Introduction: Type 2 Diabetes (T2D) is associated with reduced muscle mass, strength and function leading to frailty and disability. Little is known regarding the continuous movement patterns and glucose fluctuation in these functional states. Aims: To identify differences in movement patterns and glucose levels in elderly people with diabetes with ranging functional status.
Methods: We conducted a cross sectional study, amongst people with diabetes over the age of 60. Participants were provided with a blinded Continuous Glucose Monitoring (CGM) system (iPro™ professional CGM, Medtronic) and an activity monitoring device (ActiGraph® GT9X) for 1 week. In order to evaluate their physical functionality, participants underwent elaborate physical-function (PF) tests which were conducted in the beginning and at the end of the week. Participants (n=103) were classified into 3 groups: Low PF (LPF; n=20) , reduced PF (RPF; n=37) and normal PF (NPF; n=46) by using the Fried frailty scale; aerobic, strength and balance score. Movement and glucose indices differences between the groups were determined using Kruskal-Wallis and Dunn post-hoc statistical tests.
Results: LPF group had lower average X (Medio-lateral - side to side) and Y (Vertical - up down) axes movements and higher variability expressed by root mean square of the X, Y, Z (Antero-posterior - forwards backwards) axes. In addition, LPF group spent less time performing moderate to vigorous physical activity and had fewer daily steps compared to RPF and NPF groups. CGM data revealed that the LPF group had higher mean glucose levels and they spent less time in target glucose range (70-180 mg/dl) and more time above range (>180 mg/dl) compared to the other groups. All findings were statistically significant (p<0.05) .
Conclusion: In this study of older people with diabetes, participants in the LPF group demonstrated lower stability, lower activity levels and higher glucose rates compared to those in the NPF group.
T.Yahalom-peri: None. E.Kodesh: None. Y.Basson-shleymovich: None. M.Azmon: n/a. V.Bogina: None. T.Kuflik: None. T.Cukierman-yaffe: Research Support; European Association for the Study of Diabetes, Medtronic, Merck Sharp & Dohme Corp., Novo Nordisk, Speaker's Bureau; AstraZeneca, Eli Lilly and Company, Medtronic, Merck Sharp & Dohme Corp., Novo Nordisk, Sanofi.
EFSD & an Investigator Initiated Study Medtronic