Clinical Nutrition Strategies for the Prevention and Management of Sarcopenia in Older Adults with Type 2 Diabetes

The prevalence of sarcopenia is significantly higher in older adults with type 2 diabetes mellitus (T2DM) than in non-diabetic populations, contributing to functional decline, poor glycemic control, and increased morbidity and mortality. This review summarizes current evidence and clinical nutrition strategies for the prevention and management of sarcopenia in older adults with T2DM. Energy deficiency accelerates muscle protein breakdown, and adequate caloric intake ≥ 30 kcal/kg/day is recommended. Protein intake of 1.0~1.2 g/kg/day, evenly distributed across meals, supports muscle synthesis and function. Vitamin D supplementation and omega-3 fatty acids may have synergistic benefits when combined with adequate protein intake and exercise. In sarcopenic obesity, a hypocaloric but protein-preserving diet and resistance training are crucial. Adherence to a Mediterranean-style dietary pattern, emphasizing vegetables, whole grains, fish, and unsaturated fats, is associated with lower frailty and better physical performance. Integrated multidisciplinary approaches involving medicine, nutrition, exercise, and nursing are essential for optimizing outcomes. Future research should focus on optimal nutrient targets and long-term combined interventions in this growing population.