifty-nine participants (69-79 years) were classified in 3 groups according to their F-V profile based on the leg press exercise: nondeficit (NDEF = 40.7%), force deficit (FDEF = 28.8%), and velocity deficit (VDEF = 30.5%). Both VDEF and FDEF groups showed lower muscle power than NDEF (Cohen's d 0.87 and 0.75 for effect size, respectively). Serum Sesn2 levels, maximal dynamic strength, arms and legs fat-free mass were reduced in FDEF compared to the NDEF group (p < 0.05), whereas glycated hemoglobin (HbA1c) and fasting glucose levels were similar among groups. ROC analysis revealed the distinction between the NDEF and FDEF group based on Sesn2 concentrations (<0.72 ng/mL), suggesting their potential use as functional biomarkers for early intervention through exercise. Older adults with T2DM show different F-V profiles, related to low levels of Sesn2, impaired body composition and physical performance, and may be taken into consideration to target exercise training in this specific population.
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Affiliation(s)
- Raquel González-Martos
- ImFINE Research Group. Department of Health and Human Performance. Universidad Politécnica de Madrid. Madrid, 28040, Spain.,Cancer Stem Cell Research Group. Department of Biotechnology-Vegetal Biology. Centro de Tecnología Biomédica. Universidad Politécnica de Madrid. Madrid, 28223, Spain.,GENUD Toledo Research Group, Universidad Castilla-La Mancha. Toledo, 45071, Spain
| | - Raquel Aparicio-Ugarriza
- ImFINE Research Group. Department of Health and Human Performance. Universidad Politécnica de Madrid. Madrid, 28040, Spain.,CIBER of Biomedical Research Networking Center on Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III (ISCIII). Madrid, 28222, Spain
| | - Julian Alcazar
- GENUD Toledo Research Group, Universidad Castilla-La Mancha. Toledo, 45071, Spain.,CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, ISCIII. Madrid, 28222, Spain
| | - Carmen Ramirez-Castillejo
- Cancer Stem Cell Research Group. Department of Biotechnology-Vegetal Biology. Centro de Tecnología Biomédica. Universidad Politécnica de Madrid. Madrid, 28223, Spain
| | - Dace Reihmane
- Department of Human Physiology and Biochemistry, Riga Stradiņš University. Riga, LV-1007, Latvia
| | - Adrian Menéndez-Rey
- Cancer Stem Cell Research Group. Department of Biotechnology-Vegetal Biology. Centro de Tecnología Biomédica. Universidad Politécnica de Madrid. Madrid, 28223, Spain
| | - Marcela González-Gross
- ImFINE Research Group. Department of Health and Human Performance. Universidad Politécnica de Madrid. Madrid, 28040, Spain.,CIBER of Biomedical Research Networking Center on Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III (ISCIII). Madrid, 28222, Spain
| | - Amelia Guadalupe-Grau
- ImFINE Research Group. Department of Health and Human Performance. Universidad Politécnica de Madrid. Madrid, 28040, Spain.,GENUD Toledo Research Group, Universidad Castilla-La Mancha. Toledo, 45071, Spain.,CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, ISCIII. Madrid, 28222, Spain
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14
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SELVİ ÖZTORUN H, GÖZÜKARA B, BAHŞİ R, TURGUT T, MUT SÜRMELİ D, COŞARDERELİOĞLU Ç, ATMIŞ V, VARLI M, ARAS S. A higher incidence of diabetic peripheral neuropathy may be associated with decreased sleep and increased depression in older adults. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2022. [DOI: 10.32322/jhsm.1133659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Aim: Diabetes mellitus (DM) tends to increase with aging. Nearly half of the patients with DM develop neuropathy (DPN). Despite its high burden and morbidity, the conditions that DPN may be associated with have not been adequately studied in older adults. We aimed to identify sleep duration and comprehensive geriatric assessment components that may be associated with DPN.
Material and Method: This is a cross-sectional retrospective study. DPN diagnosed with a medical history, neurologic examination, and electromyography (EMG). 125 diabetic older patients were included. All comprehensive geriatric assessment tests and questions about sleep quality and time were performed. We divided the patients into two groups those without neuropathy and with neuropathy and compared them.
Results: The median age of 125 patients was 72 (min-max; 64-94). 58.8% of them were women. The percentage of married people and living with their spouse and slept for 6 hours or more had a lower percentage in the DPN group. Polypharmacy and the percentage of heart failure were significantly higher in the DPN group. Lawton-Brody score, which shows instrumental daily living activities (IADL) and geriatric depression score (GDS) was higher in the DPN group. In logistic regression, we found that depression scores were higher and sleep duration was shorter in the DPN group (respectively, odd ratio:265 p:.012; odd ratio:.1.917 p:.045)
Conclusions: DPN in older adults may affect the functionality and be associated with fewer sleep hours and depression. Not only blood glucose regulation but also other factors such as sleep duration and depressed mood may be associated with DPN in older adults.
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Affiliation(s)
- Hande SELVİ ÖZTORUN
- Republic of Turkey Ministry of Health Ankara City Training and Research Hospital Department of Geriatrics
| | - Bilge GÖZÜKARA
- Ankara University, Faculty of Medicine, Department of Internal Medicine
| | - Remzi BAHŞİ
- Ankara University, Faculty of Medicine, Ibn-i Sina Hospital, Department of Geriatrics
| | - Tuğba TURGUT
- Republic of Turkey Ministry of Health ,Antalya Training and Research Hospital, Department of Geriatrics, Antalya, Turkey
| | - Deniz MUT SÜRMELİ
- Ankara University, Faculty of Medicine, Ibn-i Sina Hospital, Department of Geriatrics
| | | | - Volkan ATMIŞ
- Ankara University, Faculty of Medicine, Ibn-i Sina Hospital, Department of Geriatrics
| | - Murat VARLI
- Ankara University, Faculty of Medicine, Ibn-i Sina Hospital, Department of Geriatrics
| | - Sevgi ARAS
- Ankara University, Faculty of Medicine, Ibn-i Sina Hospital, Department of Geriatrics
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Brasser M, Frühholz S, Schneeberger AR, Ruschetti GG, Schaerli R, Häner M, Studer-Luethi B. A Randomized Controlled Trial Study of a Multimodal Intervention vs. Cognitive Training to Foster Cognitive and Affective Health in Older Adults. Front Psychol 2022; 13:866613. [PMID: 35795412 PMCID: PMC9251428 DOI: 10.3389/fpsyg.2022.866613] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 05/30/2022] [Indexed: 11/29/2022] Open
Abstract
Research over the past few decades has shown the positive influence that cognitive, social, and physical activities have on older adults’ cognitive and affective health. Especially interventions in health-related behaviors, such as cognitive activation, physical activity, social activity, nutrition, mindfulness, and creativity, have shown to be particularly beneficial. Whereas most intervention studies apply unimodal interventions, such as cognitive training (CT), this study investigates the potential to foster cognitive and affective health factors of older adults by means of an autonomy-supportive multimodal intervention (MMI). The intervention integrates everyday life recommendations for six evidence-based areas combined with psychoeducational information. This randomized controlled trial study compares the effects of a MMI and CT on those of a waiting control group (WCG) on cognitive and affective factors, everyday life memory performance, and activity in everyday life. Three groups, including a total of 119 adults aged 65–86 years, attended a 5- or 10-week intervention. Specifically, one group completed a 10-week MMI, the second group completed 5-week of computer-based CT followed by a 5-week MMI, whereas the third group paused before completing the MMI for the last 5 weeks. All participants completed online surveys and cognitive tests at three test points. The findings showed an increase in the number and variability of activities in the everyday lives of all participants. Post hoc analysis on cognitive performance of MMI to CT indicate similar (classic memory and attention) or better (working memory) effects. Furthermore, results on far transfer variables showed interesting trends in favor of the MMI, such as increased well-being and attitude toward the aging brain. Also, the MMI group showed the biggest perceived improvements out of all groups for all self-reported personal variables (memory in everyday life and stress). The results implicate a positive trend toward MMI on cognitive and affective factors of older adults. These tendencies show the potential of a multimodal approach compared to training a specific cognitive function. Moreover, the findings suggest that information about MMI motivates participants to increase activity variability and frequency in everyday life. Finally, the results could also have implications for the primary prevention of neurocognitive deficits and degenerative diseases.
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Affiliation(s)
- Maria Brasser
- Cognitive and Affective Neuroscience Unit, University of Zürich, Zürich, Switzerland
- *Correspondence: Maria Brasser,
| | - Sascha Frühholz
- Cognitive and Affective Neuroscience Unit, University of Zürich, Zürich, Switzerland
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Andres R. Schneeberger
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital, Zürich, Switzerland
| | | | - Rahel Schaerli
- Department of Psychology, University of Bern, Bern, Switzerland
| | - Michèle Häner
- Department of Psychology, University of Bern, Bern, Switzerland
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Influence of Discontinuation of Cardiac Rehabilitation in Elderly Outpatients Due to the COVID-19 Pandemic. J Cardiovasc Dev Dis 2022; 9:jcdd9060194. [PMID: 35735824 PMCID: PMC9225516 DOI: 10.3390/jcdd9060194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 06/14/2022] [Accepted: 06/14/2022] [Indexed: 02/04/2023] Open
Abstract
Background: The coronavirus disease 2019 (COVID-19) pandemic has restricted people’s activities and necessitated the discontinuation of cardiac rehabilitation (CR) programs for outpatients. In our hospital, CR for outpatients had to be discontinued for 3 months. We investigated the influence of this discontinuation of CR on physical activity, body composition, and dietary intake in cardiovascular outpatients. Method: Seventy-eight outpatients who restarted CR were investigated. We measured body composition, balance test, stage of locomotive syndrome, and food frequency questionnaire (FFQ) results at restart and 3 months later. We also investigated the results of examination that were obtained before discontinuation. Results: With regard to baseline characteristics, the percentage of male was 62.7% (n = 49), and average age and body mass index were 74.1 ± 8.5 years and 24.9 ± 7.0 kg/m2, respectively. Stage of locomotive syndrome and the results of FFQ did not change significantly. The one-leg standing time with eyes open test significantly worsened at restart (p < 0.001) and significantly improved 3 months later (p = 0.007). With regard to body composition, all limb muscle masses were decreased at restart and decreased even further 3 months later. Conclusions: Discontinuation of CR influenced standing balance and limb muscle mass. While the restart of CR may improve a patient’s balance, more time is required for additional daily physical activities. The recent pandemic-related interruption of CR should inspire the development of alternatives that could ensure the continuity of CR in a future crisis.
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