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Life-long physical activity restores metabolic and cardiovascular function in type 2 diabetes

  • Original Article
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European Journal of Applied Physiology Aims and scope Submit manuscript

Abstract

Purpose

Short-to-moderate duration exercise training improves fitness and lowers cardiovascular risk in type 2 diabetes (T2DM). However, the impact of long-term compliance to an active lifestyle of T2DM patients on cardiovascular risk factors has never been studied but could provide information on the maximal achievable health effect of physical activity in T2DM. This study examined the impact of a life-long active lifestyle by comparing physical fitness, cardiovascular risk and vascular function between long-term physically active T2DM patients versus sedentary T2DM patients and controls.

Methods

Fitness, HOMA-IR, brachial artery flow-mediated dilation (FMD) and lifetime risk for cardiovascular disease were assessed in 15 exercising T2DM patients, 12 age-, sex- and weight-matched sedentary T2DM patients and 9 sedentary men free of established cardiovascular and metabolic disease as controls. Long-term regular exercise was defined as self-reported participation of >2.5 h of (predominantly) endurance exercise per week, which was performed for 18–47 years.

Results

Sedentary T2DM patients showed lower fitness (21.8 ± 2.3, 32.6 ± 6.0 and 31.1 ± 3.2 ml O2/kg/min), higher HOMA-IR (8.3 ± 5.0, 2.0 ± 1.8 and 1.1 ± 0.5 100/%S) and higher lifetime risk scores (17.3 ± 5.4, 9.3 ± 5.0 and 8.9 ± 3.9 %) compared to active peers and controls, respectively. Brachial artery FMD was lower in sedentary T2DM patients compared with active peers, but not in controls (3.3 ± 1.2, 5.2 ± 2.1 and 3.8 ± 1.2 %).

Conclusions

Life-long active T2DM patients have superior fitness levels, HOMA-IR, cardiovascular risk and FMD compared to sedentary peers, whilst no differences were found when compared to controls. This study provides evidence that a life-long active lifestyle, even in T2DM, may be able to effectively normalize cardiovascular risk.

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Abbreviations

ACSM:

American College of Sports Medicine

ANOVA:

Analysis of variance

BA:

Brachial artery

bpm:

Beats per minute

CADC:

Conduit artery dilator capacity

CCA:

Common carotid artery

Deg:

Degrees

FMD:

Flow-mediated dilation

GTN:

Glyceryl trinitrate

HR:

Heart rate

IPAQ:

International Physical Activity Questionnaire

IR:

Insulin resistance

LRS:

Lifetime Risk Score for cardiovascular disease

METs:

Metabolic equivalents

NO:

Nitric oxide

rpm:

Rotations per minute

RQ:

Respiratory quotient

SD:

Standard deviation

SE:

Standard error

T2DM:

Type 2 diabetes mellitus

Ve:

Ventilation

VO2 :

Volume of oxygen consumption

VO2max:

Maximal volume of oxygen consumption

W:

Watt

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Acknowledgments

We acknowledge the help of Ronique Timmer (Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands) with the inclusion of the research population as well as the planning of the measurements. We acknowledge the help of Jos Evers (Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands) with the execution of the incremental cycling tests. DHJT is financially supported by the Dutch Heart Foundation (E Dekker stipend, 2009T064) and Actelion BV (2009 Actelion Endothelin Research Award).

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Authors and Affiliations

  1. Department of Physiology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands

    Tim H. A. Schreuder, Martijn F. H. Maessen, Dick H. J. Thijssen & Maria T. E. Hopman

  2. Department of Internal Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands

    Cees J. Tack

  3. Research Institute for Sports and Exercise Sciences, Liverpool John Moores University, Tom Reilly Building, Byrom Street, Liverpool, L3 3AF, UK

    Dick H. J. Thijssen

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  1. Tim H. A. Schreuder
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  2. Martijn F. H. Maessen
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  3. Cees J. Tack
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  4. Dick H. J. Thijssen
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  5. Maria T. E. Hopman
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Correspondence to Tim H. A. Schreuder.

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Communicated by Fabio Fischetti.

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Schreuder, T.H.A., Maessen, M.F.H., Tack, C.J. et al. Life-long physical activity restores metabolic and cardiovascular function in type 2 diabetes. Eur J Appl Physiol 114, 619–627 (2014). https://doi.org/10.1007/s00421-013-2794-5

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