Rehabilitation of Individuals With Diabetes Mellitus: Focus on Diabetic Myopathy

Abstract

Diabetes mellitus (DM) is a chronic metabolic disease characterized by high blood glucose levels, causing serious damage to the cardiovascular, respiratory, renal and other systems. The prevalence of type 2 diabetes mellitus (T2DM) was 6.28% in 2017, considering all age groups worldwide (prevalence rate of 6,059 cases per 100,000), and its global prevalence is projected to increase to 7,079 cases per 100,000 by 2030. Furthermore, these individuals are often affected by diabetic myopathy, which is the failure to preserve muscle mass and function in the course of DM. This happens in type 1 diabetes mellitus (T1DM) and T2DM. As skeletal muscle plays a key role in locomotion and glucose homeostasis, diabetic myopathy may contribute to additional complications of the disease. In addition, chronic hyperglycemia is associated with lung functional changes seen in patients with DM, such as reduced lung volumes and compliance, inspiratory muscle strength, and lung elastic recoil. Thus, the weakness of the inspiratory muscles, a consequence of diabetic myopathy, can influence exercise tolerance. Thus, moderate strength training in T2DM can contribute to the gain of peripheral muscle strength. Although the literature is robust on the loss of mass and consequent muscle weakness in diabetic myopathy, triggering pathophysiological factors, the impact on functional capacity, as well as the prescription of physical exercise for this condition deserves to be further explored. This review aims to explore the consequences of diabetic myopathy and its implication in rehabilitation from prescription to safety in the practice of physical exercises for these individuals.

To do one and to get more: Part I. Diabetes and bone

“…104 Additionally, physical training (exercise), based on the type, intensity, and duration of exercise, may improve mitochondrial function of muscle, attenuates oxidative stress, and increased the antioxidant capacity in muscle, and all may increase muscle mass and strength against the "fall" accident. 105 Furthermore, it is reported that T2DM patients may be at higher risk of poor cognitive perspective of osteoporosis because recent study showed that these T2DM patients expressed a low self-efficacy for both exercise and calcium intake experience. 106 Moreover, other components of healthy lifestyle may be also important for all patients with chronic illnesses, including pre-DM and DM patients to prevent the occurrence of osteoporosis and reduce fracture, such as adequate nutritional support, vitamin D supplementation, calcium replacement, and essential micronutrition supports.…”

“…104 Additionally, physical training (exercise), based on the type, intensity, and duration of exercise, may improve mitochondrial function of muscle, attenuates oxidative stress, and increased the antioxidant capacity in muscle, and all may increase muscle mass and strength against the “fall” accident. 105…”

Application of conventional ultrasound coupled with shear wave elastography in the assessment of muscle strength in patients with type 2 diabetes

“…The presence of diabetes and its related complications can accelerate the development of sarcopenia ( 2 ). For example, decreased mitochondrial function induces changes in muscle fiber composition and the transition from an oxidative to glycolytic fiber type, which leads to sarcopenia ( 3 ). Another mechanism that contributes to sarcopenia in diabetes is diabetic peripheral neuropathy (DPN) and reduction in motor neurons ( 4 ), which can cause muscle weakness, atrophy, and adipose tissue infiltration.…”

Transcriptomic Profiling of Rectus Abdominis Muscle in Women with Gestational Diabetes-Induced Myopathy: Characterization of Pathophysiology and Potential Muscle Biomarkers of Pregnancy-Specific Urinary Incontinence

“…GDM was an independent risk factor for pregnant-specific urinary incontinence (PSUI), a urinary incontinence that starts during pregnancy [ 11 , 16 ]. This scenario of atrophy and the transition from oxidative to glycolytic fiber type [ 17 , 18 ] results in skeletal muscle changes, such as muscle weakness, a shift in fiber type composition, increased collagen deposition, and an elevated collagen type I/III ratio [ 13 , 14 , 19 ]. The latter characteristics mimic those found in the GDiM of PFM and RAM, and are considered a profile of skeletal muscle injury induced by GDM [ 14 , 20 , 21 ] associated with a decreased quality of life [ 22 ].…”