The Association between Glucose Control and Functional Indices in Older People with Diabetes

Abstract

Diabetes may be viewed as a disease of accelerated aging as it is a risk factor for physical disability and impairment in simple and complex activities, and is a higher risk for falls and fractures. Data from the last several years suggests that this increased risk is due not only to recognized diabetes complications but also to an accelerated decline in physical capacity due to lower muscle quality and a more rapid decline in muscle mass and lower extremity strength over time. Aim. To find the association between glucose control and functional indices. Methods. A cross-sectional study conducted at the Center for Successful Aging with Diabetes at the Sheba Medical Center. Individuals with a diagnosis of type 2 diabetes over the age of 60 were included. Functional status was assessed using tools that assess aerobic, strength, and balance capacities. Medical assessment was conducted through interview, physical examination, and collection of information from medical records. The association between functional indices and A1C was assessed using linear regression. Results. 153 consecutive individuals were evaluated. There was an inverse association between A1C and score achieved on the 6-minute walk; with increasing meters walked on the 6-minute walk test, there was a reduction in A1C (p = 0.003). There was also an inverse association with the 10-meter walk (p = 0.007), BERG balance test (p = 0.0006), and timed up and go (p = 0.01). Conclusion. In this cohort of older people with diabetes, there was an association between A1C and measures of functional indices. Future studies of glucose-lowering medication should include physical and functional assessment.

Physio-cognitive decline syndrome among middle-aged diabetes patients: Handgrip strength significantly correlates with glycaemic control and cognitive score

“…It may be because the mean age in Azmon et al (2018) [ 18 ] study was much older (70.7 vs 53 [40–59] years) and the duration of T2DM was much longer (17.09 vs. 7 [0–30] years) than our study. Furthermore, the GS was measured with different method, using a 10-m walk test with an addition of 2 m for acceleration at the beginning and 2 m for deceleration at the end [ 18 ]. The mean usual GS of all subjects in our study was also still normal based on AWGS 2019 criteria (1.02 [0.23] m/s).…”

“…Our study found no significant correlation between glycaemic control and GS. In contrast, Azmon et al (2018) [ 18 ] reported significant negative weak correlation between HbA1c and GS among T2DM elderly patients ( r = −0.208; p = 0.007). It may be because the mean age in Azmon et al (2018) [ 18 ] study was much older (70.7 vs 53 [40–59] years) and the duration of T2DM was much longer (17.09 vs. 7 [0–30] years) than our study.…”

“…In contrast, Azmon et al (2018) [ 18 ] reported significant negative weak correlation between HbA1c and GS among T2DM elderly patients ( r = −0.208; p = 0.007). It may be because the mean age in Azmon et al (2018) [ 18 ] study was much older (70.7 vs 53 [40–59] years) and the duration of T2DM was much longer (17.09 vs. 7 [0–30] years) than our study. Furthermore, the GS was measured with different method, using a 10-m walk test with an addition of 2 m for acceleration at the beginning and 2 m for deceleration at the end [ 18 ].…”

“…This study set the statistical power at 80 % and α value at 5 %. The minimum sample size was 133 based on the correlation coefficient formula and the value of r in the previous studies [ [17] , [18] , [19] ].…”