What Causes Diabetic Amyotrophy
Diabetic amyotrophy is thought to be caused by an abnormality of the immune system, which damages the tiny blood vessels which supply the nerves to the legs. This process is called microvasculitis. The likelihood of getting it does not seem to be related to how long you have diabetes, or how severely you are affected. However, it occurs only very rarely if you don’t have diabetes. It is therefore thought that although having raised blood sugar does not directly damage the nerves, it may contribute in some way to the process of damage.
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Lower Vitamin B And D Intake Linked To Muscle Loss In Older People With Type 2 Diabetes
Related tags:Japan, Vitamin, Diabetes, Muscle
Diabetes has been shown to cause a loss in muscle strength and mass due to decreasing insulin signalling and increasing insulin resistance. For people with type 2 diabetes, maintaining muscle mass is crucial because muscle is a main organ for glucose metabolism.
In older people with type 2 diabetes, loss of muscle mass is associated to increasing risk of sarcopenia, cardiovascular disease and mortality.
Studies have shown vitamin D is effective for the prevention of muscle loss, lower vitamin B12 is associated with sarcopenia, and vitamin C and E associated with fraility, however their effects on older people with diabetes is unknown.
For this study, researchers in Japan wanted to establish the relationship between vitamins A, B1, B2, B6, B12, C, D and E and the loss of muscle mass in older people with type 2 diabetes.
The results were published in the journal Nutrients.
Study setting
Forming part of the KAMOGAWA-DM cohort study on people with diabetes mellitus, the current study involved 197 individuals with type 2 diabetes who were recruited between 2016 to 2018.
At baseline and follow-up visits, a multifrequency impedance body composition analyser was used to evaluate body composition and food intake recorded.
Muscle mass loss was calculated as a percentage reduction from baseline to follow-up. A rate of 1.2% was considered as loss of muscle mass.
Significant findings
Vitamins ACE
Limitations
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You Need More Physical Activity
If your metabolism has taken a nosedive or youve slacked off a bit with the exercise, weight loss can stop. When you were losing weight, your body became more efficient at burning energy . Physical activity is a must when you lose weight, and its even more important to do after youve reached your goal.
Muscle And Its Role In Diabetes Risk
Home»Blogs»Muscle and Its Role in Diabetes Risk
A widely-known but often misunderstood disease is steadily overtaking an increasing portion of the U.S. population. In this country, more than one-third of adults are at a high risk for developing this condition and causes about 330,000 deaths each year. This disease is diabetes.
Diabetes, type 2 in particular, is a condition affecting an ever-expanding pool of Americans. In fact, the Centers for Disease Control and Prevention reports that 30.3 million Americans had diabetes in 2015. Thats nearly 10 percent of the population! Furthermore, about 90 percent of those people had Type 2 Diabetes, and those numbers are only expected to rise.
So whats going on here? How does your body composition affect your diabetes risk, and can improve your body composition reduce that risk or help you overcome diabetes?
Lets first take a look at body composition. What is it and why is it important?
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How Can Diabetics Gain Muscle Mass
In addition to regular aerobic exercise, the American Diabetes Association recommends regular strength training at least two times a week for people with diabetes. According to ADA, strength training activities include using free weights or weight machines at a fitness facility, using resistance bands, lifting light objects in the home such as canned goods and water bottles and engaging in exercises that use your own body weight, such as push-ups, sit-ups and squats.
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Assessment Of Diabetes Status
At baseline, diagnosed diabetes was defined by a report of physician-diagnosed type 2 diabetes or the current use of oral hypoglycemic agents or insulin with onset after age 25 years. We also performed 75-g oral glucose challenge tests for all participants without diagnosed diabetes. Undiagnosed diabetes was defined by a fasting plasma glucose concentration 7.0 mmol/l or a 2-h postchallenge plasma glucose 11.1 mmol/l. The average duration of diagnosed diabetes was 13.3 ± 10.9 years from the time of diagnosis. Plasma glucose was measured by an automated glucose oxidase reaction . A1C was measured by the enzymatic method .
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How Is Diabetic Amyotrophy Diagnosed
If your doctor suspects that you have this condition, it is likely that they will refer you to a neurologist or diabetes specialist for further tests.
The doctor will examine you, looking for muscle weakness and wasting and for changes in your leg reflexes. He or she will check the sensation in your legs. If you also have peripheral neuropathy then this may be markedly reduced, although in pure diabetic amyotrophy it is often unchanged.
They will ask you to have some blood tests to check for vitamin deficiencies also, your diabetic control will be reviewed. Other possible tests include:
- An MRI scan of your lower back may be done to rule out compression of the nerves around the spine
What Is Muscle Mass
Muscle mass is the amount of skeletal muscle in the body. The ratio of a persons muscle mass to the total body weight is called the skeletal muscle index. In response to insulin, skeletal muscle uses glucose in the bloodstream for energy, and research has shown that for every 10% increase in the skeletal muscle index, there is an 11% reduction in insulin resistance and a 12% reduction in the risk of prediabetes .
People tend to lose muscle mass as they age, and those with diabetes tend to lose muscle mass faster than nondiabetic individuals of the same age. Fortunately, strength exercises can increase muscle mass and improve blood glucose levels in people with diabetes.
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Talk To Your Healthcare Team
As with any exercise program, check with your healthcare team before starting a weight-training regimen. Especially important is to discuss is your blood sugar management. People dont typically associate strength training with low blood sugars, but some patients will have significant impacts on blood sugar with strength training, Wilson says. Your doctor may recommend testing your blood sugar level before, during, and after exercise, as well as eating carbohydrates around workout time to prevent or address hypoglycemia, she says.
Biochemical Examination Quantitative Sensory Examination And Nerve Conduction Studies
At the start, a blood sample was drawn for determination of blood glucose, HbA1c, and creatinine levels in all patients using standard laboratory methods.
Nerve conduction was evaluated with standardized transcutaneous stimulation and recording techniques using an electromyograph with standard filter settings. Motor nerve conduction velocity was measured in the dominant forearm segment of the median nerve and in the nondominant leg segment of the peroneal nerve. Sensory nerve conduction velocity was measured with antidromic activation of the nondominant sural nerve and the dominant median nerve . Z-scores were calculated for all MNCVs.
Vibratory perception threshold was determined by stimulating the pulp of the index finger of the dominant hand and the corresponding area of the nondominant great toe. As in the initial study, the 4, 2, 1 stepping algoritm and a CASE IV unit was used , .
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What Is Diabetic Amyotrophy Like
The main features of diabetic amyotrophy are:
- Weakness of the lower legs, buttocks or hip.
- Muscle wasting, usually in the front of the thigh, which follows within weeks.
- Pain, sometimes severe, usually in the front of the thigh but sometimes in the hip, buttock or back.
Other features which occur in some patients are:
- Altered sensation and tingling in the thigh, hip or buttock, which tends to be mild in comparison to the pain and weakness.
- About half of patients also have distal neuropathy, meaning that sensation in the nerves of the lower legs and feet may be separately affected by this condition . See the separate leaflet called Diabetic Neuropathy.
- About half of people affected lose weight.
Symptoms generally begin on one side and then spread to the other in a stepwise progression. The condition may come on quickly or more slowly and usually remains asymmetrical throughout its course. About half of patients also have distal symmetrical polyneuropathy, which means the sensation in their feet and toes on both sides is also affected.
The condition tends to go on for several months but can last up to three years. By the end of this time it usually recovers, although not always completely. During its course it may be severe enough to necessitate wheelchair use.
Reduces The Risk Of Peripheral Neuropathy And Vision Loss
When we have chronically high blood sugar, glucose molecules start attaching themselves to everything, including our red blood cells. This can prevent healthy blood flow many places in the body where we have very small blood vessels, Occhipinti says. It just so happens that the eyes and nerves of the hands and feet have these small vessels. When these areas dont get the blood flow they need, peripheral neuropathy and diabetic retinopathy can result. Strength training improves blood flow to reduce the risk of these complications, Occhipinti explains.
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Determine Your Ideal Weight
Its important to know what your current weight is, as well as establish how much weight you want to gain overall. Setting weekly gain goals can help you chart your progress.
You should also know what the appropriate BMI is, for your frame and height. Plugging your height and weight into a BMI calculator can help you get an idea of where your weight should be.
Your doctor or dietitian can provide you with more specific information about your ideal weight. They can also help you determine what your daily caloric intake should be.
Changes And Risk Factors Of Skeletal Muscle Mass And Strength In Patients With Type 2 Diabetes Over 60 Years Old: A Cross
Xiaoming Wang
1Department of Geriatrics, Xijing Hospital, Fourth Military Medical University, Xian, Shaanxi Province 710032, China
2Clinical Research Center for Geriatric Diseases of Shaanxi Province, Xian, Shaanxi Province 710032, China
Abstract
1. Background
Therefore, a cross-sectional, controlled observational study was performed to evaluate the muscle mass and strength in older adults with and without diabetes and to have a better understanding of the underlying mechanism among them.
2. Methods
2.1. Study Population
We recruited 120 participants with T2DM aged 60 years or older, who admitted to the department of endocrinology of Xijing Hospital between January 2019 and April 2019. The participants were excluded if they were accompanied by one or more of the following conditions: have serious bone and joint disease or neuromuscular disease that affect the daily activities patients with a history of serious physical impairment, such as acute cerebrovascular events, gastrointestinal bleeding, sepsis, acute kidney failure, acute coronary syndrome, acute liver failure, and acute respiratory failure serious diabetic complications, such as severe diabetic nephropathy and diabetic retinopathy and diabetic foot gangrene accompanied with similar diseases such as malignant tumors. In addition, we enrolled 126 elderly non-T2DM volunteers at the health examination center in the same period.
2.2. Measurements
2.2.1. Muscle Mass
2.2.2. Muscle Strength
2.3. Statistical Analysis
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Have A Protein Shake Before Your Workout
Protein shakes are very effective for improving strength.
While many trainers have a post-workout shake, research has shown that drinking a shake containing at least 6 grams of amino acids the muscle-building blocks of protein and 35 grams of carbohydrates 30-60 minutes before exercising increases your protein synthesis more than drinking the same shake after training.
Since exercise increases bloodflow to your working tissues, drinking a carbohydrate-protein mixture before your workout may lead to greater uptake of the amino acids in your muscles, says Kevin Tipto, PhD, an exercise and nutrition researcher at the University of Texas.
Good quality whey-protein powders usually contain at least 30 grams of protein per serving, as well as a healthy supply of vitamins and minerals.
Other liquid supplements such as weight-gain powders can also provide a lot of high quality protein and nutrients in each serving, but they also tend to be extremely high in calories, carbohydrates and sugar.
While this is sufficient for most weight lifters, it is not ideal for those with conditions such as type 2 diabetes, for whom weight loss may be a key goal.
Literature Search Outcomes And Validity Assessment
The search strategy identified 2,331 potentially relevant records, from multiple scientific studies and 713 were excluded as duplicates. The remaining manuscripts were searched for screening the title and abstract, and 1,559 publications were excluded because they were reviews, letters, or conference abstracts. Thus, 59 articles were eligible for full-text review and data assessment. Finally, 16 studies were included in the current meta-analysis and systemic review. Among those publications, three mentioned the relationship between HbA1c and sarcopenia, one mentioned prediabetes, seven mentioned diabetes, and five mentioned diabetes-related complications, . The characteristics of studies included were shown in Table 1. The total sample size in 16 studies was 15,326, and all participants were > 18 years old. All studies included control groups.
Figure 1 PRISMA study.
Table 1 Characteristics of the included studies.
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Why You Should Be Lifting Weights If You Have Type 2 Diabetes
Weight training can help lower your blood sugar and potentially reduce your risk for health complications, among other health benefits. Here’s how to get started.
No ones disputing the benefits of regular aerobic exercise for diabetes management. Running, walking, swimming, and biking can all help you keep your blood sugar level in check while boosting your overall health.
But now scientists are finding that people with diabetes can benefit from regular weight lifting, or strength training, as well. In fact, research in the Internal Journal of Cardiology shows that in people with type 2 diabetes, strength training can be more beneficial to blood sugar regulation than cardio, says Audra Wilson, RD, CSCS, a bariatric dietitian and strength and conditioning specialist at the Northwestern Medicine Metabolic Health and Surgical Weight Loss Center at Delnor Hospital in Geneva, Illinois. That said, she points out that research in JAMA shows the best results come when strength training combines with aerobic exercise.
That’s why in a November 2016 position statement the American Diabetes Association recommended that, in addition to performing at least 150 minutes of moderate- to vigorous-intensity physical activity per week , adults with type 2 diabetes strength train at least two or three times per week.
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So whats so great about weight lifting with type 2 diabetes?