{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T22:48:51Z","timestamp":1784674131025,"version":"3.55.0"},"reference-count":57,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2020,9,29]],"date-time":"2020-09-29T00:00:00Z","timestamp":1601337600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Top Sector AgriFood, The Netherlands","award":["AF12174"],"award-info":[{"award-number":["AF12174"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>(1) Background: Recent research showed that subtypes of patients with type 2 diabetes may differ in response to lifestyle interventions based on their organ-specific insulin resistance (IR). (2) Methods: 123 Subjects with type 2 diabetes were randomized into 13-week lifestyle intervention, receiving either an enriched protein drink (protein+) or an isocaloric control drink (control). Before and after the intervention, anthropometrical and physiological data was collected. An oral glucose tolerance test was used to calculate indices representing organ insulin resistance (muscle, liver, and adipose tissue) and \u03b2-cell functioning. In 82 study-compliant subjects (per-protocol), we retrospectively examined the intervention effect in patients with muscle IR (MIR, n = 42) and without MIR (no-MIR, n = 40). (3) Results: Only in patients from the MIR subgroup that received protein+ drink, fasting plasma glucose and insulin, whole body, liver and adipose IR, and appendicular skeletal muscle mass improved versus control. Lifestyle intervention improved body weight and fat mass in both subgroups. Furthermore, for the MIR subgroup decreased systolic blood pressure and increased VO2peak and for the no-MIR subgroup, a decreased 2-h glucose concentration was found. (4) Conclusions: Enriched protein drink during combined lifestyle intervention seems to be especially effective on increasing muscle mass and improving insulin resistance in obese older, type 2 diabetes patients with muscle IR.<\/jats:p>","DOI":"10.3390\/nu12102979","type":"journal-article","created":{"date-parts":[[2020,9,29]],"date-time":"2020-09-29T08:43:27Z","timestamp":1601369007000},"page":"2979","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Obese Older Type 2 Diabetes Mellitus Patients with Muscle Insulin Resistance Benefit from an Enriched Protein Drink during Combined Lifestyle Intervention: The PROBE Study"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6962-2674","authenticated-orcid":false,"given":"Wilrike J.","family":"Pasman","sequence":"first","affiliation":[{"name":"Netherlands Organisation for Applied Scientific Research (TNO), 3704 HE Zeist, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0780-7360","authenticated-orcid":false,"given":"Robert G.","family":"Memelink","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Dietetics, Faculty of Sports and Nutrition, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, 1067 SM Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5249-3992","authenticated-orcid":false,"given":"Johan","family":"de Vogel-Van den Bosch","sequence":"additional","affiliation":[{"name":"Danone Nutricia Research, 3584 CT Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark P. V.","family":"Begieneman","sequence":"additional","affiliation":[{"name":"Netherlands Organisation for Applied Scientific Research (TNO), 3704 HE Zeist, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4493-2382","authenticated-orcid":false,"given":"Willem J.","family":"van den Brink","sequence":"additional","affiliation":[{"name":"Netherlands Organisation for Applied Scientific Research (TNO), 3704 HE Zeist, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8281-0426","authenticated-orcid":false,"given":"Peter J. M.","family":"Weijs","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Dietetics, Faculty of Sports and Nutrition, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, 1067 SM Amsterdam, The Netherlands"},{"name":"Department of Nutrition and Dietetics, Amsterdam University Medical Centres, Vrije Universiteit, 1081 HV Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9612-657X","authenticated-orcid":false,"given":"Suzan","family":"Wopereis","sequence":"additional","affiliation":[{"name":"Netherlands Organisation for Applied Scientific Research (TNO), 3704 HE Zeist, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,9,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2506","DOI":"10.1007\/s00125-011-2204-7","article-title":"Reversal of Type 2 Diabetes: Normalisation of Beta Cell Function in Association with Decreased Pancreas and Liver Triacylglycerol","volume":"54","author":"Lim","year":"2011","journal-title":"Diabetologia"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"158","DOI":"10.2337\/dc15-0750","article-title":"Weight Loss Decreases Excess Pancreatic Triacylglycerol Specifically in Type 2 Diabetes","volume":"39","author":"Steven","year":"2016","journal-title":"Diabetes Care"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"808","DOI":"10.2337\/dc15-1942","article-title":"Very Low-Calorie Diet and 6 Months of Weight Stability in Type 2 Diabetes: Pathophysiological Changes in Responders and Nonresponders","volume":"39","author":"Steven","year":"2016","journal-title":"Diabetes Care"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1016\/S0140-6736(17)33102-1","article-title":"Primary Care-Led Weight Management for Remission of Type 2 Diabetes (DiRECT): An Open-Label, Cluster-Randomised Trial","volume":"391","author":"Lean","year":"2018","journal-title":"Lancet"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1007\/s00394-012-0338-0","article-title":"Comparison of the Effects of Weight Loss from a High-Protein versus Standard-Protein Energy-Restricted Diet on Strength and Aerobic Capacity in Overweight and Obese Men","volume":"52","author":"Wycherley","year":"2013","journal-title":"Eur. 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