1. Introduction
sarcopenia, T2DM, metabolic disorders, dynapenia, chronic disease
RENAL, INFLAMMATION, SARCOPENIA, PATHOPHYSIOLOGY, DIABETES MELLITUS (DM), METABOLIC DISORDERS, TYPE 2 DIABETES MELLITUS, CHRONIC DISEASE
Objectives: To evaluate the effect of whey protein (WP) supplementation associated with resistance training (RT) on glycemic control, functional tasks, muscle strength, and body composition in older adults living with type 2 diabetes mellitus (T2DM). Secondly, to evaluate the safety of the protocol for renal function. Methods: The population comprised twenty-six older men living with T2DM (68.5 ± 11.5 years old). The participants were randomly assigned to the Protein Group (PG) and the Control Group (CG). The handgrip test and evolution of exercise loads, according to the Omni Resistance Exercise Scale, evaluated muscle strength. Functional tasks were assessed by force platform in three different protocols: Sit-to-Stand, Step/Quick Turn, and Step Up/Over. Body composition was evaluated by bioimpedance and glycemic control and renal function were assessed by biochemical analyses. Both groups performed RT for 12 weeks, twice a week, prioritizing large muscle groups. Protein supplementation was 20 g of whey protein isolate and the CG was supplemented with an isocaloric drink, containing 20 g of maltodextrin. Results: There was a significant difference in muscle strength, according to the evolution of the exercise loads, but it was not confirmed in the handgrip test. However, there was no significant difference between the groups, regarding performance in functional tasks, glycemic control, or body composition. Renal function showed no alteration. Conclusion: The intake of 20 g of WP in older male adults living with T2DM did not increase the effect of RT on muscle strength, functional tasks, and glycemic control. The intervention was proven safe regarding renal function.Diabetes mellitus (DM) is a chronic disease characterized by metabolic disorders, mainly due to inadequate regulation of blood glucose. This is associated with damage to the mechanisms of production and/or use of the hormone insulin, which is primarily responsible for transporting glucose from the bloodstream to cells [There is a natural increase in muscle protein hydrolysis, associated with a decrease in its synthesis during aging. This is a description of anabolic resistance, potentially aggravated in people living with T2DM, due to the worsening of the insulin and intracellular anabolic signaling pathways [Resistance training (RT) can positively intervene during the aging process and in several distinct mechanisms of T2DM pathophysiology, emphasizing the improvement in sarcopenia and/or dynapenia and glycemic control. In addition, RT can be an essential therapeutic ally to minimize the chances of serious outcomes, involving loss of autonomy, falls, decreased quality of life, and metabolic disorders that can threaten multiple systems [There is an important body of evidence that shows supplementation with WP can optimize the anabolic effect of RT in older adults, thus promoting an increase in lean mass with a decrease in total body mass [Recently, a systematic review comprising eleven studies was published combining diet, supplements, and exercises [The positive effects of RT, WP supplementation, and the combination of both in glycemic control, body composition, metabolic profile, inflammation, strength, and potential balance are well documented [Therefore, the hypothesis is that the effects of this supplementation are synergistic with RT and optimize a set of desirable adaptations in older adults living with T2DM. Hence, the present study aims to evaluate the effect of protein supplementation associated with RT for 12 weeks on glycemic control, functional tasks, muscle strength, and body composition in older adult men living with T2DM and secondarily, to evaluate the safety of the protocol, concerning renal function.