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Review Lifestyle Type 2 Diabetes Mellitus and Sarcopenia as Comorbid Chronic Diseases in Older Adults: Established and Emerging Treatments and Therapies
Jakub Mesinovic1,2orcid , Jackson J. Fyfe1, Jason Talevski1,3,4, Michael J. Wheeler1,5, Gloria K.W. Leung6, Elena S. George1, Melkamu T. Hunegnaw1,2, Costas Glavas1,2, Paul Jansons1,2, Robin M. Daly1, David Scott1,2

DOI: [Epub ahead of print]
Published online: September 14, 2023
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1Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
2Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia
3Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St Albans, Australia
4School of Rural Health, Monash University, Warragul, Australia
5Baker Heart and Diabetes Institute, Melbourne, Australia
6Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, Australia
Corresponding author:  Jakub Mesinovic,
Received: 14 April 2023   • Accepted: 12 August 2023

Type 2 diabetes mellitus (T2DM) and sarcopenia (low skeletal muscle mass and function) share a bidirectional relationship. The prevalence of these diseases increases with age and they share common risk factors. Skeletal muscle fat infiltration, commonly referred to as myosteatosis, may be a major contributor to both T2DM and sarcopenia in older adults via independent effects on insulin resistance and muscle health. Many strategies to manage T2DM result in energy restriction and subsequent weight loss, and this can lead to significant declines in muscle mass in the absence of resistance exercise, which is also a first-line treatment for sarcopenia. In this review, we highlight recent evidence on established treatments and emerging therapies targeting weight loss and muscle mass and function improvements in older adults with, or at risk of, T2DM and/or sarcopenia. This includes dietary, physical activity and exercise interventions, new generation incretin-based agonists and myostatin-based antagonists, and endoscopic bariatric therapies. We also highlight how digital health technologies and health literacy interventions can increase uptake of, and adherence to, established and emerging treatments and therapies in older adults with T2DM and/or sarcopenia.

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