Effects of the antidiabetic drugs on the age-related atrophy and sarcopenia associated with diabetes type II.

The skeletal muscle atrophy and sarcopenia are negative prognostic factors in the treatment of the diabetic aged-population. Insulin therapy stimulated protein anabolism in younger but not older patients and failed to prevent atrophy. The insulin- sensitizer glitazones are promising agents against atrophy but the un-favorable benefit/risk profile limits their use. Metformin is an AMPK agonist potentiating insulin actions in the adult human muscle, but not in the aged individuals. The AMPK agonists have the potential to induce atrophy. The KATP channel blockers such as the sulfonylureas and glinide may induce atrophy. Glibenclamide indeed induces atrophy in rat and in human. Within the glinides, repaglinide is the most potent atrophic agent "in vitro" in animals. The GLP-1 and incretins showed beneficial effects in skeletal muscle but their effects on the age-dependent muscle atrophy in human and animals are not known. The novel sodium glucose co-transporter inhibitors may not have been recognized as drug-induced atrophic/anti-atrophic effects. Here we reviewed the effects of the anti-diabetic drugs on the age-related muscle atrophy.