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“Metabolic and cardiovascular response to exercise in patients with type 1 diabetes”

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Abstract

Purpose

Physical activity is an effective therapeutic tool for cardiovascular risk prevention. However, exercise aerobic capacity of patients with type 1 diabetes (T1DM) has not been thoroughly investigated. Aim of the present study is to evaluate exercise aerobic capacity in patients with T1DM compared to a normal control population.

Methods

This observational study included 17 T1DM patients and 17 matched healthy volunteers. Cardiopulmonary exercise test (CPET) was conducted on an electronically-braked cycle ergometer. Blood samples were collected for evaluation of glycemia and lactate levels.

Results

Mean oxygen uptake at peak exercise (VʹO2,peak) was significantly lower in T1DM subjects (V′O2,peak T1DM 2200 ± 132ml/min vs VʹO2,peak Healthy subjects of 2659 ± 120 ml/min p = 0.035). Cardiovascular response analysis did not show statistically significant differences. Respiratory exchange ratio (RER) was significantly higher in healthy subjects at peak exercise and at the first minute of recovery (p = 0.022, p = 0.024). Peak exercise lactate levels were significantly higher in healthy subjects. There was no statistical correlation between CPET results and diabetes-related parameters.

Conclusions

Patients affected by T1DM have a worse exercise tolerance than normal subjects. The two groups differed by RER which can be greatly influenced by the substrate type utilized to produce energy. Because of the impaired carbohydrate utilization, T1DM subjects may use a larger amount of lipid substrates, such hypothesis could be strengthened by the lower lactate levels found in T1DM group at peak exercise. The lack of correlation between exercise tolerance and disease-related variables suggests that the alterations found could be independent from the glycemic levels.

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Authors and Affiliations

  1. Department of Public Health and Infectious Diseases, Sapienza University of Rome, Viale dell’ Università 37, 00185, Rome, Italy

    I. Turinese, P. Marinelli, M. Bonini, M. Rossetti, G. Statuto & P. Palange

  2. Department of Experimental Medicine, “Sapienza” University of Rome, Viale del Policlinico 151, 00185, Rome, Italy

    T. Filardi, A. Lenzi & S. Morano

  3. Department of Clinical Medicine, “Sapienza” University of Rome, Viale dell’ Università 37, 00185, Rome, Italy

    A. Paris

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  1. I. Turinese
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  2. P. Marinelli
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  3. M. Bonini
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  4. M. Rossetti
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  5. G. Statuto
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Correspondence to I. Turinese.

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The authors declare that they have no competing interests.

Ethical approval

The study was conducted in compliance with ethical standards, research involving human subjects.

Informed consent

Written informed consent was obtained from each subject. The study was approved by the Internal Review Board (IRB) and the local Ethics Committee.

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Turinese, I., Marinelli, P., Bonini, M. et al. “Metabolic and cardiovascular response to exercise in patients with type 1 diabetes”. J Endocrinol Invest 40, 999–1005 (2017). https://doi.org/10.1007/s40618-017-0670-6

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  • DOI: https://doi.org/10.1007/s40618-017-0670-6

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