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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

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Abstract

Lung diffusing capacity (DLCO) is influenced by alveolar-capillary membrane conductance (D M) and pulmonary capillary blood volume (V C), 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, D M, V C and SaO2 during maximal exercise in aerobically fit T1DM subjects. We recruited 12 T1DM subjects and 18 non-diabetic subjects measuring DLNO, DLCO, D M, and V C along with SaO2 and cardiac output (Q) at peak exercise. The T1DM subjects had significantly lower DLCO/Q and D M/Q with no difference in Q, DLNO, DLCO, D M, or V C (DLCO/Q = 2.1 ± 0.4 vs. 1.7 ± 0.3, D M/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 D M/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, D M/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, D M and D M/Q at peak exercise (DLCO: r = −0.70, p = 0.01; D M: r = −0.70, p = 0.01; D M/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.

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Abbreviations

HbA1c:

Glycosylated hemoglobin

DLCO:

Diffusion of the lung for carbon monoxide

DLNO:

Diffusion of the lung for nitric oxide

D M :

Alveolar-capillary membrane conductance

V C :

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

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Authors and Affiliations

  1. Department of Pharmacy Practice and Science, University of Arizona, 1703 E. Mabel, Tucson, AZ, 85721, USA

    Courtney M. Wheatley, Nicholas A. Cassuto, William T. Foxx-Lupo & Eric M. Snyder

  2. Department of Biological Sciences, Northern Arizona University, Flagstaff, AZ, USA

    James C. Baldi

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  1. Courtney M. Wheatley
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  2. James C. Baldi
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  3. Nicholas A. Cassuto
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  4. William T. Foxx-Lupo
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  5. Eric M. Snyder
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Correspondence to Eric M. Snyder.

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Communicated by Susan Ward.

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Wheatley, C.M., Baldi, J.C., Cassuto, N.A. et al. Glycemic control influences lung membrane diffusion and oxygen saturation in exercise-trained subjects with type 1 diabetes. Eur J Appl Physiol 111, 567–578 (2011). https://doi.org/10.1007/s00421-010-1663-8

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