Diabetes and Sarcopenic Obesity: Pathogenesis, Diagnosis, and Treatments

In the paper

“On the other hand, the loss of muscle mass leads to less insulin-responsive target tissue, resulting in a severe condition of insulin resistance (12, 13).”

What the sources say

• Not checked yetcites [12] Dominguez, 2007, The cardiometabolic syndrome and sarcopenic obesity in older persons , J Cardiometab Syndr. source
• Not checked yetcites [13] Baek, 2014, Sarcopenia and sarcopenic obesity and their association with dyslipidemia in Korean elderly men: the 2008–2010 Korea National health and nutrition examination survey, J Endocrinol Invest. source

In the paper

“it has been shown that more than 50% of the diabetics are obese (10).”

What the sources say

• Not checked yetcites [10] Khan, 2019, From pre-diabetes to diabetes: diagnosis, treatments and translational research, Medicina (Kaunas). source

In the paper

“Furthermore, the increasing fat mass facilitates various cytokines which accelerate the catabolism of muscles.”

In the paper

“Therefore, the vicious cycle continues until more negative health consequences occur (Figure 1).”

In the paper

“Although the impact of sarcopenia has been well-demonstrated, the effect of obesity on it emerges as a new public health problem (2).”

What the sources say

• Not checked yetcites [2] Koliaki, 2019, Sarcopenic obesity: epidemiologic evidence, pathophysiology, therapeutic perspectives, Curr Obesity Rep. source

In the paper

“Hence, there is a good reason to suspect that diabetes and SO have a strong relationship (11).”

What the sources say

• Not checked yetcites [11] Khadra, 2019, Association between sarcopenic obesity and higher risk of type 2 diabetes in adults: a systematic review and meta-analysis, World J Diabetes. source

In the paper

“As less amount of fatty acid are oxidized in muscles, more fat mass deposits in visceral such as liver, heart, and spleen.”

In the paper

“Furthermore, the reduction of fatty acid consumption is coupled with the increase of reactive oxygen species generation.”

In the paper

“Oxidative stress is strongly associated with the expression of various inflammatory transcription factors, such as nuclear factor-kB (NF- kB) that modulates proteolytic pathways and promotes inflammation (29–31).”

What the sources say

• Not checked yetcites [29] Jensen, 2008, Inflammation: roles in aging and sarcopenia, JPEN J Parenter Enteral Nutr. source
• Not checked yetcites [30] Meng, 2010, Oxidative stress, molecular inflammation and sarcopenia, Int J Mol Sci source
• Not checked yetcites [31] Liao, 2019, Reactive oxygen species: a volatile driver of field cancerization and metastasis, Mol Cancer. source

In the paper

“It is difficult to sustain muscle mass and strength with insufficient amount of protein intake (18).”

What the sources say

• Not checked yetcites [18] Muscariello, 2016, Dietary protein intake in sarcopenic obese older women, Clin Interv Aging. source

In the paper

“The imbalance of energy intake and expenditure is also linked to SO, especially for the old.”

In the paper

“which supports the theory that low-grade inflammation is linked to SO.”

In the paper

“As an endocrine organ, the muscle can produce a variety of myokines such as myostatin and irisin.”

In the paper

“Hence, another vicious circle leading to SO forms.”

In the paper

“Hence, the loss of muscle strength and the gain of fat which characterize SO is attributed by insulin resistance (41).”

What the sources say

• Not checked yetcites [41] Abbatecola, 2011, Discovering pathways of sarcopenia in older adults: a role for insulin resistance on mitochondria dysfunction, J Nutr Health Aging. source

In the paper

“Previous studies have indicated that an inflammatory state plays a significant role in the progression of SO as well as the morbidity and mortality driven by SO.”

In the paper

“Therefore, insulin resistance is involved in poor muscle mass and muscle strength, progressively resulting in SO.”

In the paper

“Age-related SO is usually due to the lack of physical activity.”

In the paper

“Furthermore, insulin resistance is correlated to mitochondrial dysfunction as well.”

In the paper

“On one hand, old people obtain inadequate protein in their diet.”

In the paper

“On the other hand, owing to decrease of outdoor physical activities, vitamin D produces less with scanty expose of ultraviolet radiation (19).”

What the sources say

• Not checked yetcites [19] Oh, 2016, The most effective factors to offset sarcopenia and obesity in the older Korean: physical activity, vitamin D, protein intake, Nutrition. source

In the paper

“Particularly, myokines can exacerbate insulin resistance.”

In the paper

“Hence, inadequate vitamin D accelerates SO (20).”

What the sources say

• Not checked yetcites [20] Son, 2019, Sarcopenic obesity can be negatively associated with active physical activity and adequate intake of some nutrients in Korean elderly: findings from the Korea National Health and Nutrition Examination Survey (2008-2011), Nutr Res Pract. source

In the paper

“Eventually, the crosstalk between muscle and fat leads to muscle damage, eliciting SO.”

In the paper

“Once the imbalance between the secretion of insulin and glucagon occurs, the levels of blood glucose skew improperly as well.”

In the paper

“This leads to the destruction and dysfunction of certain cells, like islet β cells that produce insulin.”

In the paper

“Furthermore, the characteristic may attribute to physical disability and metabolic syndromes, which has been clarified in another Korean study (57).”

What the sources say

• Not checked yetcites [57] Kim, 2010, Prevalence and determinant factors of sarcopenia in patients with type 2 diabetes: the Korean Sarcopenic Obesity Study (KSOS), Diabetes Care. source

In the paper

“The accumulation of free fatty acids in the islet β cells accelerates the production of NO, which causes the apoptosis of β cells.”

In the paper

“Noteworthily, according to different definition of SO, the risk of all-cause mortality changes.”

What the sources say

• Not checked yetcites [52] Tian, 2016, Association of sarcopenic obesity with the risk of all-cause mortality: a meta-analysis of prospective cohort studies, Geriatr Gerontol Int. source

In the paper

“The function of β cells and α cells changes with the glucose environment in an individual's body (69, 70).”

What the sources say

• Not checked yetcites [69] Giwa, 2020, Current understandings of the pathogenesis of type 1 diabetes: genetics to environment, World J Diabetes. source
• Not checked yetcites [70] Kautzky-Willer, 2016, Sex and gender differences in risk, pathophysiology and complications of type 2 diabetes mellitus, Endocr Rev. source

In the paper

“Furthermore, long chain saturated fatty acids can inhibit the expression of adenine nucleotide translocator.”

In the paper

“Secondly, metabolic disorders including cardiometabolic syndrome (CMS), diabetes, cardiovascular disease (CVD), and cancer are common comorbidities of SO (54, 55).”

What the sources say

• Not checked yetcites [54] Hong, 2020, Sarcopenic obesity, insulin resistance, and their implications in cardiovascular and metabolic consequences, Int J Mol Sci. source
• Not checked yetcites [55] Liao, 2019, Cancer-associated fibroblasts in tumor microenvironment–Accomplices in tumor malignancy, Cell Immunol. source

In the paper

“Hence, the muscle mass and strength weaken with the reduced testosterone and estrogen concentrations (50).”

What the sources say

• Not checked yetcites [50] Sipilä, 2013, Sex hormones and skeletal muscle weakness, Biogerontology. source

In the paper

“In fact, the chronic activation of the innate immune system, leading to intra-islet inflammation also seems to be the key part of β cells apoptosis (77).”

What the sources say

• Not checked yetcites [77] Donath, 2003, Inflammatory mediators and islet β-cell failure: a link between type 1 and type 2 diabetes source

In the paper

“Firstly, SO is overtly associated with an increased risk of all-cause mortality.”

In the paper

“Moreover, adverse clinical cancer outcomes reported to be relevant to SO, especially with respect to dose-limiting toxicity, surgical complications, physical disability, and shorter survival (59–61).”

What the sources say

• Not checked yetcites [59] Baracos, 2018, Sarcopenic obesity: hidden muscle wasting and its impact for survival and complications of cancer therapy, Ann Oncol. source
• Not checked yetcites [60] Carneiro, 2016, Clinical implications of sarcopenic obesity in cancer, Curr Oncol Rep. source
• Not checked yetcites [61] Gonzalez-Molina, 2019, MMP14 in sarcoma: a regulator of tumor microenvironment communication in connective tissues, Cells. source

In the paper

“Other hormones, including insulin-like growth factors-1 (IGF-1), growth hormone, testosterone, and estrogen, also regulate the anabolic and catabolic progressions in muscle (46, 47).”

What the sources say

• Not checked yetcites [46] Wang, 2012, Sarcopenia in the elderly: basic and clinical issues, Geriatr Gerontol Int. source
• Not checked yetcites [47] Choi, 2013, Sarcopenia and sarcopenic obesity, Endocrinol Metab (Seoul). source

In the paper

“The cluster of abdominal obesity, hyperglycemia, hyperinsulinemia, dyslipidemia, and hypertension that composes CMS progressively leads to diabetes and CVD.”

In the paper

“A cross-sectional study has evaluated the association between SO and cognitive function in geriatric population, and found that SO is an indicator of probable cognitive impairment (65).”

What the sources say

• Not checked yetcites [65] Magdalena, 2018, Sarcopenic obesity and cognitive performance, Clin Interv Aging. source

In the paper

“Furthermore, the islet β cells are especially sensitive to ROS because of their low inherent level of antioxidant enzymes.”

In the paper

“A meta-analysis including 606 articles has demonstrated that SO increases the risk of T2D by almost 38% compared to individuals with excess weight or obesity alone (11).”

What the sources say

• Not checked yetcites [11] Khadra, 2019, Association between sarcopenic obesity and higher risk of type 2 diabetes in adults: a systematic review and meta-analysis, World J Diabetes. source

In the paper

“Therefore, aberrant hormonal changes with age exacerbate SO.”

In the paper

“Finally, even if there is no discrepancies between SO group and other groups of physical capacity found in a study (62), most studies support that SO causes physical disability.”

What the sources say

• Not checked yetcites [62] Brochu, 2012, Sarcopenic/obesity and physical capacity in older men and women: data from the nutrition as a determinant of successful aging (NuAge)-the Quebec longitudinal study, Obesity(Sliver Spring). source

In the paper

“Specifically, all-cause mortality is higher basing on the criteria of mid-arm muscle circumference or muscle strength (HR 1.46, 95% CI 1.23–1.73 and 1.23, 1.09–1.38, respectively) rather than on the definition of skeletal muscle mass (pooled HR 1.24, 95% CI 1.12–1.37, P < 0.001) (52).”

What the sources say

• Not checked yetcites [52] Tian, 2016, Association of sarcopenic obesity with the risk of all-cause mortality: a meta-analysis of prospective cohort studies, Geriatr Gerontol Int. source

In the paper

“Besides, diabetic individuals with liver cancer and bladder cancer are associated with a poor survival compared with non-diabetic subjects (122).”

What the sources say

• Not checked yetcites [122] Wang, 2020, Diabetes and cancer: epidemiological and biological links, World J Diabetes. source

In the paper

“In order to sustain a stable levels of blood glucose, islet β cells secret excessive insulin to compensate, leading to hyperinsulinemia (86).”

What the sources say

• Not checked yetcites [86] Nolan, 2019, Insulin resistance and insulin hypersecretion in the metabolic syndrome and type 2 diabetes: time for a conceptual framework shift, Diab Vasc Dis Res. source

In the paper

“The elevated amount of these components stimulates several signaling pathways such as inhibitor kappa beta kinase beta (IKKβ), Jun N-terminal kinase (JNK), and NF-κB signaling pathways to induce the development of insulin resistance (92, 93).”

What the sources say

• Not checked yetcites [92] Akash, 2018, Tumor necrosis factor-alpha: role in development of insulin resistance and pathogenesis of type 2 diabetes mellitus, J Cell Biochem. source
• Not checked yetcites [93] Gomes, 2019, Immunoinflammatory mediators in the pathogenesis of diabetes mellitus, Einstein (Sao Paulo). source

In the paper

“Increased insulin content results in less affinity of insulin receptor (IR) thus, cells (major muscle) gradually become insensitive to insulin.”

In the paper

“Moreover, chronically excessive levels of ROS can cause the loss of transcription factors PDX-1 and MsfA, disturbing the expression of insulin gene (84).”

What the sources say

• Not checked yetcites [84] Robertson, 2007, Chronic oxidative stress as a mechanism for glucose toxicity of the beta cell in type 2 diabetes, Cell Biochem Biophys. source

In the paper

“However, Indian patients with T2D are as twice likely to develop coronary artery diseases as white Europeans who have T2D (115).”

What the sources say

• Not checked yetcites [115] Forouhi, 2006, Do known risk factors explain the higher coronary heart disease mortality in South Asian compared with European men? prospective follow-up of the Southall and Brent studies, UK, Diabetologia. source

In the paper

“Furthermore, there are multiple factors, particular obesity, increase the levels of adipocytes, inflammatory cytokines (IL-1, IL-6, and TNFα) (91).”

What the sources say

• Not checked yetcites [91] Polsky, 2015, Obesity, insulin resistance, and type 1 diabetes mellitus, Curr Opin Endocrinol Diabetes Obes. source

In the paper

“Numerous epidemiological evidences have indicated that diabetes is considered as an independent risk factor for increased rates of various types of cancer.”

In the paper

“Therefore, diabetic neuropathy extremely influences the quality of life in diabetic people.”

In the paper

“For endometrial cancer, the new-onset diabetics (<5 years) have a two-fold risk compared with those with long-standing diabetes (≥5 years) (121).”

What the sources say

• Not checked yetcites [121] Saltzman, 2008, Diabetes and endometrial cancer: an evaluation of the modifying effects of other known risk factors, Am J Epidemiol. source

In the paper

“Therefore, any impairments occur on main phosphorylation sites will reduce insulin receptor tyrosine kinase activity, eventually affecting the insulin function (88–90).”

What the sources say

• Not checked yetcites [88] Abdul-Ghani, 2010, Pathogenesis of insulin resistance in skeletal muscle, J Biomed Biotechnol. source
• Not checked yetcites [89] Kasuga, 2019, Structure and function of the insulin receptor-a personal perspective, Proc JPN Acad B Phys Biol Sci. source
• Not checked yetcites [90] De Meyts, 2004, Insulin and its receptor: structure, function and evolution, Bioessays. source

In the paper

“Meanwhile, distal symmetric polyneuropathy mainly contributes to disability in diabetics, stemming from gait disturbance, fall-related injury, and foot ulceration and amputation (109).”

What the sources say

• Not checked yetcites [109] Lechleitner, 2019, Diabetic neuropathy and diabetic foot syndrome (Update 2019), Wien Klin Wochenschr. source

In the paper

“A study has verified that 25-hydroxyvitamin D3 can indirectly impact muscle function as its free metabolite is more closely related to body fat than muscle gene expression (155).”

What the sources say

• Not checked yetcites [155] Hassan-Smith, 2017, 25-hydroxyvitamin D3 and 1,25-dihydroxyvitamin D3 exert distinct effects on human skeletal muscle function and gene expression, PLoS ONE. source

In the paper

“Alternatively, cutoffs of BF% (Body Fat Percentage) or other adiposity indices have been regarded as useful outcomes measure of obesity (126, 127).”

What the sources say

• Not checked yetcites [126] Weir, 2020, BMI Classification Percentile And Cut Off Points
• Not checked yetcites [127] Panuganti, 2020, Obesity

In the paper

“As acute caloric restriction could promote proteolysis and negatively affect muscle protein synthesis, resulting in a further reduction of muscle mass, acute caloric restriction is not recommended.”

In the paper

“Hence, an overestimation is accompanied with a poor distinction between extracellular and intracellular fluid (133).”

What the sources say

• Not checked yetcites [133] Yu, 2016, The performance of five bioelectrical impedance analysis prediction equations against dual x-ray absorptiometry in estimating appendicular skeletal muscle mass in an adult australian population, Nutrients. source

In the paper

“Furthermore, dietary intervention is an important modifiable factor to reduce the incidence of cardiovascular diseases in diabetics (161).”

What the sources say

• Not checked yetcites [161] 2017, Curr Obes Rep. source

In the paper

“In spite of the widespread use of anthropometric measurements, such as mid-upper arm circumference, calf circumference, and skin fold thickness, they are inaccurate (135).”

What the sources say

• Not checked yetcites [135] Choi, 2016, Sarcopenia and sarcopenic obesity, Korean J Inter Med. source

In the paper

“The macrobiotic and vegan diets were beneficial to glycemic control, while the vegetarian diet demonstrated better weight loss and insulin sensitivity.”

What the sources say

• Not checked yetcites [159] Papamichou, 2019, Dietary patterns and management of type 2 diabetes: a systematic review of randomised clinical trials, Nutr Metab Cardiovasc Dis. source

In the paper

“The intake of low glycemic food including cereal fiber or a mixture of whole grain and bran can decrease 18–40% of risk for diabetics (157).”

What the sources say

• Not checked yetcites [157] Cho, 2013, Am J Clin Nutr. source

In the paper

“However, there were no evident differences of low carbohydrate diets and low-fat diets in glycemic control, weight and lipids.”

What the sources say

• Not checked yetcites [159] Papamichou, 2019, Dietary patterns and management of type 2 diabetes: a systematic review of randomised clinical trials, Nutr Metab Cardiovasc Dis. source

In the paper

“A study assessed the effect of a diet moderately rich in proteins on lean mass in SO older women, and has indicated that sufficient protein intake is able to preserve muscle mass in older women with SO (18).”

What the sources say

• Not checked yetcites [18] Muscariello, 2016, Dietary protein intake in sarcopenic obese older women, Clin Interv Aging. source

In the paper

“Besides, studies have elucidated that vitamin D has the capability of regulating bioactive metabolites, and thus, improving muscle function (156).”

What the sources say

• Not checked yetcites [156] Sohl, 2013, Vitamin D status is associated with physical performance: the results of three independent cohorts, Osteoporos Int. source

In the paper

“Although there are various approved and effective drugs for diabetes, there is currently no recommended pharmacological intervention for SO, not even for diabetics with SO.”

• Also stated in: § Conventional Treatments for Sarcopenic Obesity and Diabetes · plain

  “In spite of many novel pharmacological interventions are under investigation, such as testosterone supplement, selective androgen receptor modulators, and myostatin inhibitors, there is currently no approved drugs for SO (176–178).”

What the sources say

• Not checked yetcites [176] Ferrando, 2002, Testosterone administration to older men improves muscle function: molecular and physiological mechanisms, Am J Physiol Endocrinol Metab. source
• Not checked yetcites [177] Papanicolaou, 2013, A phase IIA randomized, placebo-controlled clinical trial to study the efficacy and safety of the selective androgen receptor modulator (SARM), MK-0773 in female participants with sarcopenia, J Nutr Health Aging. source
• Not checked yetcites [178] J.-Camporez, 2016, Anti-myostatin antibody increases muscle mass and strength and improves insulin sensitivity in old mice, Proc Natl Acad Sci USA. source

In the paper

“Moreover, the risk of diabetes reduces by 26% due to the consumption of one sugar-containing beverage more than 1 month compared to one per day (158).”

What the sources say

• Not checked yetcites [158] Malik, 2010, Sugar-sweetened beverages and risk of metabolic syndrome and type 2 diabetes: a meta-analysis, Diabetes care. source

In the paper

“Besides, the Mediterranean diet showed a greater regulation of A1C levels.”

What the sources say

• Not checked yetcites [159] Papamichou, 2019, Dietary patterns and management of type 2 diabetes: a systematic review of randomised clinical trials, Nutr Metab Cardiovasc Dis. source

In the paper

“A combination of physical activity and dietary intervention is a more effective strategy to treat SO.”

In the paper

“Increased dietary protein can prevent weight loss-induced sarcopenia.”

What the sources say

• Not checked yetcites [149] Deutz, 2014, Protein intake and exercise for optimal muscle function with aging: recommendations from the ESPEN Expert Group, Clin Nutr. source
• Not checked yetcites [150] Bauer, 2013, Evidence-based recommendations for optimal dietary protein intake in older people: a position paper from the PROT-AGE Study Group, J Am Med Direct Assoc. source
• Not checked yetcites [151] Paddon-Jones, 2009, Dietary protein recommendations and the prevention of sarcopenia, Curr Opin Cin Nutr Metab Care. source

In the paper

“In contrast, chronic caloric restriction might increase muscle protein synthesis rather than downregulate (144, 145).”

What the sources say

• Not checked yetcites [144] Heymsfield, 2014, Weight loss composition is one-fourth fat-free mass: a critical review and critique of this widely cited rule, Obes Rev. source
• Not checked yetcites [145] Freiberger, 2015, Sarcopenic obesity and complex interventions with nutrition and exercise in community-dwelling older persons – a narrative review, Clin Intervent Aging. source

In the paper

“Noteworthy, the grip strength and knee extensor performance of resistance group were superior to those of the other groups (170).”

What the sources say

• Not checked yetcites [170] Chen, 2017, Effects of different types of exercise on body composition, muscle strength, and igf-1 in the elderly with sarcopenic obesity, J Am Geriatr Soc. source

In the paper

“Thus, resistance training combined aerobic training is the most effective way to alleviated physical disability (171).”

What the sources say

• Not checked yetcites [171] Villareal, 2017, Aerobic or resistance exercise, or both, in dieting obese older adults, N Engl J Med. source

In the paper

“however, there was a significant absolute mean change of A1C in the combination training group.”

What the sources say

• Not checked yetcites [175] Church, 2010, Effects of aerobic and resistance training on hemoglobin A1c levels in patients with type 2 diabetes: a randomized controlled trial, JAMA. source

In the paper

“Whereas, it should be noted that they do not increase insulin sensitization (190)”

What the sources say

• Not checked yetcites [190] Shimabukuro, 2017, α-Glucosidase inhibitor miglitol attenuates glucose fluctuation, heart rate variability and sympathetic activity in patients with type 2 diabetes and acute coronary syndrome: a multicenter randomized controlled (MACS) study, Cardiovasc Diabetol. source

In the paper

“A meta-analysis involving 14 RCTs and a quasi-experimental trial has clarified that exercise, particularly resistance training plays a key part in improving body composition and physical performance in patients with SO (169).”

What the sources say

• Not checked yetcites [169] Hsu, 2019, Effects of exercise and nutritional intervention on body composition, metabolic health, and physical performance in adults with sarcopenic obesity: a meta-analysis, Nutrients. source

In the paper

“After 3 weeks of WGC intervention, the two patients had an increase in muscle mass, protein content, and basal metabolic rate.”

What the sources say

• Not checked yetcites [195] Hwang, 2018, Effects of pharmacopuncture with wild ginseng complex in 2 elderly patients with obesity: case report, Medicine (Baltimore). source

In the paper

“In another study, three major herbal medicine including Zuo Gui Wan, red raspberry leaves, and Orthosiphon stamineus were found beneficial to gestational diabetes by controlling glucose (196).”

What the sources say

• Not checked yetcites [196] Xu, 2019, Evaluating traditional chinese medicine and herbal products for the treatment of gestational diabetes mellitus, J Diabetes Res. source

In the paper

“a systematic review disapproves of acarbose dosages higher than 50 mg (three times a day), as there is no better effects on glycated hemoglobin (191).”

What the sources say

• Not checked yetcites [191] van de Laar, 2005, Alpha-glucosidase inhibitors for patients with type 2 diabetes: results from a Cochrane systematic review and meta-analysis, Diabetes Care. source

In the paper

“Several studies have demonstrated that physical activity is an effective regimen to lower the risk of developing diabetes by improving the β-cell function (172).”

What the sources say

• Not checked yetcites [172] Aune, 2015, Physical activity and the risk of type 2 diabetes: a systematic review and dose-response meta-analysis, Eur J Epidemiol. source

In the paper

“an RCT, allocating 60 men and women to four groups (resistance training, aerobic training, combination training, and control), has found that the skeletal muscle mass, body fat mass, ASM/weight % and visceral fat area of treatment groups exhibited better results than control group.”

What the sources say

• Not checked yetcites [170] Chen, 2017, Effects of different types of exercise on body composition, muscle strength, and igf-1 in the elderly with sarcopenic obesity, J Am Geriatr Soc. source

In the paper

“It has revealed that the physical performance test score was the highest in the combination group (21% increase) compared to the resistance group (14% increase) and aerobic group (14% increase).”

What the sources say

• Not checked yetcites [171] Villareal, 2017, Aerobic or resistance exercise, or both, in dieting obese older adults, N Engl J Med. source

In the paper

“While peak oxygen consumption (milliliters per kilogram of body weight per minute) increased most in the aerobic group (18% increase) compared to the combination group (17% increase) and resistance group (8% increase).”

What the sources say

• Not checked yetcites [171] Villareal, 2017, Aerobic or resistance exercise, or both, in dieting obese older adults, N Engl J Med. source

In the paper

“Hence, effective management of diabetics with SO using herbal medicine and derivatives may be plausible but more supportive evidences are still required.”

In the paper

“Another study also has confirmed that high-intensity interval training is strongly associated with the improvement of β-cell function in patients with T2D.”

What the sources say

• Not checked yetcites [174] Nieuwoudt, 2017, Functional high-intensity training improves pancreatic β-cell function in adults with type 2 diabetes, Am J Physiol Endocrinol Metab. source

In the paper

“Because of the impact on weight reduction, incretins may find increasing use in diabesity, which is the coexistence of diabetes and obesity (193).”

What the sources say

• Not checked yetcites [193] Chia, 2020, Incretins in obesity and diabetes, Ann N Y Acad Sci. source

In the paper

“Therefore, WGC intervention may be a new alternative treatment for age-related sarcopenic obesity but more studies using larger samples are required to support this (195).”

What the sources say

• Not checked yetcites [195] Hwang, 2018, Effects of pharmacopuncture with wild ginseng complex in 2 elderly patients with obesity: case report, Medicine (Baltimore). source

In the paper

“Meanwhile, they can also positively affect cardiovascular diseases due to sodium decrease, uric acid absorption, and blood pressure reduction (194).”

What the sources say

• Not checked yetcites [194] List, 2011, Glucose dynamics and mechanistic implications of SGLT2 inhibitors in animals and humans, Kidney Int. source

In the paper

“Moreover, the combination training group had a maximal progression of oxygen consumption compared to other groups.”

What the sources say

• Not checked yetcites [175] Church, 2010, Effects of aerobic and resistance training on hemoglobin A1c levels in patients with type 2 diabetes: a randomized controlled trial, JAMA. source

In the paper

“All three exercise groups decreased waist circumference by 1.9–2.8 cm as compared to the control group.”

What the sources say

• Not checked yetcites [175] Church, 2010, Effects of aerobic and resistance training on hemoglobin A1c levels in patients with type 2 diabetes: a randomized controlled trial, JAMA. source

In the paper

“Pioglitazone and troglitazone, belonging to thiazolidinediones, have the effect of controlling the progression on gestational diabetes (187, 188).”

What the sources say

• Not checked yetcites [187] Berkowitz, 1996, Effect of troglitazone on insulin sensitivity and pancreatic beta-cell function in women at high risk for NIDDM, Diabetes. source
• Not checked yetcites [188] Xiang, 2006, Effect of pioglitazone on pancreatic beta-cell function and diabetes risk in Hispanic women with prior gestational diabetes, Diabetes. source

In the paper

“Besides, a meta-analysis of randomized controlled trials has confirmed that acupuncture should be recommended as a complementary treatment in T2D control, particularly with obesity or other metabolic disorders (195).”

What the sources say

• Not checked yetcites [195] Hwang, 2018, Effects of pharmacopuncture with wild ginseng complex in 2 elderly patients with obesity: case report, Medicine (Baltimore). source

In the paper

“indicating that diabetes is associated with increased risk of SO.”

What the sources say

• Not checked yetcites [57] Kim, 2010, Prevalence and determinant factors of sarcopenia in patients with type 2 diabetes: the Korean Sarcopenic Obesity Study (KSOS), Diabetes Care. source

In the paper

“Although the underlying mechanism of acupuncture on diabetes remains unclear, studies have suggested that it may be related to adjust nerve conduction, modulate signal pathways, regulate hormonal level, and ameliorate oxidative stress level (200).”

What the sources say

• Not checked yetcites [200] Feng, 2018, Acupoint therapy on diabetes mellitus and its common chronic complications: a review of its mechanisms, Biomed Res Int. source

In the paper

“different treatment options have been exhibited that dietary intervention and physical activity are considered as prevalently effective treatments for diabetics with SO”

In the paper

“some complementary and alternative interventions have shown some positive effects on SO and diabetes.”

In the paper

“Moreover, the combination group can increase muscle mass in a shorter time (197).”

What the sources say

• Not checked yetcites [197] Zhou, 2018, The effects of electrical acupuncture and essential amino acid supplementation on sarcopenic obesity in male older adults: a randomized control study, Obes Facts. source

In the paper

“SO combines sarcopenia and obesity, and low-grade inflammation plays a crucial role in the pathogenesis of diabetes (11).”

What the sources say

• Not checked yetcites [11] Khadra, 2019, Association between sarcopenic obesity and higher risk of type 2 diabetes in adults: a systematic review and meta-analysis, World J Diabetes. source