2514-P: Older Adults with Prediabetes or Type 2 Diabetes Experience Poor Recovery of Muscle Power and Torque but Not Volume following 10 Days of Bed Rest

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Introduction and Objective: Older adults with pre-diabetes (p-D) or type 2 diabetes (T2D) may be vulnerable to an accelerated loss of muscle mass and function due to poor recovery following physical inactivity. To test this paradigm, we conducted a 10-day bed rest study to characterize the recovery of muscle volume and function in older adults with p-D or T2D. Methods: Thirty-nine older adults with p-D or T2D (p-D/T2D 14M/13F, 65 ± 5.0 y) or who were metabolically healthy (CON, 6M/6F, 68 ± 2.9 y) completed a 10-day bed rest intervention, followed by 4 weeks of ambulatory recovery. Mid-thigh muscle volume was assessed by MRI. Knee extensor power and torque were determined by isokinetic dynamometry. Free living activity was quantified via actigraphy. Mitochondrial oxidative phosphorylation capacity (ATPmax) was assessed by 31P-MRS. All assessments were completed pre- and post-bed rest, and weekly during recovery with analyses performed via repeated measures ANCOVA controlling for baseline. Results: Bed rest decreased muscle volume similarly between groups (~2.3%), with volume returning to baseline levels after only 1 week of ambulatory recovery. However, knee extensor power (CON: 115.8 ± 41.6 vs p-D/T2D: 99.0 ± 43.1 watts, P<0.05) and torque (CON: 87.6 ± 26.6 vs p-D/T2D: 78.0 ± 30.6 N*m, P<0.05) remained significantly lower in the p-D/T2D group during ambulatory recovery. Physical activity levels returned to baseline after 1 week of ambulatory recovery for both groups. ATPmax decreased (~11.5%) and failed to return to baseline in both groups. Conclusion: Older adults with pre-diabetes/T2D had delayed recovery of muscle function after bed rest, despite recovery of muscle volume. Muscle mitochondrial energetics did not recover during ambulatory recovery for both groups. These data suggest that older adults with pre-diabetes or type 2 diabetes are uniquely vulnerable to inactivity induced muscle dysfunction and may require a targeted rehabilitation strategy to facilitate recovery of muscle function. Disclosure C. Elliehausen: None. S.V. Ramos: None. J. Hinkley: None. F. Yi: None. R. Pratley: Consultant; Current; Lilly USA LLC. Research Support; Current; National Institutes of Health, Novo Nordisk. Speaker's Bureau; Current; Novo Nordisk. Other - Consulting: Thru 12/31/2023 payment directed to Dr. Pratley's employer; as of 1/1/2024 payment directed to Dr. Pratley personally.; Current; Novo Nordisk. Consultant; Current; Pfizer Inc., Recordati Rare Diseases Inc., Regeneron Pharmaceuticals Inc., Response Pharmaceuticals, Rona Therapeutics Ltd. Research Support; Current; Sanofi. Consultant; Current; Scholar Rock Inc. Other - Consulting: Thru 12/31/2023 payment directed to Dr. Pratley's employer; as of 1/1/2024 payment directed to Dr. Pratley personally.; Current; Sun Pharmaceutical Industries Ltd. Consultant; Current; Third Rock Ventures, Verdiva Bio Dev Limited. Research Support; Current; AstraZeneca AB, Boehringer Ingelheim International GmbH, Abbott Laboratories. Consultant; Current; Abbott Laboratories, AbbVie Inc. Other - Consulting; stock options; Current; Altanine, Inc. Consultant; Current; Amgen Inc., AstraZeneca Pharmaceuticals LP. Other - Consulting: Thru 12/31/2023 payment directed to Dr. Pratley's employer; as of 1/1/2024 payment directed to Dr. Pratley personally.; Current; Bayer AG, Bayer HealthCare Pharmaceuticals Inc. Research Support; Current; Biomea Fusion. Consultant; Current; Boehringer Ingelheim Pharmaceuticals Inc., Carmot Therapeutics, Inc., Corcept Therapeutics. Research Support; Current; Dompé, Eli Lilly and Company. Other - Consulting: Thru 12/31/2023 payment directed to Dr. Pratley's employer; as of 1/1/2024 payment directed to Dr. Pratley personally.; Current; Eli Lilly and Company. Research Support; Current; Endogenex Inc. Other - Consulting: Thru 12/31/2023 payment directed to Dr. Pratley's employer; as of 1/1/2024 payment directed to Dr. Pratley personally.; Current; Endogenex Inc. Consultant; Current; F. Hoffmann-La Roche Ltd. Research Support; Current; Fractyl Health, Inc. Other - Consulting: Thru 12/31/2023 payment directed to Dr. Pratley's employer; as of 1/1/2024 payment directed to Dr. Pratley personally.; Ended; Gasherbrum Bio Inc., Genprex. Consultant; Current; Hanmi Pharm. Co., Ltd. Other - Consulting: Thru 12/31/2023 payment directed to Dr. Pratley's employer; as of 1/1/2024 payment directed to Dr. Pratley personally.; Ended; Intas Pharmaceuticals Ltd. Research Support; Current; Lexicon Pharmaceuticals, Inc. Consultant; Current; Lexicon Pharmaceuticals, Inc. Speaker's Bureau; Current; Lilly USA LLC. J.P. DeLany: None. B. Goodpaster: Advisory Panel; Ended; AbbVie Inc., Altimmune, Merck & Co., Inc., Novo Nordisk, Regeneron Pharmaceuticals Inc. P.M. Coen: None. Funding National Institutes of Health (R01AG060153 to PMC)

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