European Journal of Applied Physiology

, Volume 111, Issue 3, pp 567–578

Glycemic control influences lung membrane diffusion and oxygen saturation in exercise-trained subjects with type 1 diabetes

Alveolar-capillary membrane conductance in type 1 diabetes
  • Courtney M. Wheatley
  • James C. Baldi
  • Nicholas A. Cassuto
  • William T. Foxx-Lupo
  • Eric M. Snyder
Original Article

DOI: 10.1007/s00421-010-1663-8

Cite this article as:
Wheatley, C.M., Baldi, J.C., Cassuto, N.A. et al. Eur J Appl Physiol (2011) 111: 567. doi:10.1007/s00421-010-1663-8

Abstract

Lung diffusing capacity (DLCO) is influenced by alveolar-capillary membrane conductance (DM) and pulmonary capillary blood volume (VC), both of which can be impaired in sedentary type 1 diabetes mellitus (T1DM) subjects due to hyperglycemia. We sought to determine if T1DM, and glycemic control, affected DLNO, DLCO, DM, VC and SaO2 during maximal exercise in aerobically fit T1DM subjects. We recruited 12 T1DM subjects and 18 non-diabetic subjects measuring DLNO, DLCO, DM, and VC along with SaO2 and cardiac output (Q) at peak exercise. The T1DM subjects had significantly lower DLCO/Q and DM/Q with no difference in Q, DLNO, DLCO, DM, or VC (DLCO/Q = 2.1 ± 0.4 vs. 1.7 ± 0.3, DM/Q = 2.8 ± 0.6 vs. 2.4 ± 0.5, non-diabetic and T1DM, p < 0.05). In addition, when considering all subjects there was a relationship between DLCO/Q and SaO2 at peak exercise (r = 0.46, p = 0.01). Within the T1DM group, the optimal glycemic control group (HbA1c <7%, n = 6) had higher DLNO, DLCO, and DM/Q than the poor glycemic control subjects (HbA1c ≥7%, n = 6) at peak exercise (DLCO = 38.3 ± 8.0 vs. 28.5 ± 6.9 ml/min/mmHg, DLNO = 120.3 ± 24.3 vs. 89.1 ± 21.0 ml/min/mmHg, DM/Q = 3.8 ± 0.8 vs. 2.7 ± 0.2, optimal vs. poor control, p < 0.05). There was a negative correlation between HbA1c with DLCO, DM and DM/Q at peak exercise (DLCO: r = −0.70, p = 0.01; DM: r = −0.70, p = 0.01; DM/Q: r = −0.68, p = 0.02). These results demonstrate that there is a reduction in lung diffusing capacity in aerobically fit athletes with T1DM at peak exercise, but suggests that maintaining near-normoglycemia potentially averts lung diffusion impairments.

Keywords

Lung diffusion Cycle Diabetes Oxygen saturation Alveolar-capillary membrane conductance Pulmonary capillary blood volume 

Abbreviations

HbA1c

Glycosylated hemoglobin

DLCO

Diffusion of the lung for carbon monoxide

DLNO

Diffusion of the lung for nitric oxide

DM

Alveolar-capillary membrane conductance

VC

Pulmonary capillary blood volume

Q

Cardiac output

DLCO/Q

DLCO corrected for Q

DM/Q

DM corrected for Q

SaO2

Peripheral oxygen saturation

MTT

Mean transit time

FVC

Forced vital capacity

FEF25–75

Forced expiratory flow at 27–75% of forced vital capacity

FEF50

Expiratory flow at 50% of forced vital capacity

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Courtney M. Wheatley
    • 1
  • James C. Baldi
    • 2
  • Nicholas A. Cassuto
    • 1
  • William T. Foxx-Lupo
    • 1
  • Eric M. Snyder
    • 1
  1. 1.Department of Pharmacy Practice and ScienceUniversity of ArizonaTucsonUSA
  2. 2.Department of Biological SciencesNorthern Arizona UniversityFlagstaffUSA

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