Our publication on effectiveness of a multimodal intervention in functionally impaired older people with type 2 diabetes mellitus (T2DM) is published today [1].

We report the results of the MID-Frail randomised trial that assessed whether a multimodal intervention in pre-frail and frail older people with T2DM leads to an improvement in physical performance measured at 12 months at an individual level. We evaluated whether this multimodal approach would lead to improvements in a range of relevant secondary outcomes, whether the intervention could be delivered in both primary and secondary settings without excess difficulty, and whether the intervention was cost-effective in this population.

After 12 months, intervention procedures participants had mean SPPB scores 0.85 points higher than those in the usual care group (95% CI, 0.44 to 1.26, P < 0.0001). Dropouts were higher in frail participants and in the intervention group, but significant differences in Short

Physical Performance Battery scores between treatment groups remained consistent after sensitivity analysis. Estimates suggest a mean saving following intervention of 428.02 EUR (2016) per patient per year, with incremental cost-effectiveness ratio analysis indicating a consistent benefit of the described health care intervention over usual care. No statistically significant differences between groups were detected in any of the other secondary outcomes.

In conclusion, we have demonstrated that a 12-month structured multimodal intervention programme across several clinical settings in different European countries leads to a clinically relevant and cost-effective improvement in the functional status of older frail and pre-frail participants with type 2 diabetes mellitus.

References

1. Rodriguez-Mañas L, et al. Effectiveness of a multimodal intervention in functionally impaired older people with type 2 diabetes mellitus. J Cachexia Sarcopenia Muscle. 2019 Aug;10(4):721-733.