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Diabetes accelerates the aging of skeletal muscles and blood vessels through mechanisms, such as increased oxidative stress, chronic inflammation, insulin resistance, mitochondrial dysfunction, genetic polymorphism (fat mass and obesity\u2010associated genes) and accumulation of advanced glycation end\u2010products. Diabetes is associated with early onset, and progression of muscle weakness and sarcopenia, thus resulting in diminished daily life function. The type and duration of diabetes, insulin section\/resistance, hyperglycemia, diabetic neuropathy, malnutrition and low physical activity might affect muscular loss and weakness. To prevent the decline in daily activities in older adults with diabetes, resistance training or multicomponent exercise should be recommended. To maintain muscle function, optimal energy and sufficient protein intake are necessary. Although no specific drug enhances muscle mass and function, antidiabetic drugs that increase insulin sensitivity or secretion could be candidates for improvement of sarcopenia. The goals of glycemic control for older patients are determined based on three functional categories through an assessment of cognitive function and activities of daily living, and the presence or absence of medications that pose a hypoglycemic risk. As these functional categories are associated with muscle weakness, frailty and mortality risk, providing multimodal interventions (exercise, nutrition, social network or support and optimal medical treatment) is important, starting at the category\u2009II stage for maintenance or improvement in daily life functions. <jats:bold>Geriatr Gerontol Int 2022; 22: 110\u2013120<\/jats:bold>.<\/jats:p>","DOI":"10.1111\/ggi.14339","type":"journal-article","created":{"date-parts":[[2022,1,5]],"date-time":"2022-01-05T23:39:06Z","timestamp":1641425946000},"page":"110-120","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":48,"title":["Skeletal muscle as a treatment target for older adults with diabetes mellitus: The importance of a multimodal intervention based on functional category"],"prefix":"10.1111","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5490-8653","authenticated-orcid":false,"given":"Takuya","family":"Omura","sequence":"first","affiliation":[{"name":"Department of Diabetes, Metabolism and Endocrinology Tokyo Metropolitan Geriatric Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9088-2841","authenticated-orcid":false,"given":"Atsushi","family":"Araki","sequence":"additional","affiliation":[{"name":"Department of Diabetes, Metabolism and Endocrinology Tokyo Metropolitan Geriatric Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,1,5]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/ggi.12688"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu12113367"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.4103\/jrms.JRMS_242_19"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.abe5017"},{"key":"e_1_2_14_6_1","unstructured":"Dietary Reference Intakes for Japanese2020Ministry of Health Labour and Welfare Japan(in Japanese). 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