Metabolic and functional factors associated with a change in resting metabolic rate among older adults with type 2 diabetes- results from the CEV-65 randomized trial.

Aims: This study evaluated the effects of circuit resistance training (CRT), a vegetarian/Mediterranean diet (VegMedD), and empagliflozin on Resting Metabolic Rate (RMR) in older adults with Type 2 Diabetes (T2DM).
Methods: 67 participants from CEV-65 trial (≥65 years, 61 % female) were randomly assigned to CRT, VegMedD, or empagliflozin for 10 weeks. Assessments included RMR, medical, metabolic, nutritional, anthropometric and functional measurements. RMR changes were analyzed using paired t-tests, effect sizes, and repeated analysis of variance.
Results: No significant RMR differences were found between groups at baseline and post-intervention with minor RMR increases in 16 (CRT) to 25 % (VegMeD/empagliflozin). Factors correlating with RMR changes included sleep hours (r = 0.25), fat percentage (r = -0.27), leg strength (r = 0.29), and systolic blood pressure (r = 0.24). Except for blood pressure, all the other variables predicted RMR changes ( R ²  = 0.22).
Conclusions: CRT, VegMedD, and empagliflozin showed similar effects on RMR in elderly with T2DM. Factors predicting changes in RMR are sleep hours, fat percentage, and leg strength, with those who increased/did not change their RMR presenting greater improvement in the aforementioned variables. These findings highlight the potential of these factors as therapeutic targets for improving metabolic health and warrant further investigation.
Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(© 2025 The Authors.)