Impact of Biological Sex on Physical Function After 16-Week Elastic-band Resistance Training Along With Diabetes Education in Older Men and Women With Type 2 Diabetes Mellitus and Frailty.

OBJECTIVES

Older adults living with type 2 diabetes mellitus (T2DM) and frailty have greater physical function impairment than those with either condition alone. Women have disproportionately worse outcomes, including reduced physical function, higher glycated hemoglobin (A1C), and greater frailty. However, little is known about sex effects on physical function after elastic-band training with diabetes education. In this study we aimed to determine how sex influences physical function after 16-week elastic-band resistance training combined with T2DM education in older adults living with T2DM and frailty.

METHODS

Participants (n=182) included in the Band-Frail program were: 1) ≥65 years of age; 2) living with T2DM or with an A1C ≥6.5%; and 3) were at least pre-frail based on the Fried Frailty Scale. The intervention was a 16-week elastic-band resistance training twice per week and T2DM education once per week. The primary outcome was physical function (Short Physical Performance Battery: score 0 to 12), with secondary outcomes of A1C, and frailty score (1 to 5).

RESULTS

Intention-to-treat assessment revealed significant changes for physical function (β=0.83, 95% confidence interval [CI] 0.28% to 1.37%; p=0.004), A1C (β=-0.28, 95% CI -0.53% to -0.03%; p=0.03), and frailty (β=-0.49, 95% CI -0.73% to -0.24%; p<0.01). A significant time × sex interaction (β=0.70, 95% CI 0.07% to 1.33%; p=0.028) was observed for physical function, with women improving by 0.70 point more than men after completion of the 16-week intervention.

CONCLUSIONS

Biological sex impacts the change in physical function after a 16-week elastic-band resistance training program and T2DM education in older adults living with T2DM and frailty.