4. Discussion
hyperglycemia, atrophy, T2DM, insulin insufficiency, demyelination
DISEASE, PATHOPHYSIOLOGY, HYPERGLYCEMIA, INSULIN RESISTANCE, ATROPHY, DEMYELINATION
The main findings of the present study show that RT improves muscle strength in T2DM, regardless of WP supplementation. However, the findings also suggest that RT does not improve the glycemic profile, especially when measured by HbA1c. Body composition or functional tasks also had no significant differences. However, we have demonstrated that WP supplementation during RT can be a safe intervention regarding renal function.Our hypothesis was denied, as it was expected that the group that was submitted to WP supplementation would be superior to the CG, concerning muscle strength, functional tasks, glycemic control, and body composition. This advantage has been demonstrated in other studies with non-diabetic populations [These findings are analogous to the study of Miller et al. [In another study, Yang et al. [Our study also corroborates with Gaffney et al. [The RT program did not improve functional tasks, such as going up and down stairs, walking and returning, and sitting and standing in both groups. This may also be related to the harmful effects of hyperglycemia on peripheral nerves, which causes demyelination and atrophy of motor axons, damage in mechanisms of neuron regeneration, leading to a reduction in the number of nerve fibers over the years, and also affecting the capacity of transmission of nerve action potentials [Ernandes et al. [According to Mavros et al. [In our study, both groups experienced reductions in fat mass; however, these benefits were modest and unlikely to be clinically relevant. In addition, there were no thorough controls of postprandial glycemia or amplified lifestyle interventions, aiming to achieve better glycemic control. Moreover, in the present study, the values of HbA1c were 7.2 (+/−1.1) for the PG and 7.0 (+/−1.2) for the CG, which were within the recommended range for people living with T2DM, according to the American College of Physicians [Although both groups were using drugs with protective and deleterious effects on muscle tissue and RT adaptations, the CG had more individuals using metformin, DPP4-inhibitors, as well as angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) that are recognized protective agents of the skeletal muscle [According to Caplan et al. [The clinical implications of the present study showed the safety of the adopted protocol with nutritional guidance greater than 1g per kilogram of body weight per day (g∙kgThe study’s limitations are related to the heterogeneity of the aging process and T2DM pathophysiology. This is a disease with multiple characteristics that implicate directly or indirectly the outcomes of nutrition or exercise interventions. We can emphasize the time elapsed since diagnosis, body composition, the severity of insulin insufficiency and/or insulin resistance, and the vast number of commonly associated comorbidities. These factors are distributed in such a diverse way, that it makes the stratification of a sample extremely difficult when we intend to create better levels of homogeneity and maintain generalizability.The present study opens perspectives for further research on T2DM involving adequate amounts and variety of protein ingestion or WP supplementation, either by acute or chronic effect, and the best type, volume, and intensity of physical exercises, since the literature related to the subject is still insufficient.