Supplementary Material



Background: This short term structured, multimodal, home-based, self-help program was designed to reduce frailty of elderly type 2 diabetes mellitus (T2DM) patients, and detect the major predictors of frailty status improvement.

Method: This study recruited T2DM patients aged 65 years and older from theDMshared care center in a regional hospital whowere frail or prefrail according to Fried Frailty Phenotype. Short term (12weeks) home-based intervention including an elastic band low resistance exercise, a smart bracelet monitored walking exercise, and nutrition consultation was conducted. Change of frailty status, functional outcomes, body composition and metabolic indices after intervention were analyzed. A logistic regression was applied to determine the predictive factors associated with frailty status improvement.

Results: 81 participants were enrolled after they were fully consented. After 12 weeks' intervention, 60 participants completed the program. Since two participants with incomplete data were excluded, there were 58 remaining in the analysis. They were on average 71.7 ± 4.9 years old and 22 persons (36.7%) were male. 46 (79.3%) of them were prefrail and 12 (20.7%) were frail. The average duration between the pre-test and the post-testwas 107.1 ± 25.6 days. The average incidence of home-based exercisewas 1.4 ± 1.1 times a week. Fried Frailty Phenotype, handgrip strength, muscle quality, HbA1c, and symptomatic hypoglycemic episodes significantly improved. Initial poorer frailty status was the major predictor (OR = 104.446, 95% CI = 7.551–1444.726, p = 0.001) of frailty status improvement.

Conclusions: Short term structured, multimodal, interdisciplinary, home-based, self-help program is effective in reducing frailty status among elderly T2DM patients.