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Differential Patterns of Impaired Cardiorespiratory Fitness and Cardiac Autonomic Dysfunction in Recently Diagnosed Type 1 and Type 2 Diabetes.
- Source :
-
Diabetes care [Diabetes Care] 2017 Feb; Vol. 40 (2), pp. 246-252. Date of Electronic Publication: 2016 Nov 29. - Publication Year :
- 2017
-
Abstract
- Objective: Both impaired cardiorespiratory fitness (CRF) and heart rate variability (HRV) are predictors of mortality, but their relative roles in recent-onset diabetes are unknown. We determined to which extent CRF and HRV are reduced and interrelated in recent-onset diabetes.<br />Research Design and Methods: Participants from the German Diabetes Study with type 1 (n = 163) or type 2 (n = 188) diabetes with known diabetes duration <1 year and two age-matched glucose-tolerant control groups (n = 40 each) underwent spiroergometry and HRV assessment during a hyperinsulinemic-euglycemic clamp.<br />Results: Compared with control subjects, patients with type 2 diabetes showed reduced VO <subscript>2max</subscript> (median [1st-3rd quartiles] 19.3 [16.5-22.9] vs. 25.6 [20.7-29.9] mL/kg body weight/min; P < 0.05), diminished VCO <subscript>2max</subscript> (23.0 [19.1-26.8] vs. 30.9 [24.5-34.4] mL/kg body weight/min; P < 0.05), blunted heart rate recovery after 2 min (-29.0 [-35.0 to -23.0] vs. -36.0 [-42.8 to -28.0] beats/min; P < 0.05), and reduced HRV in four of nine indices, whereas patients with type 1 diabetes had unaltered CRF but reduced HRV in three of nine indices (P < 0.05), indicating diminished vagal and sympathetic HRV modulation. HRV measures correlated with VO <subscript>2max</subscript> in patients with type 1 diabetes (r >0.34; P < 0.05) but not in those with type 2 diabetes.<br />Conclusions: CRF is reduced in recently diagnosed type 2 diabetes but preserved in type 1 diabetes, whereas cardiac autonomic function is reduced in both diabetes types but is strongly associated with CRF only in type 1 diabetes. These results support the therapeutic concept of promoting physical fitness in the early course of diabetes.<br /> (© 2017 by the American Diabetes Association.)
- Subjects :
- Adolescent
Adult
Aged
Autonomic Nervous System Diseases complications
Creatinine blood
Cross-Sectional Studies
Diabetes Mellitus, Type 1 complications
Diabetes Mellitus, Type 2 complications
Electric Impedance
Female
Germany
Glycated Hemoglobin
Heart Diseases complications
Heart Rate
Humans
Insulin Resistance
Male
Middle Aged
Prospective Studies
Young Adult
Autonomic Nervous System physiopathology
Autonomic Nervous System Diseases diagnosis
Cardiorespiratory Fitness
Diabetes Mellitus, Type 1 diagnosis
Diabetes Mellitus, Type 2 diagnosis
Heart Diseases diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 1935-5548
- Volume :
- 40
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Diabetes care
- Publication Type :
- Academic Journal
- Accession number :
- 27899499
- Full Text :
- https://doi.org/10.2337/dc16-1898