中国全科医学2025，Vol.28Issue(21)：2604-2610,7.DOI:10.12114/j.issn.1007-9572.2024.0422
抗阻力运动联合营养干预对老年2型糖尿病合并肌少症患者血糖稳定性影响的临床研究
Effects of Resistance Exercise Combined with Nutritional Intervention on Blood Glucose Stability in Elderly Patients with Type 2 Diabetes Mellitus with Sarcopenia
摘要
Abstract
Background Type 2 diabetes mellitus(T2DM)and sarcopenia are common conditions that significantly impact the health of elderly individuals.However,clinical intervention studies focusing on T2DM with sarcopenia are relatively limited in China.Objective To investigate the effects of resistance exercise combined with nutritional intervention on skeletal muscle mass and blood glucose stability in elderly T2DM patients with sarcopenia at a primary care hospital.Methods A total of 61 elderly T2DM patients with sarcopenia(aged≥65)who attended the Shanghai Huangpu District Yuyuan Community Health Service Center between February 2022 and May 2024 were enrolled in the study.The patients were randomly assigned to a control group(n=30)and an intervention group(n=31).All patients were managed by routine diabetes education,and those in the intervention group additionally received resistance exercise combined with nutritional intervention.A 12-week intervention was performed to compare the time in glucose target range(TIR),mean amplitude of glycemic excursions(MAGE),appendicular skeletal muscle mass index(ASMI),grip strength,and 6-meter walking speed.The correlations between grip strength,6-meter walking speed,ASMI with TIR and MAGE were assessed before and after the intervention.Results Before the intervention,there was no significant difference in parameters between the two groups(P<0.05).After the 12-week intervention,significantly decreased TIR was detected in the control group(P<0.05),and significantly improved glycated hemoglobin(HbA1c),TIR,MAGE,and 6-meter walking speed and grip strength were found in the intervention group(P<0.05),with statistical differences between groups(P<0.05).Before and after intervention,the change of HbA1c,TIR,MAGE,and 6-meter walking speed,ASMI,and grip strength showed statistically significant differences between control and intervention group(P<0.05).The change in 6-meter walking speed was positively correlated with the change in TIR(rs=0.411,P<0.05),and negatively correlated with changes in MAGE(rs=-0.472,P<0.05)and HbA1c(rs=-0.315,P<0.05).No adverse events were reported.Conclusion Resistance exercise combined with nutritional intervention can not only increase muscle mass and physical function,but also improve blood glucose stability and TIR in elderly T2DM patients with sarcopenia.Our interventions are simple,easy to implement,with high safety,making them valuable for promotion in primary healthcare setting.关键词
抗阻训练/运动疗法/糖尿病,2 型/肌少症/肌,骨骼/血糖控制/血糖稳定性/社区/随机对照试验Key words
Resistance training/Exercise therapy/Diabetes mellitus,type 2/Sarcopenia/Muscle,skeletal/Glycemic control/Blood glucose stability/Community/Randomized controlled trial分类
临床医学引用本文复制引用
王颖,颜轶隽,刘蕾,胡毓敏,张扬,刘凯,姜博仁..抗阻力运动联合营养干预对老年2型糖尿病合并肌少症患者血糖稳定性影响的临床研究[J].中国全科医学,2025,28(21):2604-2610,7.基金项目
中华国际医学交流基金(Z-2017-26-1902) （Z-2017-26-1902）
上海市黄浦区卫生健康委员会科研项目(HLM202135) （HLM202135）
