OBJECTIVE Lifestyle intervention is recommended as first-line treatment of diabetes at all ages; however, little is known about the efficacy of lifestyle intervention in older adults with diabetes. We aimed to determine whether lifestyle intervention would improve glycemic control and age-relevant outcomes in older adults with diabetes and comorbidities. RESEARCH DESIGN AND METHODS A total of 100 older adults with diabetes were randomly assigned to 1-year intensive lifestyle intervention (ILI) (diet and exercise at a facility transitioned into community-fitness centers and homes) or healthy lifestyle (HL) group. The primary outcome was change in HbA1c. Secondary outcomes included glucoregulation, body composition, physical function, and quality of life. Changes between groups were analyzed with mixed-model repeated-measures ANCOVA following the intention-to-treat principle. RESULTS HbA1c improved more in the ILI than the HL group (mean ± SE −0.8 ± 0.1 vs. 0.1 ± 0.1%), associated with improved insulin sensitivity (1.2 ± 0.2 vs. −0.4 ± 0.2) and disposition (26.0 ± 8.9 vs −13.0 ± 8.4 109 min−1) indices (between-group P < 0.001 to 0.04). Body weight and visceral fat decreased more in the ILI than HL group (−8.4 ± 0.6 vs. −0.3 ± 0.6 kg, P < 0.001, and −261 ± 29 vs. −30 ± 27 cm3, P < 0.001, respectively). Physical Performance Test score increased more in the ILI than HL group (2.9 ± 0.6 vs. −0.1 ± 0.4, P < 0.001) as did VO2peak (2.2 ± 0.3 vs. −1.2 ± 0.2 mL/kg/min, P < 0.001). Strength, gait, and 36-Item Short Form Survey (SF-36) Physical Component Summary score also improved more in the ILI group (all P < 0.001). Total insulin dose decreased in the ILI group by 19.8 ± 4.4 units/day. Adverse events included increased episodes of mild hypoglycemia in the ILI group. CONCLUSIONS A lifestyle intervention strategy is highly successful in improving metabolic and functional health of older adults with diabetes.

中文翻译：

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治疗老年人糖尿病的生活方式干预策略：随机对照试验

目的 建议将生活方式干预作为所有年龄段糖尿病的一线治疗方法；然而，人们对生活方式干预对老年糖尿病患者的疗效知之甚少。我们的目的是确定生活方式干预是否会改善患有糖尿病和合并症的老年人的血糖控制和年龄相关的结果。研究设计和方法 总共 100 名患有糖尿病的老年人被随机分配到为期 1 年的强化生活方式干预 (ILI)（在社区健身中心和家庭转变的设施中进行饮食和锻炼）或健康生活方式 (HL) 组。主要结果是 HbA1c 的变化。次要结果包括血糖调节、身体成分、身体功能和生活质量。遵循意向治疗原则，使用混合模型重复测量 ANCOVA 分析组间变化。结果 ILI 组的 HbA1c 比 HL 组改善更多（平均值 ± SE -0.8 ± 0.1 vs. 0.1 ± 0.1%），与改善的胰岛素敏感性（1.2 ± 0.2 vs. -0.4 ± 0.2）和处置（26.0 ± 8.9 vs. −13.0 ± 8.4 109 min−1) 指数（组间P＜0.001至0.04）。ILI组的体重和内脏脂肪比HL组下降更多（分别为-8.4 ± 0.6 vs. -0.3 ± 0.6 kg，P < 0.001，以及-261 ± 29 vs. -30 ± 27 cm3，P < 0.001） ）。ILI 组的体能测试分数比 HL 组增加更多（2.9 ± 0.6 vs. -0.1 ± 0.4，P < 0.001），VO2peak 也增加更多（2.2 ± 0.3 vs. -1.2 ± 0.2 mL/kg/min，P < 0.001）。 0.001）。ILI 组的力量、步态和 36 项简短调查 (SF-36) 身体成分摘要评分也有较大改善（所有 P < 0.001）。ILI 组的胰岛素总剂量减少了 19.8 ± 4.4 单位/天。不良事件包括 ILI 组轻度低血糖发作次数增加。结论 生活方式干预策略在改善老年糖尿病患者的代谢和功能健康方面非常成功。