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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
  • 28
    Citations
  • 0
    Usage
  • 81
    Captures
  • 0
    Mentions
  • 20
    Social Media
Metric Options:   Counts1 Year3 Year

Metrics Details

  • Citations
    28
  • Captures
    81
  • Social Media
    20
    • Shares, Likes & Comments
      20
      • Facebook
        20

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

Martin Röhling; Alexander Strom; Gidon Bönhof; Sonja Püttgen; Kálmán Bódis; Karsten Müssig; Julia Szendrödi; Daniel Markgraf; Michael Roden; Dan Ziegler; Stefan Lehr; A. E. Buyken; J. Eckel; G. Geerling; H. Al-Hasani; C. Herder; A. Icks; J. Kotzka; O. Kuss; E. Lammert; J. Lundbom; D. Markgraf; K. Müssig; W. Rathmann; J. Szendrödi; D. Ziegler; M. Roden

American Diabetes Association

Medicine; Nursing

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