Short-term intervention improves frailty status of older people with type 2 diabetes for up to two years

A further analysis of the European MIDFRAIL intervention study demonstrates lasting improvements in frailty status and physical function in older adults with type 2 diabetes.

Participants are likely to experience benefits for up to 18 months after completing the programme, even if they only took part for a limited period.

Professor Alan Sinclair, a World Health Organization recognised expert in diabetes, older people and frailty, jointly led the research team who looked at the health outcomes of 298 community-dwelling older adults participating in MIDFRAIL and followed-up for up to 24 months.

All study subjects were older than 70 years, had type 2 diabetes, and were either frail, or pre-frail. Participants were allocated by trial site to follow either usual care or intervention procedures. Those in the intervention group underwent a 16-week exercise programme and seven-sessional nutritional-educational sessions.

Frailty status was assessed by the Fried Frailty Phenotype criteria at baseline and final visit. The Fried Frailty Phenotype criteria refer to a set of five physical indicators used to assess frailty in an individual, including: unintentional weight loss, weakness (low handgrip strength), self-reported exhaustion, slow walking speed and low physical activity. A person is considered frail if they meet three or more of these criteria.

According to the study’s results, the probability of improving the frailty status and decreasing the number of Fried’s frailty criteria continued to be higher in the intervention group than in the usual care group.

A key figure in the evolution of the relationship between frailty and diabetes around the world, Professor Sinclair is the chair of the Foundation for Diabetes Research in Older People (fDROP) and the National Advisory Panel for Care Home Diabetes (NAPCHD).

He said: “Once again, we see evidence that frailty is not irreversible but can be effectively managed if frail older people with type 2 diabetes can be encouraged to adhere to an exercise-based intervention.

“It is essential that all diabetes specialists and commissioners of diabetes services recognise that frailty has a more prognostic significance in terms of clinical outcome and mortality than diabetes-related complications.”

To read the study, click here.