Innovative biomarkers for predicting type 2 diabetes mellitus: relevance to dietary management of frailty in older adults

http://crossmark.crossref.org/dialog/?doi=10.1007/s10522-016-9634-z&domain=pdf

Web End = http://crossmark.crossref.org/dialog/?doi=10.1007/s10522-016-9634-z&domain=pdf

Web End = http://crossmark.crossref.org/dialog/?doi=10.1007/s10522-016-9634-z&domain=pdf

Web End = Biogerontology (2016) 17:511527 DOI 10.1007/s10522-016-9634-z

http://crossmark.crossref.org/dialog/?doi=10.1007/s10522-016-9634-z&domain=pdf

Web End = http://crossmark.crossref.org/dialog/?doi=10.1007/s10522-016-9634-z&domain=pdf

Web End = http://crossmark.crossref.org/dialog/?doi=10.1007/s10522-016-9634-z&domain=pdf

Web End = http://crossmark.crossref.org/dialog/?doi=10.1007/s10522-016-9634-z&domain=pdf

Web End = http://crossmark.crossref.org/dialog/?doi=10.1007/s10522-016-9634-z&domain=pdf

Web End = REVIEW ARTICLE

http://crossmark.crossref.org/dialog/?doi=10.1007/s10522-016-9634-z&domain=pdf

Web End = http://crossmark.crossref.org/dialog/?doi=10.1007/s10522-016-9634-z&domain=pdf

Web End = Innovative biomarkers for predicting type 2 diabetes mellitus: relevance to dietary management of frailty in older adults

John Ikwuobe . Srikanth Bellary . Helen R. Grifthhttp://orcid.org/0000-0002-2666-2147

Web End =s

Received: 19 July 2015 / Accepted: 18 January 2016 / Published online: 20 February 2016 Springer Science+Business Media Dordrecht 2016

Abstract Type 2 diabetes mellitus (T2DM) increases in prevalence in the elderly. There is evidence for signicant muscle loss and accelerated cognitive impairment in older adults with T2DM; these comorbidities are critical features of frailty. In the early stages of T2DM, insulin sensitivity can be improved by a healthy diet. Management of insulin resistance by diet in people over 65 years of age should be carefully re-evaluated because of the risk for falling due to hypoglycaemia. To date, an optimal dietary programme for older adults with insulin resistance and T2DM has not been described. The use of biomarkers to identify those at risk for T2DM will enable clinicians to offer early dietary advice that will delay onset of disease and of frailty. Here we have used an in silico literature search for putative novel biomarkers of T2DM risk and frailty. We suggest that plasma bilirubin, plasma, urinary DPP4-positive microparticles and plasma pigment epithelium-derived factor merit further investigation as predictive biomarkers for T2DM and frailty risk in older adults. Bilirubin is screened routinely in clinical practice. Measurement of specic microparticle frequency in urine is less invasive than a blood sample so is a good choice for biomonitoring. Future studies should

investigate whether early dietary changes, such as increased intake of whey protein and micronutrients that improve muscle function and insulin sensitivity, affect biomarkers and can reduce the longer term complication of frailty in people at risk for T2DM.

Keywords Insulin resistance Ageing Falls

Obesity

Introduction

Frailty is a condition of dependency on others that occurs in elderly people (Evans et al. 2010). Older adults who have chronic metabolic and cognitive diseases are predisposed to frailty (Chen et al. 2010b). In...