Background: It is expected that GLP-1 Receptor Agonists (GLP-1RA) have not only glucose lowering effect but also weight loss and protection of diabetic kidney disease. On the other hand, sarcopenia and frailty is becoming important, because elderly diabetic patients increase in Japan. In the present study, we report about falling risk, dietary surveys and exercise therapy of diabetic patients treated with GLP-1RA.
Methods: The questionnaire was tested in type 2 diabetic outpatients treated with GLP-1RA at our hospital (mean age 65.7 years). The control group was the diabetic outpatient treated without GLP-1RA in nearly the same age range (mean age 63.6 years). We measured hand grip strength and one-leg standing (OLS) time. Participants were defined as patients with a high risk of falling, If their hand grip strength was ≤30kg(male) or ≤20kg(female) and their OLS time was <20s. Especially if their OLS time was <5s, defined as patients with a severe high risk of falling. We also analyzed their dietary surveys in three days. Finally, we planned original exercise program to patients with a high risk of falling, and investigated the effect of this exercise every month.
Result: A total of 194 cases (male, 61%; female, 39 %) were included in this study. The prevalence of patients with a high risk falling was 36.1%. In patients treated with GLP-1RA (92 cases) and without GLP-1RA (102 cases), the prevalence of patients with a high risk falling was 45.7% and 27.5%. In patient treated with GLP-1RA, the prevalence of patients with severe high risk falling was 27.5% in liraglutide group (51 cases) and was 36.6% in dulaglutide group (41 cases). Dietary surveys and the effect of exercise program are on-going.
Conclusion: These findings show that type 2 diabetic patients treated with GLP-1RA are high risk group of falling compared with patients treated without GLP-1RA. Therefore, in use of GLP-1RA, we should be careful of sarcopenia and frailty involves in weight loss and muscle atrophy. Exercise and diet therapy are important.
S. Ikejima: None. S. Kondo: None. T. Sakai: None. H. Taniai: None. T. Takahashi: None. J. Umezu: None. M. Iseka: None. M. Inoue: None. H. Nishihara: None. K. Murata: None. A. Hirai: None.