Energy Requirements for Older Patients with Type 2 Diabetes: A Narrative Review of the Current Findings and Future Tasks

• Published in: Nutrients Vol. 13; no. 3; p. 753
• Main Author: Katsukawa, Fuminori
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 26-02-2021; MDPI
• Subjects: Activities of daily living; Aged; Aging; Body mass; Body Mass Index; Body size; Cardiovascular disease; Diabetes; Diabetes mellitus; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - physiopathology; Disability; doubly labeled water; Energy; Energy expenditure; Energy Metabolism; Energy requirements; Exercise; Exercise - physiology; Female; Frail Elderly; Frailty - prevention & control; Geriatric Assessment; Glucose; Heart failure; Humans; Hyperglycemia; Hypertension; Insulin; low-intensity physical activity; Male; Metabolism; Mortality; Nutritional Requirements; Nutritional Status; Obesity; older patients; Physical activity; Physical fitness; Population; Review; Risk management; Weight control; Weight reduction; older patients; diabetes mellitus; energy expenditure; doubly labeled water; low-intensity physical activity; body mass index
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu13030753

Aging patients with type 2 diabetes (T2DM) have a high risk of frailty and disability. This narrative review summarizes the current findings and future tasks regarding the following issues: (1) the optimum body mass index (BMI) target for patients with T2DM, (2) energy expenditure and requirements of patients with T2DM, and (3) the significance of low-intensity physical activity (LPA) as a key determinant of total energy expenditure (TEE) among the older population. While weight reduction is associated with an improvement in glycemic control, an increased risk of mortality as well as disability related to unhealthy BMI must also be considered, especially in older patients. The optimum BMI range and energy requirements for maintaining a healthy BMI should be identified. Limited evidence has shown that the TEE measured using the doubly labeled water method in patients with T2DM did not differ from that of subjects without diabetes, suggesting that the energy requirement data of subjects without diabetes may be applicable to these populations. LPA is one of the determinants of variability in the energy requirements of older patients with T2DM, and the beneficial effects of increasing LPA on nutritional intake and frailty prevention should be investigated further.