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Nutrition and Geriatric Syndromes in Older Adults with Diabetes

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A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutritional Epidemiology".

Deadline for manuscript submissions: closed (31 December 2020) | Viewed by 33319

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Special Issue Editor

Dr. Atsushi Araki

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Guest Editor

Department of Diabetes, Metabolism and Endocrinology, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan
Interests: diabetes mellitus; older adults; nutrition; aging; geriatric syndromes; frailty; sarcopenia; dementia; polypharmacy; epidemiology

Special Issue Information

Dear Colleagues,

Diabetes in older adults is becoming a major global health problem because of the rapid increase in individuals with functional disability and multimorbidity. Older diabetics are also more likely to have geriatric syndromes such as sarcopenia, frailty, cognitive impairment, depression, polypharmacy, and malnutrition, which lead to disability, a low QOL, and an increased rate of mortality. Dietary therapy is important in order to prevent geriatric syndromes as well as diabetic complications.

However, there are still many open questions about the optimal intake of total energy, protein, carbohydrate, fat, vitamins, and minerals to prevent adverse health outcomes in these patients. Information about nutrition in older diabetics is also needed for prevention and treatment.

This Special Issue of Nutrients aims to present a collection of the latest findings on “Nutrition and geriatric syndromes in Older Adults with Diabetes”. Authors are invited to submit relevant review articles, systematic reviews, meta-analyses, and original contributions for consideration for inclusion in this Special Issue. Particularly, papers dealing with the roles of nutrition on geriatric syndromes and diabetic complications as well as contributions addressing the effects of nutritional interventions on functional ability are of interest.

Dr. Atsushi Araki
Guest Editor

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Keywords

Diabetes
Older Adults
Energy Requirement
Nutrients
Sarcopenia/Frailty

Published Papers (6 papers)

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Research

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13 pages, 290 KiB

Open AccessArticle

Sodium Intake and Incidence of Diabetes Complications in Elderly Patients with Type 2 Diabetes—Analysis of Data from the Japanese Elderly Diabetes Intervention Study (J-EDIT)

by Chika Horikawa, Rei Aida, Shiro Tanaka, Chiemi Kamada, Sachiko Tanaka, Yukio Yoshimura, Remi Kodera, Kazuya Fujihara, Ryo Kawasaki, Tatsumi Moriya, Hidetoshi Yamashita, Hideki Ito, Hirohito Sone and Atsushi Araki

Nutrients 2021, 13(2), 689; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13020689 - 21 Feb 2021

Cited by 7 | Viewed by 3576

Abstract

This study investigates the associations between sodium intake and diabetes complications in a nationwide cohort of elderly Japanese patients with type 2 diabetes aged 65–85. Data from 912 individuals regarding their dietary intake at baseline is analyzed and assessed by the Food Frequency Questionnaire based on food groups. Primary outcomes are times to diabetic retinopathy, overt nephropathy, cardiovascular disease (CVD), and all-cause mortality during six years. We find that mean sodium intake in quartiles ranges from 2.5 g to 5.9 g/day. After adjustment for confounders, no significant associations are observed between sodium intake quartiles and incidence of diabetes complications and mortality, except for a significant trend for an increased risk of diabetic retinopathy (p = 0.039). Among patients whose vegetable intake was less than the average of 268.7 g, hazard ratios (HRs) for diabetic retinopathy in patients in the second, third, and fourth quartiles of sodium intake compared with the first quartile were 0.87 (95% CI, 0.31–2.41), 2.61 (1.00–6.83), and 3.70 (1.37–10.02), respectively. Findings indicate that high sodium intake under conditions of low vegetable intake is associated with an elevated incidence of diabetic retinopathy in elderly patients with type 2 diabetes. Full article

(This article belongs to the Special Issue Nutrition and Geriatric Syndromes in Older Adults with Diabetes)

10 pages, 794 KiB

Open AccessArticle

Low Dietary Variety and Diabetes Mellitus Are Associated with Frailty among Community-Dwelling Older Japanese Adults: A Cross-Sectional Study

by Misato Hayakawa, Keiko Motokawa, Yurie Mikami, Kaori Yamamoto, Maki Shirobe, Ayako Edahiro, Masanori Iwasaki, Yuki Ohara, Yutaka Watanabe, Hisashi Kawai, Motonaga Kojima, Shuichi Obuchi, Yoshinori Fujiwara, Hunkyung Kim, Kazushige Ihara, Hiroki Inagaki, Shoji Shinkai, Shuichi Awata, Atsushi Araki and Hirohiko Hirano

Nutrients 2021, 13(2), 641; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13020641 - 16 Feb 2021

Cited by 8 | Viewed by 2809

Abstract

The association between dietary diversity and frailty remains unknown in older people. We evaluated whether a limited dietary variety is associated with frailty in older adults with diabetes mellitus (DM). This cross-sectional investigation included 1357 adults (median age: 77 years, women: 61.3%). DM was determined by self-reporting, the Dietary Variety Score (DVS) was used to evaluate dietary variety, and the revised Japanese version of the Cardiovascular Health Study criteria evaluated frailty. Participants were divided into 4 groups: no DM/high DVS (non-DMHV), no DM/low DVS (non-DMLV), DM/high DVS (DMHV), and DM/low DVS (DMLV). The prevalence of frailty in each group was 3.6%, 6.7%, 6.7%, and 12.2%. After adjusting for covariates, logistic regression analysis revealed the highest odds ratio (OR) of frailty in the DMLV (non-DMLV, OR = 2.18 (95% confidence interval (CI): 1.25–3.83); DMHV, OR = 1.87 (95% CI: 0.63–5.52); DML, OR = 5.03 (95% CI: 2.05–12.35)). Another logistic regression analysis revealed that a low DVS and DM were independently associated with frailty. Both a low dietary variety and DM were independently related to frailty in older people and the combination increased the prevalence of frailty. These findings suggest that high dietary variety could be important for the prevention of frailty in people with DM. Full article

(This article belongs to the Special Issue Nutrition and Geriatric Syndromes in Older Adults with Diabetes)

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11 pages, 912 KiB

Open AccessArticle

Effect of Exercise Habit on Skeletal Muscle Mass Varies with Protein Intake in Elderly Patients with Type 2 Diabetes: A Retrospective Cohort Study

by Yoshitaka Hashimoto, Ayumi Kaji, Ryosuke Sakai, Fuyuko Takahashi, Rena Kawano, Masahide Hamaguchi and Michiaki Fukui

Nutrients 2020, 12(10), 3220; https://0-doi-org.brum.beds.ac.uk/10.3390/nu12103220 - 21 Oct 2020

Cited by 16 | Viewed by 4045

Abstract

Exercise has been reported to be effective in maintaining and recovering muscle; however, the effect of exercise combined with adequate or inadequate protein intake on muscle mass is not clear. Therefore, this study investigates the effect of exercise habit on changes in muscle mass, with adequate or inadequate protein intake. This retrospective cohort study included 214 elderly patients with type 2 diabetes. The rate of skeletal muscle mass index (SMI) change (%) was defined as ((SMI at follow-up minus SMI at baseline)/(follow-up years [kg/m²/year] × SMI at baseline [kg/m²])) × 100. Adequate protein intake was defined as protein intake ≥1.2 g/kg ideal body weight/day. During a mean follow-up duration of 18.0 (7.1) months, the rate of SMI change was −1.14 (4.10)% in the whole sample. The rate of SMI change of non-habitual exercisers with inadequate protein intake, habitual exercisers with inadequate protein intake, non-habitual exercisers with adequate protein intake, and habitual exercisers with adequate protein intake was −1.22 (3.71), −2.31 (3.30), −1.88 (4.62), and 0.36 (4.29)%, respectively. Compared with patients with exercise habit and adequate protein intake, the odds ratio for decreasing SMI was 2.50 (0.90–6.90, p = 0.078) in patients with no exercise habit and inadequate protein intake, 3.58 (1.24–10.4, p = 0.019) in those with exercise habit and inadequate protein intake, and 3.03 (1.27–7.22, p = 0.012) in those with no exercise habit and adequate protein intake, after adjusting for covariates. Therefore, exercise habit without adequate protein intake was associated with an increased risk of decreasing SMI compared with exercise habit with adequate protein intake. Full article

(This article belongs to the Special Issue Nutrition and Geriatric Syndromes in Older Adults with Diabetes)

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15 pages, 282 KiB

Open AccessArticle

Family Support for Medical Nutritional Therapy and Dietary Intake among Japanese with Type 2 Diabetes (JDDM 56)

by Chika Horikawa, Mariko Hatta, Sakiko Yoshizawa Morikawa, Yasunaga Takeda, Mizuki Takeuchi, Kazuya Fujihara, Noriko Kato, Hiroki Yokoyama, Yoshio Kurihara, Koichi Iwasaki, Shiro Tanaka, Hiroshi Maegawa and Hirohito Sone

Nutrients 2020, 12(9), 2649; https://0-doi-org.brum.beds.ac.uk/10.3390/nu12092649 - 31 Aug 2020

Cited by 4 | Viewed by 2658

Abstract

The aim of this study was to investigate the association between habitual dietary intake for patients with diabetes and the content of family support for medical nutritional therapy (MNT). Analyzed were 289 Japanese with type 2 diabetes (men, 58.5%; mean age, 62.0 years; mean HbA1c, 53.4 mmol/mol) who completed the Food Frequency Questionnaire and Diabetes Family Behavior Checklist (DFBC). Relationships of mean values for food group intake to DFBC responses regarding MNT were examined using multivariate analysis of covariance. Positive response to “Praise for following diet” was associated with lower sweets intake (none: 60.1 g/day; ≥once monthly: 50.9 g/day, p = 0.038) and higher seasoning intake (none: 21.6 g/day, ≥once monthly: 24.1 g/day, p = 0.046). Energy intake was higher with positive responses to “Eat at the same time that you do” (none: 1636 kcal/day, ≥once monthly: 1818 kcal/day, p = 0.038). “Nags about not following diet” was associated with higher fish (none: 68.7 g/day, ≥once monthly: 78.7 g/day, p = 0.042) and salt intake (none: 8.3 g/day, ≥once monthly: 9.0 g/day, p = 0.014). Eating foods not part of the diabetic diet (none: 218.4 g/day, ≥once monthly: 246.9 g/day, p = 0.014) resulted in a higher vegetable intake. In females, significant differences in relationships in the overall analysis were reversed. Our results clarified relationships between types of family support of patients with type 2 diabetes and their dietary intake and the importance of sex differences for more effective MNT. Full article

(This article belongs to the Special Issue Nutrition and Geriatric Syndromes in Older Adults with Diabetes)

Review

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8 pages, 269 KiB

Open AccessReview

Energy Requirements for Older Patients with Type 2 Diabetes: A Narrative Review of the Current Findings and Future Tasks

by Fuminori Katsukawa

Nutrients 2021, 13(3), 753; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13030753 - 26 Feb 2021

Cited by 4 | Viewed by 2304

Abstract

Aging patients with type 2 diabetes (T2DM) have a high risk of frailty and disability. This narrative review summarizes the current findings and future tasks regarding the following issues: (1) the optimum body mass index (BMI) target for patients with T2DM, (2) energy expenditure and requirements of patients with T2DM, and (3) the significance of low-intensity physical activity (LPA) as a key determinant of total energy expenditure (TEE) among the older population. While weight reduction is associated with an improvement in glycemic control, an increased risk of mortality as well as disability related to unhealthy BMI must also be considered, especially in older patients. The optimum BMI range and energy requirements for maintaining a healthy BMI should be identified. Limited evidence has shown that the TEE measured using the doubly labeled water method in patients with T2DM did not differ from that of subjects without diabetes, suggesting that the energy requirement data of subjects without diabetes may be applicable to these populations. LPA is one of the determinants of variability in the energy requirements of older patients with T2DM, and the beneficial effects of increasing LPA on nutritional intake and frailty prevention should be investigated further. Full article

(This article belongs to the Special Issue Nutrition and Geriatric Syndromes in Older Adults with Diabetes)

29 pages, 1823 KiB

Open AccessReview

Nutrition Management in Older Adults with Diabetes: A Review on the Importance of Shifting Prevention Strategies from Metabolic Syndrome to Frailty

by Yoshiaki Tamura, Takuya Omura, Kenji Toyoshima and Atsushi Araki

Nutrients 2020, 12(11), 3367; https://0-doi-org.brum.beds.ac.uk/10.3390/nu12113367 - 01 Nov 2020

Cited by 87 | Viewed by 17145

Abstract

The increasing prevalence of older adults with diabetes has become a major social burden. Diabetes, frailty, and cognitive dysfunction are closely related to the mechanisms of aging. Insulin resistance, arteriosclerosis, chronic inflammation, oxidative stress, and mitochondrial dysfunction may be common mechanisms shared by frailty and cognitive impairment. Hyperglycemia, hypoglycemia, obesity, vascular factors, physical inactivity, and malnutrition are important risk factors for cognitive impairment and frailty in older adults with diabetes. The impact of nutrients on health outcomes varies with age; thus, shifting diet therapy strategies from the treatment of obesity/metabolic syndrome to frailty prevention may be necessary in patients with diabetes who are over 75 years of age, have frailty or sarcopenia, and experience malnutrition. For the prevention of frailty, optimal energy intake, sufficient protein and vitamin intake, and healthy dietary patterns should be recommended. The treatment of diabetes after middle age should include the awareness of proper glycemic control aimed at extending healthy life expectancy with proper nutrition, exercise, and social connectivity. Nutritional therapy in combination with exercise, optimal glycemic and metabolic control, and social participation/support for frailty prevention can extend healthy life expectancy and maintain quality of life in older adults with diabetes mellitus. Full article

(This article belongs to the Special Issue Nutrition and Geriatric Syndromes in Older Adults with Diabetes)

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