Metabolic benefits of therapeutic exercise in older adults with type 2 diabetes mellitus and multimorbidity: a retrospective cohort study.

BACKGROUND

Exercise is a key component in the management of type 2 diabetes mellitus (T2DM), but its benefits in older adults with comorbidities remain unclear.

AIMS: To evaluate the metabolic effects of therapeutic exercise on older patients with T2DM and comorbidities and identify clinical characteristics associated with glycaemic improvement.

METHODS

We retrospectively analysed patients with T2DM and at least one comorbidity (e.g. chronic kidney disease, cardiovascular disease, osteoporosis, cancer, stroke and dementia) who received therapeutic exercise guidance from physical therapists between November 2022 and October 2023. Biochemical data were collected at baseline and 3 and 6 months. Patients were considered to be glycated haemoglobin (HbA1c) responders if their HbA1c levels decreased after the intervention.

RESULTS

Among 43 patients (mean age: 74.1 ± 12.5 years; 44% men), 21 were HbA1c responders at 3 months. Responders had higher baseline HbA1c levels (7.88% vs 6.87%, P < 0.05), and a greater proportion had HbA1c ≥ 7% (71.4% vs 40.9%, P < 0.05). At 6 months, triglyceride levels significantly decreased in responders (123.3 to 108.7 mg/dL, P < 0.005) and significantly increased in non-responders (113.6 to 149.7 mg/dL, P < 0.01). HbA1c declined significantly in patients with baseline HbA1c ≥ 7% compared to those with HbA1c < 7% (-0.62% vs +0.34%, P < 0.05).

CONCLUSIONS

Therapeutic exercise improves glycaemic control and triglyceride levels in older patients with T2DM and comorbidities, particularly among those with poorly controlled baseline HbA1c. Baseline HbA1c can be a useful indicator for identifying patients who are likely to benefit from exercise.