5.0.0.0 LIFESTYLE MAN­AGE­MENT

Rec­om­men­da­tion

12.10 Op­ti­mal nu­tri­tion and pro­tein in­take is rec­om­mend­ed for older adults; reg­u­lar ex­er­cise, in­clud­ing aer­o­bic ac­tiv­i­ty and re­sis­tance train­ing, should be en­cour­aged in all older adults who can safe­ly en­gage in such ac­tiv­i­ties. B

Di­a­betes in the aging pop­u­la­tion is as­so­ci­at­ed with re­duced mus­cle strength, poor mus­cle qual­i­ty, and ac­cel­er­at­ed loss of mus­cle mass, re­sulting in sar­cope­nia. Di­a­betes is also rec­og­nized as an in­de­pen­dent risk fac­tor for frailty. Frailty is char­ac­ter­ized by de­cline in phys­i­cal per­formance and an in­creased risk of poor health out­comes due to phys­i­o­log­ic vulnerabil­i­ty to clin­i­cal, func­tion­al, or psychoso­cial stres­sors. In­ad­e­quate nu­tri­tional in­take, par­tic­u­lar­ly in­ad­e­quate pro­tein in­take, can in­crease the risk of sar­cope­nia and frailty in older adults. Man­age­ment of frailty in di­a­betes in­cludes op­ti­mal nu­tri­tion with ad­e­quate pro­tein in­take com­bined with an ex­er­cise pro­gram that in­cludes aer­o­bic and re­sis­tance train­ing (31,32).