Lifestyle Intervention to Reduce the Risk of Sarcopenia in Adults With Diabetes & Obesity Treated With Semaglutide

Inclusion criteria

• Patients 65 years and above.
• Patients who were previously diagnosed with type 2 diabetes.
• Overweight / obesity (body mass index, BMI ≥ 27 kg/m2).

Exclusion criteria

• Patients with significant hearing or visual disability.
• Patients with Estimated Glomerular Filtration Rate (eGFR)\<30 ml/min/1.73 m2.
• Patients who are in active nutritional therapy.
• Patients who changed their diet recently (\< 1 month) and/or in a weight-loss program with \>5% weight loss or used anti-obesity drugs in the last 3 months.
• Patients who reported a weight loss of \>5kg within 90 days of screening
• Patients who were on Glucagon-like peptide-1 receptor agonists (GLP-1-RA) treatment during the last 3 months.
• Patients with musculoskeletal disorders, which, by the judgment of the investigators, would limit their ability to perform the exercise training.
• Patients with neurological diseases, which by the judgment of the investigators, would affect their ability to participate in the trial.
• Patients with a history of amputation that impairs their ability to participate in the exercise program.
• Patients with disabilities, which, by the judgment of the investigators, would affect their ability to participate in the trial.
• Patients who use a walking aid.
• Patients who are currently using systemic steroids.
• Patients with active oncological diseases, excluding non-melanoma skin cancer.
• Patients with diagnosed dementia or cognitive impairment that, in the view of the researchers, may impair their ability to sign a consent form or participate in the trial.
• Patients who were hospitalized in the past month.
• Patients who exercise regularly and in the eyes of the examiner will not benefit from the intervention program.
• Anyone who is not suitable to participate in the study, according to the researcher's discretion.
• Any contraindication to Magnetic resonance imaging (MRI) (e.g., MRI non-compatible cardiac implantable electronic device, metallic foreign bodies, implantable neurostimulation system, cochlear implants/ear implant, non-removable drug infusion pumps, catheters with metallic components, cerebral artery aneurysm clips which), or inability to perform an MRI scanner (e.g., claustrophobia).
• Patients who do not fit within the measurement field of view of the Dual-energy X-ray absorptiometry (DXA) scanner in a supine position with the arms next to the body.