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Jlali I, Touil I, Ibn Haj Amor H, Bouzid MA, Hammouda O, Heyman E, Fontaine P, Chtourou H, Rabasa-Lhoret R, Baquet G, Tagougui S. Impaired muscle oxygenation despite normal pulmonary function in type 2 diabetes without complications. Am J Physiol Endocrinol Metab 2024; 326:E640-E647. [PMID: 38536038 DOI: 10.1152/ajpendo.00392.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 03/22/2024] [Accepted: 03/24/2024] [Indexed: 05/01/2024]
Abstract
Long-term hyperglycemia in individuals with type 2 diabetes (T2D) can detrimentally impact pulmonary function and muscle oxygenation. As a result, these factors can impede the body's adaptation to physical exertion. We aimed to evaluate the oxygen pathway during maximal exercise among overweight/obese individuals with type 2 diabetes free from complications, in comparison with a group of matched overweight/obese individuals without diabetes, specifically concentrating on the effects on pulmonary function and muscle oxygenation. Fifteen overweight/obese adults with type 2 diabetes [glycated hemoglobin (HbA1c) = 8.3 ± 1.2%] and 15 matched overweight/obese adults without diabetes underwent pre- and post exercise lung function assessment. A maximal incremental exercise test was conducted, monitoring muscle oxygenation using near-infrared spectroscopy and collecting arterial blood gas samples. Both groups exhibited normal lung volumes at rest and after exercise. Spirometric lung function did not significantly differ pre- and post exercise in either group. During maximal exercise, the type 2 diabetes group showed significantly lower augmentation in total hemoglobin and deoxygenated hemoglobin compared with the control group. Despite comparable usual physical activity levels and comparable heart rates at exhaustion, the type 2 diabetes group had a lower peak oxygen consumption than controls. No significant differences were found in arterial blood gas analyses ([Formula: see text], [Formula: see text], [Formula: see text], and [Formula: see text]) between the groups. Individuals with type 2 diabetes free from complications displayed normal pulmonary function at rest and post exercise. However, impaired skeletal muscle oxygenation during exercise, resulting from reduced limb blood volume and altered muscle deoxygenation, may contribute to the lower V̇o2peak observed in this population.NEW & NOTEWORTHY Individuals with type 2 diabetes free from micro- and macrovascular complications have normal resting pulmonary function, but their V̇o2peak is impaired due to poor skeletal muscle oxygenation during exercise. Tailoring exercise regimes for this population should prioritize interventions aimed at enhancing muscle oxygenation and blood flow improvement.
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Affiliation(s)
- Islem Jlali
- Univ. Lille, Univ. Artois, Univ. Littoral Côte d'Opale, ULR 7369 - URePSSS - Unité de Recherche Pluridisciplinaire Sport Santé Société, Lille, France
| | - Imen Touil
- Pulmonology Department, Taher Sfar Hospital, Mahdia, Tunisia
| | | | - Mohamed Amine Bouzid
- UR15JS01: Education, Motricité, Sport et Santé (EM2S), High Institute of Sport and Physical Education, University of Sfax, Sfax, Tunisia
| | - Omar Hammouda
- Interdisciplinary Laboratory in Neurosciences, Physiology and Psychology: Physical Activity, Health and Learning (LINP2), UFR STAPS, UPL, Paris Nanterre University, Nanterre, France
| | - Elsa Heyman
- Univ. Lille, Univ. Artois, Univ. Littoral Côte d'Opale, ULR 7369 - URePSSS - Unité de Recherche Pluridisciplinaire Sport Santé Société, Lille, France
- Institut Universitaire de France (IUF), Paris, France
| | - Pierre Fontaine
- Department of Diabetology, University Hospital, Lille, France
| | - Hamdi Chtourou
- Higher Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
- Physical Activity, Sport, and Health, UR18JS01, National Observatory of Sport, Tunis, Tunisia
| | | | - Georges Baquet
- Univ. Lille, Univ. Artois, Univ. Littoral Côte d'Opale, ULR 7369 - URePSSS - Unité de Recherche Pluridisciplinaire Sport Santé Société, Lille, France
| | - Sémah Tagougui
- Univ. Lille, Univ. Artois, Univ. Littoral Côte d'Opale, ULR 7369 - URePSSS - Unité de Recherche Pluridisciplinaire Sport Santé Société, Lille, France
- Montreal Clinical Research Institute, Montreal, Quebec, Canada
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Liu BB, Niu ZR, Jia XJ, Liu XL, Lu Q. Correlation between Insulin Resistance and Cardiopulmonary Function during Physical Exams for Male Patients. Am J Health Behav 2022; 46:600-605. [PMID: 36721285 DOI: 10.5993/ajhb.46.6.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Objective: In this study, we investigated the correlation between insulin resistance (IR) and cardiopulmonary function during physical exams for male patients. Methods: We selected 124 healthy male participants in the physical examination center of our hospital. They were divided into 3 groups according to the homeostasis model assessment of insulin resistance values. The oxygen uptake, peak oxygen uptake (VO₂/kg), heart rate, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured by a cardiopulmonary exercise function tester. We analyzed the correlation between the index of IR and cardiopulmonary function. Results: There were statistically significant differences in body mass index, waist circumference, fasting insulin level, anaerobic threshold SBP, maximum VO2/kg and maximum SBP among the 3 groups (p<.05). However, no significant difference was found in SBP, DBP, total cholesterol, low-density lipoprotein cholesterol and fasting blood glucose levels (p>.05). The anaerobic threshold SBP, maximum VO2/kg and maximum SBP were all negatively correlated with the IR index. Conclusion: Our results indicate that IR is associated with cardiopulmonary function and that there are different correlations between the various cardiopulmonary function indexes and IR.
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Affiliation(s)
- Bin-Bin Liu
- Bin-Bin Liu, Department of Functional Inspection, Qinhuangdao First Hospital, Qinhuangdao, China
| | - Zi-Ru Niu
- Zi-Ru Niu, Department of Endocrinology and Metabolic Diseases, Hebei Medical University, Shijiazhuang, China
| | - Xiao-Jiao Jia
- Xiao-Jiao Jia, Department of Endocrinology, Qinhuangdao First Hospital, Qinhuangdao, China
| | - Xiao-Li Liu
- Xiao-Li Liu, Department of Endocrinology, Qinhuangdao First Hospital, Qinhuangdao, China
| | - Qiang Lu
- Qiang Lu, Department of Endocrinology, Qinhuangdao First Hospital, Qinhuangdao, China;,
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Baioccato V, Quinto G, Rovai S, Conte F, Dassie F, Neunhäeuserer D, Vecchiato M, Palermi S, Gasperetti A, Bullo V, Camozzi V, Vettor R, Ermolao A, Mioni R. Do Androgenic Pattern, Insulin State and Growth Hormone Affect Cardiorespiratory Fitness and Strength in Young Women with PCOS? Biomedicines 2022; 10:biomedicines10092176. [PMID: 36140277 PMCID: PMC9496105 DOI: 10.3390/biomedicines10092176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 08/25/2022] [Accepted: 08/29/2022] [Indexed: 11/30/2022] Open
Abstract
In this study, cardiorespiratory fitness (CRF) and strength level were assessed in women with and without polycystic ovary syndrome (PCOS), matched for age, body composition, androgenic pattern and insulinemic pattern. Patients with and without PCOS were evaluated at the Endocrinology Unit and Sport Medicine Division to assess endocrinological (insulinemic, androgenic pattern and growth hormone), anthropometric (with DEXA) and functional parameters (with cardiopulmonary exercise test and handgrip test), as well as physical activity level (with the Global Physical Activity Questionnaire). A total of 31 patients with PCOS and 13 controls were included. No statistically significant differences were found between groups in terms of age, body mass index, body composition, androgenic pattern, insulin state, growth hormone and physical activity level. The PCOS group demonstrated significantly better cardiorespiratory fitness (VO2max per kg (30.9 ± 7.6 vs. 24.8 ± 4.1 mL/kg/min; p = 0.010), VO2max per kg of fat-free mass (52.4 ± 8.9 vs. 45.3 ± 6.2 mL/kg/min; p = 0.018)), strength levels (handgrip per kg (0.36 ± 0.09 vs. 0.30 ± 0.08; p = 0.009), handgrip per kg of fat-free mass (13.03 ± 2.32 vs. 11.50 ± 1.91; p = 0.001)) and exercise capacity (METs at test (14.4 ± 2.72 vs. 12.5 ± 1.72 METs; p = 0.019)). In this study, women with PCOS showed a better cardiorespiratory fitness and strength than the control group. The only determinant that could explain the differences observed seems to be the presence of the syndrome itself. These results suggest that PCOS per se does not limit exercise capacity and does not exclude good functional capacity.
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Affiliation(s)
- Veronica Baioccato
- Sport and Exercise Medicine Division, Department of Medicine, Padova University Hospital, Regional Centre for Exercise Prescription in Chronic Diseases, 35128 Veneto, Italy
- Correspondence: (V.B.); (G.Q.); (M.V.)
| | - Giulia Quinto
- Sport and Exercise Medicine Division, Department of Medicine, Padova University Hospital, Regional Centre for Exercise Prescription in Chronic Diseases, 35128 Veneto, Italy
- Correspondence: (V.B.); (G.Q.); (M.V.)
| | - Sara Rovai
- Sport and Exercise Medicine Division, Department of Medicine, Padova University Hospital, Regional Centre for Exercise Prescription in Chronic Diseases, 35128 Veneto, Italy
| | - Francesca Conte
- Sport and Exercise Medicine Division, Department of Medicine, Padova University Hospital, Regional Centre for Exercise Prescription in Chronic Diseases, 35128 Veneto, Italy
| | - Francesca Dassie
- Department of Medicine, Clinica Medica 3, Azienda Ospedaliera Padova, University of Padova, 35122 Padova, Italy
| | - Daniel Neunhäeuserer
- Sport and Exercise Medicine Division, Department of Medicine, Padova University Hospital, Regional Centre for Exercise Prescription in Chronic Diseases, 35128 Veneto, Italy
| | - Marco Vecchiato
- Sport and Exercise Medicine Division, Department of Medicine, Padova University Hospital, Regional Centre for Exercise Prescription in Chronic Diseases, 35128 Veneto, Italy
- Correspondence: (V.B.); (G.Q.); (M.V.)
| | - Stefano Palermi
- Public Health Department, University of Naples Federico II, 80138 Naples, Italy
| | - Andrea Gasperetti
- Sport and Exercise Medicine Division, Department of Medicine, Padova University Hospital, Regional Centre for Exercise Prescription in Chronic Diseases, 35128 Veneto, Italy
| | - Valentina Bullo
- Sport and Exercise Medicine Division, Department of Medicine, Padova University Hospital, Regional Centre for Exercise Prescription in Chronic Diseases, 35128 Veneto, Italy
| | - Valentina Camozzi
- Endocrinology Division, Department of Medicine, Padova University Hospital, 35128 Padova, Italy
| | - Roberto Vettor
- Department of Medicine, Clinica Medica 3, Azienda Ospedaliera Padova, University of Padova, 35122 Padova, Italy
| | - Andrea Ermolao
- Sport and Exercise Medicine Division, Department of Medicine, Padova University Hospital, Regional Centre for Exercise Prescription in Chronic Diseases, 35128 Veneto, Italy
| | - Roberto Mioni
- Department of Medicine, Clinica Medica 3, Azienda Ospedaliera Padova, University of Padova, 35122 Padova, Italy
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Liu BB, Niu ZR, Jia XJ, Liu XL, Lu Q. A Correlational Study on Cardiopulmonary Endurance in Male Patients with New-Onset Type 2 Diabetes. Diabetes Metab Syndr Obes 2022; 15:1365-1373. [PMID: 35528721 PMCID: PMC9075895 DOI: 10.2147/dmso.s352798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 04/01/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Cardiopulmonary exercise tests (CPETs) are widely used non-invasive and reliable functional evaluation methods. This study investigated the correlation between cardiopulmonary endurance indices and plasma glucose levels and abdominal visceral fat in males with new-onset type 2 diabetes. METHODS A total of 136 male individuals, who had been treated in the First Hospital of Qinhuangdao City, were selected to form a new-onset type 2 diabetes group (66 cases) and a control group (70 cases); individuals were divided into three groups (Q1, Q2, and Q3) from low to high according to their anaerobic threshold (AT) oxygen uptake (VO2), AT VO2/kg (VO2 per kg of body weight), peak VO2, peak VO2/kg, AT heart rate (HR), peak HR, and HR recovery after 1 minute. A cardiopulmonary exercise test was used to determine the VO2 of each group of subjects for VO2 max and AT VO2/kg, HR, and HR recovery after 1 minute. The differences in fat areas and plasma glucose levels were compared under different cardiorespiratory endurance indicators. RESULTS Compared with the control group, the abdominal visceral fat (AVF) area, fasting plasma glucose (FPG), and postprandial plasma glucose (PPG) levels increased in the new-onset type 2 diabetes group. Concurrently, AT VO2, AT VO2/kg, peak VO2, peak VO2/kg, AT HR, peak HR, and 1-minute HR recovery all decreased, and the difference between the groups was statistically significant (P<0.05). The higher the AT VO2 and peak VO2 values, the lower the PPG level (P<0.05) and the smaller the area of abdominal visceral fat (P<0.05). The AT VO2/kg and peak VO2/kg values were negatively correlated with the abdominal visceral fat area, while other indicators had no obvious relationship with either plasma glucose levels or the area of fat. CONCLUSION The levels of blood glucose and visceral fat are correlated with cardiopulmonary function. With the increase in blood glucose levels and visceral fat, the indices of cardiopulmonary function gradually decrease. The correlation between different cardiopulmonary function indices and blood glucose levels and visceral fat was different.
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Affiliation(s)
- Bin-Bin Liu
- Department of Functional Inspection, Qinhuangdao First Hospital, Qinhuangdao, 066000, People’s Republic of China
| | - Zi-Ru Niu
- Department of Endocrinology and Metabolic Diseases, Hebei Medical University, Shijiazhuang, 050000, People’s Republic of China
| | - Xiao-Jiao Jia
- Department of Endocrinology, Qinhuangdao First Hospital, Qinhuangdao, 066000, People’s Republic of China
| | - Xiao-Li Liu
- Department of Endocrinology, Qinhuangdao First Hospital, Qinhuangdao, 066000, People’s Republic of China
| | - Qiang Lu
- Department of Endocrinology, Qinhuangdao First Hospital, Qinhuangdao, 066000, People’s Republic of China
- Correspondence: Qiang Lu, Department of Endocrinology, Qinhuangdao First Hospital, No. 258 of Wenhua Road, Haigang District, Qinhuangdao, 066000, People’s Republic of China, Tel +86-0335-5908385, Fax: +86-0335-3032042, Email
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Immediate Effect of Whole-Body Vibration on Skin Temperature and Lower-Limb Blood Flow in Older Adults with Type 2 Diabetes: Pilot Study. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10020690] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The purpose of this study was to evaluate the response of a single whole-body vibration (WBV) training session to peripheral skin temperature and peripheral blood flow of older adults with type 2 diabetes. A double-blind, controlled clinical trial was conducted following the Consolidated Standards of Reporting Trials (CONSORT) guidelines. A single session of WBV (24 Hz; amplitude 4 mm; vibration time 45 s, with a series of eight repetitions with recovery between repetitions of 30 s; total time of 10 min) or sham vibration on the Kikos P204 Vibrating Platform was employed. To assess skin temperature, the FLIR E40bxs thermographic camera and the ultrasonic vascular Doppler for flow velocity were used. Evaluation occurred before and after a WBV or sham intervention. The sample consisted of three men and 17 women. In the WBV group, there was a decrease in the temperature from 29.7 °C (±1.83) to 26.6 °C (±2.27), with p = 0.01. Temperature following sham decreased from 28.6 °C (±1.84) to 26.3 °C (±2.49), with p = 0.01. Regarding blood flow, there was a decrease in the analyzed arteries, especially the left posterior tibial artery, where there was a statistically significant flow reduction from 27.1 m/s (±25.36) to 20.5 m/s (±19.66), post WBV (p = 0.01). In the sham group, an increased flow velocity was observed for all the arteries analyzed, except for the left dorsal artery. Immediately following a full-body vibration session, peripheral skin temperature and lower-limb blood flow tend to decrease in diabetic patients. However, from the design of study developed, we cannot infer the maintenance of this effect in the medium and long term.
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Rocha J, Gildea N, O’Shea D, Green S, Egaña M. Influence of priming exercise on oxygen uptake and muscle deoxygenation kinetics during moderate-intensity cycling in type 2 diabetes. J Appl Physiol (1985) 2019; 127:1140-1149. [DOI: 10.1152/japplphysiol.00344.2019] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The pulmonary oxygen uptake (V̇o2) kinetics during the transition to moderate-intensity exercise is slowed in individuals with type 2 diabetes (T2D), at least in part because of limitations in O2 delivery. The present study tested the hypothesis that a prior heavy-intensity warm-up or “priming” exercise (PE) bout would accelerate V̇o2 kinetics in T2D, because of a better matching of O2 delivery to utilization. Twelve middle-aged individuals with T2D and 12 healthy controls (ND) completed moderate-intensity constant-load cycling bouts either without (Mod A) or with (Mod B) prior PE. The rates of muscle deoxygenation (i.e., deoxygenated hemoglobin and myoglobin concentration, [HHb+Mb]) and oxygenation (i.e., tissue oxygenation index) were continuously measured by near-infrared spectroscopy at the vastus lateralis muscle. The local matching of O2 delivery to O2 utilization was assessed by the Δ[HHb+Mb]-to-ΔV̇o2 ratio. Both groups demonstrated an accelerated V̇O2 kinetics response during Mod B compared with Mod A (T2D, 32 ± 9 vs. 42 ± 12 s; ND, 28 ± 9 vs. 34 ± 8 s; means ± SD) and an elevated muscle oxygenation throughout Mod B, whereas the [HHb+Mb] amplitude was greater during Mod B only in individuals with T2D. The [HHb+Mb] kinetics remained unchanged in both groups. In T2D, Mod B was associated with a decrease in the “overshoot” relative to steady state in the Δ[HHb+Mb]-to-ΔV̇o2 ratio (1.17 ± 0.17 vs. 1.05 ± 0.15), whereas no overshoot was observed in the control group before (1.04 ± 0.12) or after (1.01 ± 0.12) PE. Our findings support a favorable priming-induced acceleration of the V̇o2 kinetics response in middle-aged individuals with uncomplicated T2D attributed to an enhanced matching of microvascular O2 delivery to utilization. NEW & NOTEWORTHY Heavy-intensity “priming” exercise (PE) elicited faster pulmonary oxygen uptake (V̇o2) kinetics during moderate-intensity cycling exercise in middle-aged individuals with type 2 diabetes (T2D). This was accompanied by greater near-infrared spectroscopy-derived muscle deoxygenation (i.e., deoxygenated hemoglobin and myoglobin concentration, [HHb+Mb]) responses and a reduced Δ[HHb+Mb]-to-ΔV̇o2 ratio. This suggests that the PE-induced acceleration in oxidative metabolism in T2D is a result of greater O2 extraction and better matching between O2 delivery and utilization.
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Affiliation(s)
- Joel Rocha
- Division of Sport and Exercise Sciences, Abertay University, Dundee, United Kingdom
| | - Norita Gildea
- Department of Physiology, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Donal O’Shea
- Department of Endocrinology, St. Columcille’s Hospital, Dublin, Ireland
- Department of Endocrinology and Diabetes Mellitus, St. Vincent’s University Hospital, Dublin, Ireland
| | - Simon Green
- School of Science and Health, Western Sydney University, Sydney, New South Wales, Australia
| | - Mikel Egaña
- Department of Physiology, School of Medicine, Trinity College Dublin, Dublin, Ireland
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Obesity and inactivity, not hyperglycemia, cause exercise intolerance in individuals with type 2 diabetes: Solving the obesity and inactivity versus hyperglycemia causality dilemma. Med Hypotheses 2019; 123:110-114. [DOI: 10.1016/j.mehy.2019.01.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 01/15/2019] [Indexed: 12/29/2022]
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Francisco CDO, Beltrame T, Hughson RL, Milan-Mattos JC, Ferroli-Fabricio AM, Galvão Benze B, Ferraresi C, Parizotto NA, Bagnato VS, Borghi-Silva A, Porta A, Catai AM. Effects of light-emitting diode therapy (LEDT) on cardiopulmonary and hemodynamic adjustments during aerobic exercise and glucose levels in patients with diabetes mellitus: A randomized, crossover, double-blind and placebo-controlled clinical trial. Complement Ther Med 2019; 42:178-183. [DOI: 10.1016/j.ctim.2018.11.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 09/21/2018] [Accepted: 11/09/2018] [Indexed: 11/12/2022] Open
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Frisbee JC, Lewis MT, Wiseman RW. Skeletal muscle performance in metabolic disease: Microvascular or mitochondrial limitation or both? Microcirculation 2018; 26:e12517. [PMID: 30471168 DOI: 10.1111/micc.12517] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 11/14/2018] [Indexed: 12/20/2022]
Abstract
One of the clearly established health outcomes associated with chronic metabolic diseases (eg, type II diabetes mellitus) is that the ability of skeletal muscle to maintain contractile performance during periods of elevated metabolic demand is compromised as compared to the fatigue-resistance of muscle under normal, healthy conditions. While there has been extensive effort dedicated to determining the major factors that contribute to the compromised performance of skeletal muscle with chronic metabolic disease, the extent to which this poor outcome reflects a dysfunctional state of the microcirculation, where the delivery and distribution of metabolic substrates can be impaired, versus derangements to normal metabolic processes and mitochondrial function, versus a combination of the two, represents an area of considerable unknown. The purpose of this manuscript is to present some of the current concepts for dysfunction to both the microcirculation of skeletal muscle as well as to mitochondrial metabolism under these conditions, such that these diverse issues can be merged into an integrated framework for future investigation. Based on an interpretation of the current literature, it may be hypothesized that the primary site of dysfunction with earlier stages of metabolic disease may lie at the level of the vasculature, rather than at the level of the mitochondria.
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Affiliation(s)
- Jefferson C Frisbee
- Department of Medical Biophysics, University of Western Ontario, London, Ontario, Canada
| | - Matthew T Lewis
- Department of Physiology, Michigan State University, East Lansing, Michigan
| | - Robert W Wiseman
- Department of Physiology, Michigan State University, East Lansing, Michigan.,Department of Radiology, Michigan State University, East Lansing, Michigan
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Macia M, Pecchi E, Desrois M, Lan C, Vilmen C, Portha B, Bernard M, Bendahan D, Giannesini B. Exercise training impacts exercise tolerance and bioenergetics in gastrocnemius muscle of non-obese type-2 diabetic Goto-Kakizaki rat in vivo. Biochimie 2018; 148:36-45. [PMID: 29499298 DOI: 10.1016/j.biochi.2018.02.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Accepted: 02/23/2018] [Indexed: 12/18/2022]
Abstract
The functional and bioenergetics impact of regular physical activity upon type-2 diabetic skeletal muscle independently of confounding factors of overweight remains undocumented. Here, gastrocnemius muscle energy fluxes, mitochondrial capacity and mechanical performance were assessed noninvasively and longitudinally in non-obese diabetic Goto-Kakizaki rats using magnetic resonance (MR) imaging and dynamic 31-phosphorus MR spectroscopy (31P-MRS) throughout a 6-min fatiguing bout of exercise performed before, in the middle (4-week) and at the end of an 8-week training protocol consisting in 60-min daily run on a treadmill. The training protocol reduced plasmatic insulin level (-61%) whereas blood glucose and non-esterified fatty acids levels remained unaffected, thereby indicating an improvement of insulin sensitivity. It also increased muscle mitochondrial citrate synthase activity (+45%) but this increase did not enhance oxidative ATP synthesis capacity in working muscle in vivo while glycolytic ATP production was increased (+33%). On the other hand, the training protocol impaired maximal force-generating capacity (-9%), total amount of force produced (-12%) and increased ATP cost of contraction (+32%) during the fatiguing exercise. Importantly, these deleterious effects were transiently worsened in the middle of the 8-week period, in association with reduced oxidative capacity and increased basal [Pi]/[PCr] ratio (an in vivo biomarker of muscle damage). These data demonstrate that the beneficial effect of regular training on insulin sensitivity in non-obese diabetic rat occurs separately from any improvement in muscle mitochondrial function and might be linked to an increased capacity for metabolizing glucose through anaerobic process in exercising muscle.
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Affiliation(s)
| | | | | | - Carole Lan
- Aix Marseille Univ, CNRS, CRMBM, Marseille, France
| | | | - Bernard Portha
- Université Paris-Diderot, Sorbonne Paris Cité, Laboratoire B2PE, Unité BFA, CNRS EAC 4413, Paris, France
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Baynard T, Goulopoulou S, Sosnoff RF, Fernhall B, Kanaley JA. Cardiovagal modulation and efficacy of aerobic exercise training in obese individuals. Med Sci Sports Exerc 2017; 46:369-75. [PMID: 23899888 DOI: 10.1249/mss.0b013e3182a66411] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
UNLABELLED Type 2 diabetes (T2D) is associated with poor exercise tolerance and peak aerobic capacity (V˙O2peak) even when compared to obese nondiabetic peers. Exercise training studies have demonstrated improvements in V˙O2peak among patients with T2D, yet there is a large amount of variability in this response. Recent evidence suggests that cardiac autonomic modulation may be an important factor when considering improvements in aerobic capacity. PURPOSE This study aimed to determine the effects of a 16-wk aerobic exercise program on V˙O2peak in obese individuals, with and without T2D, who were classified as having either high or low cardiovagal modulation (HCVM or LCVM) at baseline. METHODS Obese individuals (38 women and 19 men; body mass index = 36.1 kg·m(-2)) were studied in the fasted state. ECG recordings were obtained while seated for 3 min, before and after 4 months of exercise training (4 d·wk(-1), 65% V˙O(2peak)). The ECG recording was analyzed for HR variability in the spectral domain. Groups were split on a marker of CVM (normalized high frequency (HFnu)) at the 50th percentile, as either HCVM or LCVM. RESULTS V˙O(2peak) only increased with exercise training among those classified as having HCVM, regardless of diabetes status (T2D: HCVM = 20.3-22.5 mL·kg(-1)min(-1), LCVM = 24.3-25.0 mL·kg(-1)min(-1); obese nondiabetics: HCVM = 24.5-26.3 mL·kg(-1)min(-1), LCVM = 23.1-23.7 mL·kg(-1)min(-1)) (P < 0.05). No change in V˙O(2peak) was observed for the LCVM group. Changes in weight do not explain the change in V˙O(2peak) among the HCVM group. Glucose tolerance only improved among the LCVM group with T2D. CONCLUSIONS Obese individuals, with or without T2D, when classified as having relatively HCVM before exercise training, have a greater propensity to improve V˙O(2peak) after a 16-wk aerobic training program.
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Affiliation(s)
- Tracy Baynard
- 1Integrative Physiology Laboratory, Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL; 2Department of Physiology, Georgia Regents University, Augusta, GA; 3Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL; and 4Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO
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Effects of chronic nitric oxide synthase inhibition on V'O 2max and exercise capacity in mice. NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2016; 390:235-244. [PMID: 27915453 DOI: 10.1007/s00210-016-1318-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2016] [Accepted: 11/14/2016] [Indexed: 10/20/2022]
Abstract
Acute inhibition of NOS by L-NAME (Nω-nitro-L-arginine methyl ester) is known to decrease maximal oxygen consumption (V'O2max) and impair maximal exercise capacity, whereas the effects of chronic L-NAME treatment on V'O2max and exercise performance have not been studied so far. In this study, we analysed the effect of L-NAME treatment, (LN2 and LN12, respectively) on V'O2max and exercise capacity (in maximal incremental running and prolonged sub-maximal incremental running tests), systemic NO bioavailability (plasma nitrite (NO2-) and nitrate (NO3-)) and prostacyclin (PGI2) production in C57BL6/J mice. Mice treated with L-NAME for 2 weeks (LN2) displayed higher V'O2max and better running capacity than age-matched control mice. In LN2 mice, NO bioavailability was preserved, as evidenced by maintained NO2- plasma concentration. PGI2 production was activated (increased 6-keto-PGF1α plasma concentration) and the number of circulating erythrocytes (RBC) and haemoglobin concentration were increased. In mice treated with L-NAME for 12 weeks (LN12), NO bioavailability was decreased (lower NO2- plasma concentration), and 6-keto-PGF1α plasma concentration and RBC number were not elevated compared to age-matched control mice. However, LN12 mice still performed better during the maximal incremental running test despite having lower V'O2max. Interestingly, the LN12 mice showed poorer running capacity during the prolonged sub-maximal incremental running test. To conclude, short-term (2 weeks) but not long-term (12 weeks) treatment with L-NAME activated robust compensatory mechanisms involving preservation of NO2- plasma concentration, overproduction of PGI2 and increased number of RBCs, which might explain the fully preserved exercise capacity despite the inhibition of NOS.
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13
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Wojewoda M, Tyrankiewicz U, Gwozdz P, Skorka T, Jablonska M, Orzylowska A, Jasinski K, Jasztal A, Przyborowski K, Kostogrys RB, Zoladz JA, Chlopicki S. Exercise capacity and cardiac hemodynamic response in female ApoE/LDLR(-/-) mice: a paradox of preserved V'O2max and exercise capacity despite coronary atherosclerosis. Sci Rep 2016; 6:24714. [PMID: 27108697 PMCID: PMC4842974 DOI: 10.1038/srep24714] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Accepted: 04/04/2016] [Indexed: 11/16/2022] Open
Abstract
We assessed exercise performance, coronary blood flow and cardiac reserve of female ApoE/LDLR−/− mice with advanced atherosclerosis compared with age-matched, wild-type C57BL6/J mice. Exercise capacity was assessed as whole body maximal oxygen consumption (V’O2max), maximum running velocity (vmax) and maximum distance (DISTmax) during treadmill exercise. Cardiac systolic and diastolic function in basal conditions and in response to dobutamine (mimicking exercise-induced cardiac stress) were assessed by Magnetic Resonance Imaging (MRI) in vivo. Function of coronary circulation was assessed in isolated perfused hearts. In female ApoE/LDLR−/− mice V’O2max, vmax and DISTmax were not impaired as compared with C57BL6/J mice. Cardiac function at rest and systolic and diastolic cardiac reserve were also preserved in female ApoE/LDLR−/− mice as evidenced by preserved fractional area change and similar fall in systolic and end diastolic area after dobutamine. Moreover, endothelium-dependent responses of coronary circulation induced by bradykinin (Bk) and acetylcholine (ACh) were preserved, while endothelium-independent responses induced by NO-donors were augmented in female ApoE/LDLR−/− mice. Basal COX-2-dependent production of 6-keto-PGF1α was increased. Concluding, we suggest that robust compensatory mechanisms in coronary circulation involving PGI2- and NO-pathways may efficiently counterbalance coronary atherosclerosis-induced impairment in V’O2max and exercise capacity.
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Affiliation(s)
- M Wojewoda
- Jagiellonian Centre for Experimental Therapeutics (JCET), Jagiellonian University, Krakow, Poland
| | - U Tyrankiewicz
- Department of Magnetic Resonance Imaging, Institute of Nuclear Physics, Polish Academy of Sciences Krakow, Poland
| | - P Gwozdz
- Chair of Pharmacology, Jagiellonian University Medical College, Krakow, Poland
| | - T Skorka
- Department of Magnetic Resonance Imaging, Institute of Nuclear Physics, Polish Academy of Sciences Krakow, Poland
| | - M Jablonska
- Department of Magnetic Resonance Imaging, Institute of Nuclear Physics, Polish Academy of Sciences Krakow, Poland
| | - A Orzylowska
- Department of Magnetic Resonance Imaging, Institute of Nuclear Physics, Polish Academy of Sciences Krakow, Poland
| | - K Jasinski
- Department of Magnetic Resonance Imaging, Institute of Nuclear Physics, Polish Academy of Sciences Krakow, Poland
| | - A Jasztal
- Jagiellonian Centre for Experimental Therapeutics (JCET), Jagiellonian University, Krakow, Poland
| | - K Przyborowski
- Jagiellonian Centre for Experimental Therapeutics (JCET), Jagiellonian University, Krakow, Poland
| | - R B Kostogrys
- Department of Human Nutrition, Faculty of Food Technology, University of Agriculture in Krakow, Krakow, Poland
| | - J A Zoladz
- Department of Muscle Physiology, Faculty of Rehabilitation, University School of Physical Education, Krakow, Poland
| | - S Chlopicki
- Jagiellonian Centre for Experimental Therapeutics (JCET), Jagiellonian University, Krakow, Poland.,Chair of Pharmacology, Jagiellonian University Medical College, Krakow, Poland
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14
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Poitras VJ, Bentley RF, Hopkins-Rosseel DH, LaHaye SA, Tschakovsky ME. Independent effect of type 2 diabetes beyond characteristic comorbidities and medications on immediate but not continued knee extensor exercise hyperemia. J Appl Physiol (1985) 2015; 119:202-12. [PMID: 26048976 DOI: 10.1152/japplphysiol.00758.2014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Accepted: 06/01/2015] [Indexed: 01/23/2023] Open
Abstract
We tested the hypothesis that type 2 diabetes (T2D), when present in the characteristic constellation of comorbidities (obesity, hypertension, dyslipidemia) and medications, slows the dynamic adjustment of exercising muscle perfusion and blunts the steady state relative to that of controls matched for age, body mass index, fitness, comorbidities, and non-T2D medications. Thirteen persons with T2D and 11 who served as controls performed rhythmic single-leg isometric quadriceps exercise (rest-to-6 kg and 6-to-12 kg transitions, 5 min at each intensity). Measurements included leg blood flow (LBF, femoral artery ultrasound), mean arterial pressure (MAP, finger photoplethysmography), and leg vascular conductance (LVK, calculated). Dynamics were quantified using mean response time (MRT). Measures of amplitude were also used to compare response adjustment: the change from baseline to 1) the peak initial response (greatest 1-s average in the first 10 s; ΔLBFPIR, ΔLVKPIR) and 2) the on-transient (average from curve fit at 15, 45, and 75 s; ΔLBFON, ΔLVKON). ΔLBFPIR was significantly blunted in T2D vs. control individuals (P = 0.037); this was due to a tendency for reduced ΔLVKPIR (P = 0.063). In contrast, the overall response speed was not different between groups (MRT P = 0.856, ΔLBFON P = 0.150) nor was the change from baseline to steady state (P = 0.204). ΔLBFPIR, ΔLBFON, and LBF MRT did not differ between rest-to-6 kg and 6-to-12 kg workload transitions (all P > 0.05). Despite a transient amplitude impairment at the onset of exercise, there is no robust or consistent effect of T2D on top of the comorbidities and medications typical of this population on the overall dynamic adjustment of LBF, or the steady-state levels achieved during low- or moderate-intensity exercise.
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Affiliation(s)
- Veronica J Poitras
- School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada
| | - Robert F Bentley
- School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada
| | - Diana H Hopkins-Rosseel
- Cardiac Rehabilitation Centre, Hotel Dieu Hospital, Kingston, Ontario, Canada; and School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada
| | - Stephen A LaHaye
- Cardiac Rehabilitation Centre, Hotel Dieu Hospital, Kingston, Ontario, Canada; and
| | - Michael E Tschakovsky
- School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada;
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15
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Green S, Egaña M, Baldi JC, Lamberts R, Regensteiner JG. Cardiovascular control during exercise in type 2 diabetes mellitus. J Diabetes Res 2015; 2015:654204. [PMID: 25918732 PMCID: PMC4396731 DOI: 10.1155/2015/654204] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Accepted: 03/17/2015] [Indexed: 12/31/2022] Open
Abstract
Controlled studies of male and female subjects with type 2 diabetes mellitus (DM) of short duration (~3-5 years) show that DM reduces peak VO2 (L·min(-1) and mL·kg(-1)·min(-1)) by an average of 12-15% and induces a greater slowing of the dynamic response of pulmonary VO2 during submaximal exercise. These effects occur in individuals less than 60 years of age but are reduced or absent in older males and are consistently associated with significant increases in the exercise pressor response despite normal resting blood pressure. This exaggerated pressor response, evidence of exertional hypertension in DM, is manifest during moderate submaximal exercise and coincides with a more constrained vasodilation in contracting muscles. Maximum vasodilation during contractions involving single muscle groups is reduced by DM, and the dynamic response of vasodilation during submaximal contractions is slowed. Such vascular constraint most likely contributes to exertional hypertension, impairs dynamic and peak VO2 responses, and reduces exercise tolerance. There is a need to establish the effect of DM on dynamic aspects of vascular control in skeletal muscle during whole-body exercise and to clarify contributions of altered cardiovascular control and increased arterial stiffness to exertional hypertension.
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Affiliation(s)
- Simon Green
- School of Science and Health, University of Western Sydney, Sydney, NSW 2751, Australia
- Neuroscience Research Australia, Sydney, NSW 2751, Australia
- *Simon Green:
| | - Mikel Egaña
- Department of Physiology, School of Medicine, Trinity College Dublin, Dublin 1, Ireland
| | - J. Chris Baldi
- Department of Medicine, University of Otago, Dunedin, Otago 9054, New Zealand
| | - Regis Lamberts
- Department of Physiology-HeartOtago, University of Otago, Dunedin, Otago 9054, New Zealand
| | - Judith G. Regensteiner
- Division of General Internal Medicine, Center for Women's Health Research, Department of Medicine, School of Medicine, University of Colorado, Denver, CO 80210, USA
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Francisco CO, Catai AM, Moura-Tonello SCG, Lopes SLB, Benze BG, Del Vale AM, Leal AMO. Cardiorespiratory fitness, pulmonary function and C-reactive protein levels in nonsmoking individuals with diabetes. ACTA ACUST UNITED AC 2014; 47:426-31. [PMID: 24760118 PMCID: PMC4075312 DOI: 10.1590/1414-431x20143370] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Accepted: 02/17/2014] [Indexed: 01/15/2023]
Abstract
The objective of this study was to evaluate cardiorespiratory fitness and pulmonary
function and the relationship with metabolic variables and C-reactive protein (CRP)
plasma levels in individuals with diabetes mellitus (DM). Nineteen men with diabetes
and 19 age- and gender-matched control subjects were studied. All individuals were
given incremental cardiopulmonary exercise and pulmonary function tests. In the
exercise test, maximal workload (158.3±22.3 vs 135.1±25.2, P=0.005),
peak heart rate (HRpeak: 149±12 vs 139±10, P=0.009), peak
oxygen uptake (VO2peak: 24.2±3.2 vs 18.9±2.8,
P<0.001), and anaerobic threshold (VO2VT: 14.1±3.4 vs
12.2±2.2, P=0.04) were significantly lower in individuals with diabetes than in
control subjects. Pulmonary function test parameters, blood pressure, lipid profile
(triglycerides, HDL, LDL, and total cholesterol), and CRP plasma levels were not
different in control subjects and individuals with DM. No correlations were observed
between hemoglobin A1C (HbA1c), CRP and pulmonary function test and cardiopulmonary
exercise test performance. In conclusion, the results demonstrate that nonsmoking
individuals with DM have decreased cardiorespiratory fitness that is not correlated
with resting pulmonary function parameters, HbA1c, and CRP plasma levels.
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Affiliation(s)
- C O Francisco
- Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - A M Catai
- Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - S C G Moura-Tonello
- Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - S L B Lopes
- Departamento de Medicina, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - B G Benze
- Departamento de Estatística, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - A M Del Vale
- Departamento de Medicina, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - A M O Leal
- Departamento de Medicina, Universidade Federal de São Carlos, São Carlos, SP, Brasil
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17
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A Primary Care–Based Randomized Controlled Trial of 12-Week Whole-Body Vibration for Balance Improvement in Type 2 Diabetes Mellitus. Arch Phys Med Rehabil 2013; 94:2112-8. [DOI: 10.1016/j.apmr.2013.05.030] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Revised: 05/28/2013] [Accepted: 05/29/2013] [Indexed: 11/18/2022]
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18
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Whole body vibration training improves leg blood flow and adiposity in patients with type 2 diabetes mellitus. Eur J Appl Physiol 2013; 113:2245-52. [PMID: 23657766 DOI: 10.1007/s00421-013-2654-3] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2013] [Accepted: 04/24/2013] [Indexed: 12/15/2022]
Abstract
This study aimed at examined the effect of a 12-week whole body vibration (WBV) training program on leg blood flow and body composition in people with type 2 diabetes mellitus (T2DM). Forty participants were randomly assigned to either a WBV training group (WBV; n = 20) or usual-care control group (CON; n = 20). Body composition [waist circumference, waist to hip ratio (WHR), weight, height, percentage of body fat and fat-free mass], heart rate, and blood flow [femoral artery diameter, maximum systolic velocity, maximum diastolic velocity (DV), time averaged mean, pulsatility index and resistance index (RI), mean velocity (V med), and peak blood velocities (PBV)] were assessed at baseline and after 12 weeks. There were significant increases in the blood flow (p = 0.046), V med (p = 0.050), and DV (p = 0.037) after WBV compared with CON. Within-group analysis showed significant differences in V med, PBV, and DV in the WBV group. Significant decreases after the intervention in weight (p < 0.001), waist circumference (p < 0.001), WHR (p < 0.05), and body fat (p < 0.05) were also found, with significant between-groups decreases in all these outcomes in the WBV group. Significant correlations existed between changes in percent body fat and blood flow [blood flow (-0.761), V med (-0.607), PBV (-0.677), and RI (0.0510)]. WBV training can be considered an effective means to increase leg blood flow and to reduce adiposity in patients with T2DM.
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19
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Exercise assessment and prescription in patients with type 2 diabetes in the private and home care setting: clinical recommendations from AXXON (Belgian Physical Therapy Association). Phys Ther 2013; 93:597-610. [PMID: 23392184 DOI: 10.2522/ptj.20120400] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
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20
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O'Connor E, Kiely C, O'Shea D, Green S, Egaña M. Similar level of impairment in exercise performance and oxygen uptake kinetics in middle-aged men and women with type 2 diabetes. Am J Physiol Regul Integr Comp Physiol 2012; 303:R70-6. [DOI: 10.1152/ajpregu.00012.2012] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The present study tested the hypothesis that the magnitude of the type 2 diabetes-induced impairments in peak oxygen uptake (V̇o2) and V̇o2 kinetics would be greater in females than males in middle-aged participants. Thirty-two individuals with type 2 diabetes (16 male, 16 female), and 32 age- and body mass index (BMI)-matched healthy individuals (16 male, 16 female) were recruited. Initially, the ventilatory threshold (VT) and peak V̇o2 were determined. On a separate day, subjects completed four 6-min bouts of constant-load cycling at 80% VT for the determination of V̇o2 kinetics using standard procedures. Cardiac output (CO) (inert gas rebreathing) was recorded at rest, 30, and 240 s during two additional bouts. Peak V̇o2 (ml·kg−1·min−1) was significantly reduced in men and women with type 2 diabetes compared with their respective nondiabetic counterparts (men, 27.8 ± 4.4 vs. 31.1 ± 6.2 ml·kg−1·min−1; women, 19.4 ± 4.1 vs. 21.4 ± 2.9 ml·kg−1·min−1). The time constant (s) of phase 2 (τ2) and mean response time (s) of the V̇o2 response (MRT) were slowed in women with type 2 diabetes compared with healthy women (τ2, 43.3 ± 9.8 vs. 33.6 ± 10.0 s; MRT, 51.7 ± 9.4 vs. 43.5 ± 11.4s) and in men with type 2 diabetes compared with nondiabetic men (τ2, 43.8 ± 12.0 vs. 35.3 ± 9.5 s; MRT, 57.6 ± 8.3 vs. 47.3 ± 9.3 s). The magnitude of these impairments was not different between males and females. The steady-state CO responses or the dynamic responses of CO were not affected by type 2 diabetes among men or women. The results suggest that the type 2 diabetes-induced impairments in peak V̇o2 and V̇o2 kinetics are not affected by sex in middle aged participants.
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Affiliation(s)
- Eamonn O'Connor
- Department of Physiology, Trinity College Dublin, Dublin 2, Ireland
| | - Catherine Kiely
- Department of Physiology, Trinity College Dublin, Dublin 2, Ireland
| | - Donal O'Shea
- Endocrinology, St Colmcille's and St Vincent's Hospitals, Dublin, Ireland; and
| | - Simon Green
- School of Science and Health, University of Western Sydney, Sydney, Australia
| | - Mikel Egaña
- Department of Physiology, Trinity College Dublin, Dublin 2, Ireland
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21
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Chimen M, Kennedy A, Nirantharakumar K, Pang TT, Andrews R, Narendran P. What are the health benefits of physical activity in type 1 diabetes mellitus? A literature review. Diabetologia 2012; 55:542-51. [PMID: 22189486 DOI: 10.1007/s00125-011-2403-2] [Citation(s) in RCA: 276] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2011] [Accepted: 11/02/2011] [Indexed: 02/06/2023]
Abstract
Physical activity improves well-being and reduces the risk of heart disease, cancer and type 2 diabetes mellitus in the general population. In individuals with established type 2 diabetes, physical activity improves glucose and lipid levels, reduces weight and improves insulin resistance. In type 1 diabetes mellitus, however, the benefits of physical activity are less clear. There is poor evidence for a beneficial effect of physical activity on glycaemic control and microvascular complications, and significant risk of harm through hypoglycaemia. Here we review the literature relating to physical activity and health in type 1 diabetes. We examine its effect on a number of outcomes, including glycaemic control, lipids, blood pressure, diabetic complications, well-being and overall mortality. We conclude that whilst there is sufficient evidence to recommend physical activity in the management of type 1 diabetes, it is still unclear as to what form, duration and intensity should be recommended and whether there is benefit for many of the outcomes examined.
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Affiliation(s)
- M Chimen
- Institute of Biomedical Research, School of Clinical and Experimental Medicine, University of Birmingham, Wolfson Drive, Birmingham B15 2TT, UK
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22
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Abdelmoneim SS, Basu A, Bernier M, Dhoble A, Abdel-Kader SS, Pellikka PA, Mulvagh SL. Detection of myocardial microvascular disease using contrast echocardiography during adenosine stress in type 2 diabetes mellitus: prospective comparison with single-photon emission computed tomography. Diab Vasc Dis Res 2011; 8:254-61. [PMID: 21933841 DOI: 10.1177/1479164111419973] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
PURPOSE To evaluate myocardial microvascular disease in patients with type 2 diabetes mellitus (DM) using myocardial contrast echocardiography (MCE) and to report on its diagnostic accuracy using single photon emission tomography (SPECT) as reference test. METHODS We prospectively enrolled 79 patients (25 DM; 66 ±11 years) who underwent simultaneous SPECT and MCE with contrast agent during adenosine stress. MCE and SPECT were visually analyzed using 17 segments. Quantitative MCE parameters were derived from replenishment curves. Microbubble velocity (β min(-1)), absolute myocardial blood flow (MBF ml/min/g), and reserve values were calculated. Diagnostic accuracy and area under curve (AUC) was reported. RESULTS Patients with DM had higher BMI vs non DM (33±7 vs 28±5kg/m(2) P=0 .007), with more prior myocardial infarction (40 vs 15% P=.01). Visual MCE was abnormal in 40 (51%) patients (60% in DM vs 46% in non DM P=0.04). SPECT was abnormal in 38 (48%) patients [60% in DM vs 42% non DM, P=0.01]. Reserve parameters were lower in DM vs. non DM patients: (β 1.77±1.12 vs 2.20±1.4, P<0.001 and MBF 2.86± 2.62 vs. 3.67±2.84, P<0.001). DM patients without CAD on SPECT had significantly lower β, and MBF reserve compared to non DM patients without CAD. Compared to SPECT, β reserve cutoff 1.6 had AUC 0.817, sensitivity 81%, and specificity 66% while MBF reserve cutoff 1.9 had AUC 0.760, sensitivity 79%, and specificity 63% in DM patients. CONCLUSION Diabetes is associated with myocardial microvascular abnormalities as evidenced by abnormal myocardial perfusion on visual and quantitative MCE.
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Affiliation(s)
- Sahar S Abdelmoneim
- Mayo Clinic, Division of Cardiovascular Diseases and Internal Medicine, MN 55905, USA
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23
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Copp SW, Hageman KS, Behnke BJ, Poole DC, Musch TI. Effects of type II diabetes on exercising skeletal muscle blood flow in the rat. J Appl Physiol (1985) 2010; 109:1347-53. [PMID: 20798267 DOI: 10.1152/japplphysiol.00668.2010] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
The purpose of the present investigation was to examine the muscle hyperemic response to steady-state submaximal running exercise in the Goto-Kakizaki (GK) Type II diabetic rat. Specifically, the hypothesis was tested that Type II diabetes would redistribute exercising blood flow toward less oxidative muscles and muscle portions of the hindlimb. GK diabetic (n = 10) and Wistar control (n = 8, blood glucose concentration, 13.7 ± 1.6 and 5.7 ± 0.2 mM, respectively, P < 0.05) rats were run at 20 m/min on a 10% grade. Blood flows to 28 hindlimb muscles and muscle portions as well as the abdominal organs and kidneys were measured in the steady state of exercise using radiolabeled 15-μm microspheres. Blood flow to the total hindlimb musculature did not differ between GK diabetic and control rats (161 ± 16 and 129 ± 15 ml·min(-1)·100 g(-1), respectively, P = 0.18). Moreover, there was no difference in blood flow between GK diabetic and control rats in 20 of the individual muscles or muscle parts examined. However, in the other eight muscles examined that typically are comprised of a majority of fast-twitch glycolytic (IIb/IIdx) fibers, blood flow was significantly greater (i.e., ↑31-119%, P < 0.05) in the GK diabetic rats. Despite previously documented impairments of several vasodilatory pathways in Type II diabetes these data provide the first demonstration that a reduction of exercising muscle blood flow during submaximal exercise is not an obligatory consequence of this condition in the GK diabetic rat.
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Affiliation(s)
- Steven W Copp
- Department of Kinesiology, Kansas State University, Manhattan, KS 66506-5802, USA
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24
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Thomson RL, Buckley JD, Moran LJ, Noakes M, Clifton PM, Norman RJ, Brinkworth GD. Comparison of aerobic exercise capacity and muscle strength in overweight women with and without polycystic ovary syndrome. BJOG 2009; 116:1242-50. [PMID: 19438498 DOI: 10.1111/j.1471-0528.2009.02177.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To assess maximal aerobic capacity (VO2max) and muscle strength in overweight and obese women with polycystic ovary syndrome (PCOS) and determine their relationship with metabolic and hormonal factors. DESIGN Cross-sectional study. SETTING Clinical Research Unit. POPULATION Overweight and obese women with PCOS (n = 10) and age-and weight-matched healthy controls (n = 16). METHODS VO2max was measured during an incremental treadmill test and maximal isometric (ImS) and isokinetic knee extensor strength (IkS) (120 degrees/second) were assessed by isokinetic dynamometry. MAIN OUTCOME MEASURES VO2max, ImS, IkS, waist circumference, blood lipids, glucose, insulin, insulin resistance (homeostatic model assessment [HOMA2]), C-reactive protein (CRP), hormonal profile. RESULTS PCOS women had higher levels of testosterone and free testosterone (P < or = 0.05), but there were no significant differences in any cardiovascular disease (CVD) risk markers between the groups. VO2max was similar in women with PCOS and healthy controls (PCOS 26.0 +/- 4.1 ml/kg/minute, controls 25.7 +/- 3.8 ml/kg/minute; P = 0.90), as was ImS (PCOS 1.50 +/- 0.54 Nm/kg, controls 1.50 +/- 0.47 Nm/kg; P = 0.96) and IkS (PCOS 1.04 +/- 0.32 Nm/kg, controls 1.16 +/- 0.23 Nm/kg; P = 0.32). VO2max was inversely related to waist circumference, insulin, HOMA2 and CRP. Waist circumference was inversely associated with ImS and IkS. No significant associations between exercise parameters and hormonal variables were identified. CONCLUSIONS Compared to age- and weight-matched healthy overweight and obese women with similar insulin resistance and CVD risk profiles, women with PCOS had similar aerobic capacity and muscle strength. This suggests PCOS, at least in the absence of an adverse metabolic profile is unlikely to limit physical function. Larger studies examining the effects of PCOS on exercise tolerance in a diverse range of PCOS phenotypes is required.
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Affiliation(s)
- R L Thomson
- Australian Technology Network Centre for Metabolic Fitness, Sansom Institute for Health Research, University of South Australia, Adelaide, SA, Australia
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25
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Shaibi GQ, Faulkner MS, Weigensberg MJ, Fritschi C, Goran MI. Cardiorespiratory fitness and physical activity in youth with type 2 diabetes. Pediatr Diabetes 2008; 9:460-3. [PMID: 18503498 PMCID: PMC2562936 DOI: 10.1111/j.1399-5448.2008.00407.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE The increased incidence of type 2 diabetes (T2D) among youth is hypothesized to be due, in part, to low levels of fitness and activity. Therefore, the purpose of this investigation was to examine whether cardiorespiratory fitness and physical activity are reduced in youth with T2D compared with overweight controls. PARTICIPANTS Thirteen adolescent boys with previously diagnosed T2D (mean duration 2.4 +/- 1.8 yr) were matched for age and body mass index to 13 overweight, non-diabetic controls. METHODS Cardiorespiratory fitness was assessed during a progressive exercise test to volitional fatigue and physical activity was estimated from a 7-d physical activity recall. RESULTS Youth with T2D reported performing approximately 60% less moderate to vigorous physical activity compared with their non-diabetic counterparts (0.6 +/- 0.2 vs. 1.4 +/- 0.3 h/d, p = 0.04). Furthermore, diabetic youth exhibited significantly lower cardiorespiratory fitness levels compared with controls (28.7 +/- 1.6 vs. 34.6 +/- 2.2 mL/kg/min, p < 0.05). CONCLUSIONS These findings support the hypothesis that cardiorespiratory fitness and physical activity are reduced in youth with T2D. Whether reduced fitness and activity contributed to the pathophysiology of the disorder cannot be determined from the cross-sectional analysis. Longitudinal studies are warranted to examine whether improvements in fitness and increased physical activity can prevent the development of T2D in high-risk youth.
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Affiliation(s)
- Gabriel Q. Shaibi
- College of Nursing & Healthcare Innovation, Arizona State University, Phoenix, AZ, 85004
| | | | - Marc J. Weigensberg
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033
| | - Cynthia Fritschi
- Department of Medical-Surgical Nursing, University of Illinois at Chicago, Chicago, IL, 60612
| | - Michael I. Goran
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033,Department of Physiology and Biophysics, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033
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Segerström ÅB, Glans F, Eriksson KF, Groop L, Thorsson O, Wollmer P. Assessment of exercise capacity in women with type 2 diabetes. Clin Physiol Funct Imaging 2008; 28:294-8. [DOI: 10.1111/j.1475-097x.2008.00808.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Ribisl PM, Lang W, Jaramillo SA, Jakicic JM, Stewart KJ, Bahnson J, Bright R, Curtis JF, Crow RS, Soberman JE. Exercise capacity and cardiovascular/metabolic characteristics of overweight and obese individuals with type 2 diabetes: the Look AHEAD clinical trial. Diabetes Care 2007; 30:2679-84. [PMID: 17644623 DOI: 10.2337/dc06-2487] [Citation(s) in RCA: 75] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE We examined associations of cardiovascular, metabolic, and body composition measures with exercise capacity using baseline data from 5,145 overweight and/or obese (BMI > or = 25.0 kg/m2) men and women with type 2 diabetes who were randomized participants for the Look AHEAD (Action for Health in Diabetes) clinical trial. RESEARCH DESIGN AND METHODS Peak exercise capacity expressed as METs and estimated from treadmill speed and grade was measured during a graded exercise test designed to elicit a maximal effort. Other measures included waist circumference, BMI, type 2 diabetes duration, types of medication used, A1C, history of cardiovascular disease, metabolic syndrome, beta-blocker use, and race/ethnicity. RESULTS Peak exercise capacity was higher for men (8.0 +/- 2.1 METs) than for women (6.7 +/- 1.7 METs) (P < 0.001). Exercise capacity also decreased across each decade of age (P < 0.001) and with increasing BMI and waist circumference levels in both sexes. Older age, increased waist circumference and BMI, a longer duration of diabetes, increased A1C, a history of cardiovascular disease, having metabolic syndrome, beta-blocker use, and being African American compared with being Caucasian were associated with a lower peak exercise capacity for both sexes. Hypertension and use of diabetes medications were associated with lower peak exercise capacity in women. CONCLUSIONS Individuals with diabetes who are overweight or obese have impaired exercise capacity, which is primarily related to age, female sex, and race, as well as poor metabolic control, BMI, and central obesity.
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Affiliation(s)
- Paul M Ribisl
- Health and Exercise Sciences, Department of Biostatistical Sciences, Wake Forest University, Wake Forest Road, Winston-Salem, NC 27109, USA.
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Baldi JC, Aoina JL, Whalley GA, Carrick-Ranson G, Walsh HA, O'Shaughnessy H, Bagg W, Doughty RN. The effect of type 2 diabetes on diastolic function. Med Sci Sports Exerc 2006; 38:1384-8. [PMID: 16888449 DOI: 10.1249/01.mss.0000228954.90591.95] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE This study aimed to determine whether sedentary overweight subjects with type 2 diabetes have impaired diastolic function compared with equally sedentary and overweight nondiabetic subjects. METHODS Mitral valve pulsed Doppler echocardiography and tissue Doppler imaging (TDI) were used to assess left ventricular structure and diastolic function in 40- to 60-yr-old sedentary overweight subjects with type 2 diabetes (N = 13) and age- and body mass-matched sedentary nondiabetic subjects (N = 15). Pseudonormal filling was identified using preload reduction and TDI. RESULTS Traditional Doppler mitral inflow parameters were not different between groups; however, early diastolic relaxation, as measured by peak early mitral annular velocity (E') and the ratio of E' and peak late mitral annular velocity (E'/A'), was reduced in type 2 diabetic subjects (P < 0.05). The ratio of peak early mitral inflow (E) to E' (E/E'), an estimate of left ventricular filling pressure, was also higher in the type 2 diabetes group (P < 0.05). The proportions of diastolic impairment (69 vs 40%) and pseudonormal filling (39 vs 20%) were not different between groups (P = 0.18). CONCLUSION These findings suggest that type 2 diabetes has an effect on diastolic function that is independent of age and body composition.
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Affiliation(s)
- James C Baldi
- Department of Sport and Exercise Science, The University of Auckland, Auckland, New Zealand.
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Abstract
The world-wide estimated prevalence of diabetes mellitus for 2025 is of about 300 million, resulting from a higher prevalence of obesity and sedentary lifestyles in the developed world. The group of cardiovascular diseases is responsible for 80% of deaths among diabetic patients. Several authors have suggested that patients with diabetes mellitus have a predisposition to develop a form of cardiomyopathy, known as <<diabetic cardiomyopathy>>, which is not related to ischemic heart disease or hypertension, and may progress to cardiac failure. Such condition is known to be associated with a poor prognosis in patients with diabetes mellitus. The prevalence appears to be high. Thus, tissue Doppler techniques added to conventional echocardiography assessment have estimated it to be as high as 75%. However, the use of echocardiography as a screening tool in the asymptomatic diabetic population is problematic. Biomarkers of cardiac dysfunction have been proposed for diagnosis. In this article, we have assessed the role of biomarkers in the diagnosis of this condition and proposed a diagnostic algorithm that may be useful for the assessment of asymptomatic patients with diabetes.
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Affiliation(s)
- Ignacio Gil-Ortega
- Coronary Artery Disease Research Unit. Department of Cardiological Sciences. St. George's Hospital Medical School. Londres. Reino Unido.
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Abstract
As the global burden of type 2 diabetes increases, medical science races to comprehensively understand its molecular aetiology. We suggest that the apparent struggle to seek a pharmacological or molecular victory to the diabetes epidemic is a flawed strategy given that evolution has already provided us with the best medicine. Recent molecular evidence highlights the interaction between muscle fatty acid kinetics in dictating whole body insulin action. Insights from an evolutionary perspective suggest that the ability of the body to evoke insulin resistance and store energy as fat within muscle cells is a normal physiological response to aid our survival during food or carbohydrate scarcity, but this 'hunter-gatherer physiology' predisposes to diabetes in a modern environment characterized by ample food availability and muscle inactivity. We contend that the true value of physical activity in the prevention and treatment of insulin resistance has been missed by the medical community because scientific investigation has been constructed upon physical activity recommendations that were never intended for this purpose. These recommendations provide a level of metabolic stress insufficient to be compatible with the expectations of our genes.
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Affiliation(s)
- S R Stannard
- Institute of Food, Nutrition and Human Health, Massey University, New Zealand.
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Abstract
Diabetes mellitus is responsible for a spectrum of cardiovascular disease. The best known complications arise from endothelial dysfunction, oxidation, inflammation, and vascular remodelling and contribute to atherogenesis. However, the effects on the heart also relate to concurrent hypertensive heart disease, as well as direct effects of diabetes on the myocardium. Diabetic heart disease, defined as myocardial disease in patients with diabetes that cannot be ascribed to hypertension, coronary artery disease, or other known cardiac disease, is reviewed.
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Affiliation(s)
- T H Marwick
- University of Queensland, Brisbane, Australia.
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