Differential patterns of impaired cardiorespiratory fitness and cardiac autonomic dysfunction in recently diagnosed type 1 and type 2 diabetes
Diabetes Care, ISSN: 1935-5548, Vol: 40, Issue: 2, Page: 246-252
2017
- 28Citations
- 81Captures
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Metrics Details
- Citations28
- Citation Indexes28
- 28
- CrossRef23
- Captures81
- Readers81
- 81
Article Description
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. RESEARCH DESIGN AND METHODS: Participants from the German Diabetes Study with type 1 (n = 163)or type2 (n = 188) diabetes with known diabetes duration <1 year and two age-matched glucosetolerant control groups (n = 40 each) underwent spiroergometry and HRV assessment during a hyperinsulinemic-euglycemic clamp. RESULTS: Compared with control subjects, patients with type 2 diabetes showed reduced VO (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 (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, where as 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 in patients with type 1 diabetes (r >0.34; P < 0.05) but not in those with type 2 diabetes. 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.
Bibliographic Details
http://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=85011635910&origin=inward; http://dx.doi.org/10.2337/dc16-1898; https://clinicaltrials.gov/ct2/show/NCT01055093; http://www.ncbi.nlm.nih.gov/pubmed/27899499; https://diabetesjournals.org/care/article/40/2/246/37058/Differential-Patterns-of-Impaired; https://dx.doi.org/10.2337/dc16-1898; https://care.diabetesjournals.org/content/40/2/246
American Diabetes Association
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