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The impact of type 1 diabetes and diabetic polyneuropathy on muscle strength and fatigability

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Abstract

Aims

Although it is widely accepted that diabetic polyneuropathy (DPN) is linked to a marked decline in neuromuscular performance, information on the possible impact of type 1 diabetes (T1D) on muscle strength and fatigue remains unclear. The purpose of this study was to investigate the effects of T1D and DPN on strength and fatigability in knee extensor muscles.

Methods

Thirty-one T1D patients (T1D), 22 T1D patients with DPN (DPN) and 23 matched healthy control participants (C) were enrolled. Maximal voluntary contraction (MVC) and endurance time at an intensity level of 50% of the MVC were assessed at the knee extensor muscles with an isometric dynamometer. Clinical characteristics of diabetic patients were assessed by considering a wide range of vascular and neurological parameters.

Results

DPN group had lower knee extensor muscles strength than T1D (−19%) and the C group (−37.5%). T1D group was 22% weaker when compared to the C group. Lower body muscle fatigability of DPN group was 22 and 45.5% higher than T1D and C group, respectively. T1D group possessed a higher fatigability (29.4%) compared to C group. A correlation was found between motor and sensory nerve conduction velocity and muscle strength and fatigability.

Conclusions

Patients with T1D are characterised by both a higher fatigability and a lower muscle strength, which are aggravated by DPN. Our data suggest that factors other than nervous damage play a role in the pathogenesis of such defect.

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Authors and Affiliations

  1. Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Piazza Lauro De Bosis, 15, 00135, Rome, Italy

    Giorgio Orlando, Ilenia Bazzucchi & Massimo Sacchetti

  2. Department of Clinical and Molecular Medicine, “La Sapienza” University, Rome, Italy

    Stefano Balducci & Giuseppe Pugliese

  3. Diabetes Unit, Sant’Andrea Hospital, Rome, Italy

    Stefano Balducci & Giuseppe Pugliese

  4. Metabolic Fitness Association, Monterotondo, Rome, Italy

    Stefano Balducci

Authors
  1. Giorgio Orlando
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  2. Stefano Balducci
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  3. Ilenia Bazzucchi
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  4. Giuseppe Pugliese
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  5. Massimo Sacchetti
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Corresponding author

Correspondence to Massimo Sacchetti.

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Ethical standard

All procedures were in accordance with the ethical standards of the institutional and national research committee and with the 1975 Helsinki Declaration and its later amendments.

Human and animal rights

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008.

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Informed consent was obtained from all individual participants included in the study.

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Managed by Massimo Porta.

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Orlando, G., Balducci, S., Bazzucchi, I. et al. The impact of type 1 diabetes and diabetic polyneuropathy on muscle strength and fatigability. Acta Diabetol 54, 543–550 (2017). https://doi.org/10.1007/s00592-017-0979-9

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  • DOI: https://doi.org/10.1007/s00592-017-0979-9

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