Abstract
Measurements such as weight and body mass index (BMI) have been considered practical and sensitive for predicting risks and health outcomes, however, they are not related to muscle mass. Therapeutic weight loss inevitably leads to the loss of variable amounts of skeletal muscle mass. We evaluated changes in body composition and estimated glucose disposal rate (eGDR) after 48 weeks of a program of lifestyle changes in overweight/obese patients with type 1 diabetes. The patients were invited to participate in a lifestyle change program (diet, daily steps, and resistance exercises without supervision at home). Body composition was evaluated by DXA, body weight, BMI, waist circumference (WC), and insulin sensitivity measured by eGDR at the beginning and at the end of the intervention. Continuous variables were expressed as mean ± standard deviation. For comparisons, Student's t-test was used. To determine correlations, the Pearson correlation coefficient was used. P<0.05 were considered significant. We included 13 T1D patients, aged 43.6 ±13.7 years, with a disease duration of 21.7 ± 11.6 years. The lifestyle intervention significantly reduced body weight 86.6±10.9 kg vs. 81.9±11.2 kg (p=0.018), BMI 29.2±3.04 kg/m2 vs. 27.5±2.36 kg/m2 (p=0.017), CC 95.4±8.8 cm vs. 88.8±8.4 cm (p=0.0001), fat mass index 10.1±2.85 kg/m2 vs. 8.9±2.24 kg/m2 (p=0.031), with increased the eGDR 7.61±1.5 mg/kg/min vs. 8.20±1.6mg/kg/min (p=0.026). But also, there was a reduction in the appendicular musculoskeletal index 8.3±0.8 kg/m2 vs. 8.06±0.8 kg/m2 (p=0.016). In conclusion, our lifestyle change program for people with T1D and overweight/obesity achieved a positive impact on body weight, BMI, waist circumference, fat mass, and eGDR, but not a positive impact on skeletal muscle, maybe for low adherence to resistance exercise. The knowledge of body composition is necessary to plan personalized nutritional and physical exercise interventions for the preservation of muscle tissue and avoid sarcopenia in this population.
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