Lactate threshold prediction by blood glucose and rating of perceived exertion in people with type 2 diabetes

Decreased Blood Glucose and Lactate: Is a Useful Indicator of Recovery Ability in Athletes?

During low-intensity exercise stages of the lactate threshold test, blood lactate concentrations gradually diminish due to the predominant utilization of total fat oxidation. However, it is unclear why blood glucose is also reduced in well-trained athletes who also exhibit decreased lactate concentrations. This review focuses on decreased glucose and lactate concentrations at low-exercise intensity performed in well-trained athletes. During low-intensity exercise, the accrued resting lactate may predominantly be transported via blood from the muscle cell to the liver/kidney. Accordingly, there is increased hepatic blood flow with relatively more hepatic glucose output than skeletal muscle glucose output. Hepatic lactate uptake and lactate output of skeletal muscle during recovery time remained similar which may support a predominant Cori cycle (re-synthesis). However, this pathway may be insufficient to produce the necessary glucose level because of the low concentration of lactate and the large energy source from fat. Furthermore, fatty acid oxidation activates key enzymes and hormonal responses of gluconeogenesis while glycolysis-related enzymes such as pyruvate dehydrogenase are allosterically inhibited. Decreased blood lactate and glucose in low-intensity exercise stages may be an indicator of recovery ability in well-trained athletes. Athletes of intermittent sports may need this recovery ability to successfully perform during competition.

Anaerobic Threshold Determination in Cycle Ergometer From Rating of Perceived Exertion

Santos, GAd, Numata-Filho, ES, Rosa, TdS, Passos Neves, RV, Simões, HG, and Moreira, SR. Anaerobic threshold determination in cycle ergometer from rating of perceived exertion. J Strength Cond Res XX(X): 000-000, 2020-The objective of the study was to investigate the validity of the rating of perceived exertion threshold (TRPE) for anaerobic threshold (AT) estimation during an incremental test (IT) on a cycle ergometer. Nineteen physically active and healthy men performed an IT on a cycle ergometer. The intensity corresponding to the AT was considered as the point immediately before the abrupt increase in blood lactate concentration ([La]) in the IT. TRPE was determined in the last intensity corresponding to perceptual response previous the 15 arbitrary units (AU) in the 15-point RPE scale. The heart rate (HR), [La], and RPE were obtained at the end of each stage of the IT. There was no significant difference between workload obtained from the AT (150 [120-150] watts) and TRPE (150 [120-150] watts) (p > 0.05). In addition, there were no differences between HR (AT, 139.5 ± 12.7 b·min vs. TRPE, 141.9 ± 14.6 b·min, p > 0.05) and [La] (AT, 3.1 [2.8-3.2] mM vs. TRPE, 3.1 [2.9-3.7] mM, p > 0.05). There was a strong correlation between the intensities in AT and TRPE during the IT (r = 0.88). A substantial reliability (intraclass correlation coefficient = 0.84 [0.64-0.94 confidence interval 95%]) was evidenced, as well as a substantial agreement between the AT and TRPE intensities (Pc = 0.84), as confirmed by the Bland-Altman plot (-4.7 [-34.2/24.7]). TRPE was a predictor of the AT (β = 1.146, R = 0.770, SEE = 15.070, p < 0.01). It can be concluded that TRPE is valid for AT estimation during an IT on a cycle ergometer.

DETERMINATION OF INDIVIDUAL GLUCOSE THRESHOLD USING PHARMACY PORTABLE BLOOD GLUCOSE METER

ABSTRACT Introduction The individual glucose threshold (IGT) has been used to estimate the anaerobic threshold with low-cost analyses and shorter times. However, the reliability of the glycemic analysis using a portable pharmacy glucose meter has received little attention. Objective To identify the IGT using a portable glucose meter and to compare it with the ventilatory threshold (VT). Methods Fourteen active, healthy men (25.9 ± 3.2 years; %BF = 17.9 ± 3.7%) performed an incremental treadmill test. The anaerobic threshold was identified by two different methods: (1) IGT, corresponding to the intensity of the lowest glucose value during the test; and (2) VT, corresponding to the break in linearity of the ventilation curve and an increase in the respiratory oxygen equivalent, without an equivalent increase in carbon dioxide. Results There were significant differences between VT (9.9 ± 1.2 km/h) and IGT (9.5 ± 1/1 km/h), corresponding to 75.4 ± 9.2 and 72.5 ± 10.4 %VO2max, respectively. The methods presented high correlation (r = 0.82, p = 0.002) and the Bland-Altman technique showed agreement between IGT and VT, with a mean difference of 0.5 km/h. Conclusion It was possible to determine the intensity of IGT by the glycemic response in the incremental test using a portable glucose meter. The IGT underestimated the intensity of VT by approximately 0.5 km/h, but with a high correlation and agreement between them. Level of evidence III, Case-Controle Study.

Lactate and glucose thresholds and heart rate deflection points for Beagles during intense exercise

OBJECTIVE To determine whether the lactate threshold of dogs could be determined by a visual method and to assess the extent of agreement and bias among treadmill velocities for the lactate threshold as determined by visual (LTv) and polynomial (LTp) methods, glucose threshold as determined by visual (GTv) and polynomial (GTp) methods, and heart rate deflection point (HRdp) as a method for estimating the aerobic capacity of dogs. ANIMALS 18 healthy adult Beagles. PROCEDURES Each dog underwent a standardized incremental treadmill exercise test once. The test ended when the dog began to show signs of fatigue. Plasma lactate and glucose concentrations and heart rate (HR) were plotted against exercise intensity (treadmill velocity) for the duration of the test, and the LTv, GTv, and HRdp were determined visually. The LTp and GTp were determined by means of a second-order polynomial function. One-way ANOVA, Pearson correlation, Bland-Altman analyses, and ordinary least products regression were used to assess the extent of agreement and bias among the various threshold velocities. RESULTS Mean velocity did not differ significantly among the thresholds evaluated. There was a strong positive correlation between the LTv velocity and the velocity for GTv (r = 0.91), LTp (r = 0.96), GTp (r = 0.94), and HRdp (r = 0.95). CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that LTv could be determined for dogs undergoing intense exercise on a treadmill, and the treadmill velocity corresponding to the LTv was associated with the velocity for the other hallmarks of endurance. Thus, that method may be useful for prescription and evaluation of conditioning programs for dogs.

Psychophysiological characterization of different capoeira performances in experienced individuals: A randomized controlled trial

The aim of this study was to characterize the psychophysiological demand in different capoeira performances. Eleven experienced capoeira practitioners underwent the following procedures in different days: 1) anamnesis and anthropometric measurements; 2) aerobic performance assessment; 3 to 5) performances of 90 seconds in three capoeira styles (Angola, Benguela and São Bento), which were performed in randomized controlled cross-over design. The psychophysiological demand was assessed through the heart rate (HR), R-R interval (RRi), blood pressure (BP), blood lactate ([Lac]), blood glucose ([Gluc]), rating perceived effort (RPE), feeling scale (FS) and perceived activation (PA). Descriptive statistics with mean and standard deviation was performed. A two-way repeated measures ANOVA with Bonferroni post-hoc test was used. The Angola demand was between 56–71% maximal HR with [Lac]_PEAK: 6.9±2.9 mM, RPE_PEAK: 10.0±2.2 pts and FS: 2.7±1.7 pts, while in the Benguela participants reached 64–85% maximal HR with [Lac]_PEAK: 9.5±3.0 mM, RPE_PEAK: 11.0±2.8 pts and FS: 2.1±1.6 pts and for São Bento between 69–102% maximal HR with [Lac]_PEAK: 15.7±2.6 mM, RPE_PEAK: 15.5±4.1 pts and FS: -0.8±3.0 pts. Interaction time*performance occurred to [Lac] (F = 42.157; p<0.001), HR (F = 12.154; p<0.001), RRi (F = 4.774; p<0.001), parasympathetic modulation-rMSSD (F = 3.189; p<0.01), [Gluc] (F = 2.152; p<0.05), RPE (F = 5.855; p<0.01), FS (F = 2.448; p<0.05) and PA (F = 3.893; p<0.05). We concluded that São Bento rhythm resulted in a greater physiological demand according to the HR, [Lac] and cardiac autonomic indicators, with the Benguela rhythm being intermediate while the Angola rhythm presented a reduced demand. The [Gluc] increased after the São Bento rhythm when compared to the other rhythms. The perceptual demand presented increased in terms of RPE and PA variables and decreased in terms of FS when the São Bento performance was analyzed in comparison to the Angola and/or Benguela in capoeira.

An integrative perspective of the anaerobic threshold

The concept of anaerobic threshold (AT) was introduced during the nineteen sixties. Since then, several methods to identify the anaerobic threshold (AT) have been studied and suggested as novel 'thresholds' based upon the variable used for its detection (i.e. lactate threshold, ventilatory threshold, glucose threshold). These different techniques have brought some confusion about how we should name this parameter, for instance, anaerobic threshold or the physiological measure used (i.e. lactate, ventilation). On the other hand, the modernization of scientific methods and apparatus to detect AT, as well as the body of literature formed in the past decades, could provide a more cohesive understanding over the AT and the multiple physiological systems involved. Thus, the purpose of this review was to provide an integrative perspective of the methods to determine AT.

Bradykinin, insulin, and glycemia responses to exercise performed above and below lactate threshold in individuals with type 2 diabetes

The aim of this study was to analyze the acute responses of bradykinin, insulin, and glycemia to exercise performed above and below lactate threshold (LT) in individuals with type 2 diabetes mellitus (T2D). Eleven participants with a diagnosis of T2D randomly underwent three experimental sessions 72 h apart: 1) 20 min of exercise performed at 120% of LT (120%LT), 2) 20 min of exercise performed at 80% of LT (80%LT), and 3) 20 min of control session. Blood glucose was analyzed before, during, and at 45 min post-exercise. Bradykinin and insulin were analyzed before and at 45 min post-exercise. Both exercise sessions elicited a parallel decrease in glucose level during exercise (P≤0.002), with a greater decrease being observed for 120%LT (P=0.005). Glucose decreased 22.7 mg/dL (95%CI=10.3 to 35, P=0.001) at the 45 min post-exercise recovery period for 80%LT and decreased 31.2 mg/dL (95%CI=18.1 to 44.4, P<0.001) for 120%LT (P=0.004). Insulin decreased at post-exercise for 80%LT (P=0.001) and control (P≤0.035). Bradykinin increased at 45 min post-exercise only for 80%LT (P=0.013), but was unrelated to the decrease in glucose (r=-0.16, P=0.642). In conclusion, exercise performed above and below LT reduced glycemia independently of insulin, but exercise above LT was more effective in individuals with T2D. However, these changes were unrelated to the increase in circulating bradykinin.

Lack of concordance amongst measurements of individual anaerobic threshold and maximal lactate steady state on a cycle ergometer

INTRODUCTION

The calculation of exertion intensity, in which a change is produced in the metabolic processes which provide the energy to maintain physical work, has been defined as the anaerobic threshold (AT). The direct calculation of maximal lactate steady state (MLSS) would require exertion intensities over a long period of time and with sufficient rest periods which would prove significantly difficult for daily practice. Many protocols have been used for the indirect calculation of MLSS.

OBJECTIVES

The aim of this study is to determine if the results of measurements with 12 different AT calculation methods and calculation software [Keul, Simon, Stegmann, Bunc, Dickhuth (TKM and WLa), Dmax, Freiburg, Geiger-Hille, Log-Log, Lactate Minimum] can be used interchangeably, including the method of the fixed threshold of Mader/OBLA's 4 mmol/l and then to compare them with the direct measurement of MLSS.

METHODS

There were two parts to this research. Phase 1: results from 162 exertion tests chosen at random from the 1560 tests. Phase 2: sixteen athletes (n = 16) carried out different tests on five consecutive days.

RESULTS

There was very high concordance among all the methods [intraclass correlation coefficient (ICC) > 0.90], except Log-Log in relation to the Stegamnn, Dmax, Dickhuth-WLa and Geiger-Hille. The Dickhuth-TKM showed a high tendency towards concordance, with Dmax (2.2 W) and Dickhuth-WLa (0.1 W). The Dickhuth-TKM method presented a high tendency to concordance with Dickhuth-WLa (0.5 W), Freiburg (7.4 W), MLSS (2.0 W), Bunc (8.9 W), Dmax (0.1 W). The calculation of MLSS power showed a high tendency to concordance, with Dickhuth-TKM (2 W), Dmax (2.1 W), Dickhuth-WLa (1.5 W).

CONCLUSION

The fixed threshold of 4 mmol/l or OBLA produces slightly different and higher results than those obtained with all the methods analyzed, including MLSS, meaning an overestimation of power in the individual anaerobic threshold. The Dickhuth-TKM, Dmax and Dickhuth-WLa methods defined a high concordance on a cycle ergometer. Dickhuth-TKM, Dmax, Dickhuth-WLa described a high concordance with the power calculated to know the MLSS.

Estimation of the Maximal Lactate Steady State Intensity by the Rating of Perceived Exertion

The maximal lactate steady state is the gold standard for evaluating aerobic capacity; however, it is time-consuming. The lactate minimum protocol is an easier alternative, but is not feasible and still expensive. This study investigated whether the rating of perceived exertion of 13 is an accurate predictor of lactate minimum and maximal lactate steady state intensities. Eleven physically active men performed three tests: (1) incremental exercise with workloads based on rating of perceived exertion of 10, 13, and 16 (experimental protocol - denominated RPE-13 test), (2) lactate minimum, and (3) maximal lactate steady state. No differences were observed among participants' workloads corresponding to rating of perceived exertion 13, lactate minimum, and maximal lactate steady state intensities. Thus, the workload associated with the rating of perceived exertion of 13 was equivalent to the other two protocols investigated.

Double product break point estimates ventilatory threshold in individuals with type 2 diabetes

[Purpose] To verify the identification of the anaerobic threshold through the double product breakpoint (DPBP) method for individuals with type 2 diabetes. [Subjects and Methods] Nine individuals with T2D (7 females; age=63.2 ± 8.9 y) and 10 non-diabetic (ND) (7 females; age=58.3 ± 7.8 y) performed an incremental exercise test on a cycle ergometer. Heart rate (HR), blood pressure (BP) and expired gas were measured at the end of each stage. The ventilatory threshold (VT) and DPBP were considered as the exercise intensities above which an over proportional increases in VE and DP were observed in relation to increasing workload. [Results] No differences were observed between the workloads, HR and VO2 corresponding to the AT identified respectively by VT and DPBP. For the T2D, strong correlations between VT and DBPB workloads (r=0.853), HR (r=0.714), and VO2 (r=0.863) were found. These relationships were similar to those found for the control group (r=0.923; r=0.881; and r=0.863, respectively). [Conclusion] These results demonstrate that the DPBP enables for the prediction of AT and correlated well the VT in both the T2D and ND participants.

LIMIAR ANAERÓBIO A PARTIR DA PSE EM EXERCÍCIO RESISTIDO POR MODELOS MATEMÁTICOS

Introdução: O limiar anaeróbio é comumente identificado em exercícios cíclicos, contudo, também pode ser determinado no exercício resistido (ER) por diferentes métodos, e assim, estimar a carga de trabalho relacionada ao estresse metabólico. No entanto, sua identificação a partir de outros métodos como o modelo matemático da DMáx e principalmente por variáveis mais acessíveis, como a percepção subjetiva de esforço (PSE), ainda não foi analisada. Objetivo: Comparar o limiar de lactato (LL) identificado pelo método de inspeção visual (LLIV) com o método da DMáx aplicado nas respostas do lactato (LLDMáx) e da PSE (PSE12/13 e PSEDMáx) durante exercício resistido incremental. Métodos: Dez praticantes de ER (24,8 ± 3,0 anos) foram submetidos ao teste de uma repetição máxima (1-RM) e a um teste incremental no leg-press, obtendo-se a PSE e o lactato em cada estágio. Resultados: Foi possível identificar o limiar anaeróbio por todos os métodos, entre 30% a 40% de 1-RM. As cargas absolutas, concentrações de lactato sanguíneo e PSE não foram diferentes entre os métodos empregados e apresentaram boa concordância entre si. Conclusão: É possível identificar o limiar anaeróbio tanto por inspeção visual quanto pelo modelo matemático de DMáx para o lactato e PSE, ampliando as possibilidades de determinação do limiar anaeróbio no exercício resistido por métodos de baixo custo e não invasivos.

Effects of aerobic exercise intensity on 24-h ambulatory blood pressure in individuals with type 2 diabetes and prehypertension

[Purpose] To verify the effects of different intensities of aerobic exercise on 24-hour ambulatory blood pressure (BP) responses in individuals with type 2 diabetes mellitus (T2D) and prehypertension. [Subjects and Methods] Ten individuals with T2D and prehypertension (55.8 ± 7.7 years old; blood glucose 133.0 ± 36.7 mg·dL⁻¹ and awake BP 130.6 ± 1.6/ 80.5 ± 1.8 mmHg) completed three randomly assigned experiments: non-exercise control (CON) and exercise at moderate (MOD) and maximal (MAX) intensities. Heart rate (HR), BP, blood lactate concentrations ([Lac]), oxygen uptake (VO₂), and rate of perceived exertion (RPE) were measured at rest, during the experimental sessions, and during the 60 min recovery period. After this period, ambulatory blood pressure was monitored for 24 h. [Results] The results indicate that [Lac] (MAX: 6.7±2.0 vs. MOD: 3.8±1.2 mM), RPE (MAX: 19±1.3 vs. MOD: 11±2.3) and VO₂peak (MAX: 20.2±4.1 vs. MOD: 14.0±3.0 mL·kg⁻¹·min⁻¹) were highest following the MAX session. Compared with CON, only MAX elicited post-exercise BP reduction that lasted for 8 h after exercise and during sleep. [Conclusion] A single session of aerobic exercise resulted in 24 h BP reductions in individuals with T2D, especially while sleeping, and this reduction seems to be dependent on the intensity of the exercise performed.

Combined exercise circuit session acutely attenuates stress-induced blood pressure reactivity in healthy adults

Objective

To investigate the blood pressure (BP) responses to cardiovascular stress test after a combined exercise circuit session at moderate intensity.

Method

Twenty individuals (10 male/10 fem; 33.4± 6.9 years; 70.2± 15.8 kg; 170.4± 11.5 cm; 22.3± 6.8% body fat) were randomized in a different days to control session with no exercise or exercise session consisting of 3 laps of the following circuit: knee extension, bench press, knee flexion, rowing in the prone position, squats, shoulder press, and 5 min of aerobic exercise at 75-85% of age-predicted maximum heart rate and/or 13 on the Borg Rating of Perceived Exertion [scale of 6 to 20]. The sets of resistance exercise consisted of 15 repetitions at ~50% of the estimated 1 repetition maximum test. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured at rest and during 1h of recovery in both experimental sessions. After that, blood pressure reactivity (BP_R) was evaluated using the Cold Pressor Test.

Results

During 1h of exercise recovery, there was a reduction in SBP (3-6 mmHg) and DBP (2-5 mmHg) in relation to pre-session rest (p<0.01), while this reduction was not observed in the control session. A decline in BP_R (4-7 mmHg; p<0.01) was observed 1h post-exercise session, but not in the control session. Post-exercise reductions in SBP and DBP were significantly correlated with BP_R reductions (r=0.50-0.45; p<0.05).

Conclusion

A combined exercise circuit session at moderate intensity promoted subsequent post-exercise hypotension and acutely attenuated BP_R in response to a cardiovascular stress test. In addition, the post-exercise BP reduction was correlated with BP_R attenuation in healthy adults of both genders.

Type 2 diabetes elicits lower nitric oxide, bradykinin concentration and kallikrein activity together with higher DesArg(9)-BK and reduced post-exercise hypotension compared to non-diabetic condition

This study compared the plasma kallikrein activity (PKA), bradykinin concentration (BK), DesArg(9)-BK production, nitric oxide release (NO) and blood pressure (BP) response after moderate-intensity aerobic exercise performed by individuals with and without type 2 diabetes. Ten subjects with type 2 diabetes (T2D) and 10 without type 2 diabetes (ND) underwent three sessions: 1) maximal incremental test on cycle ergometer to determine lactate threshold (LT); 2) 20-min of constant-load exercise on cycle ergometer, at 90% LT and; 3) control session. BP and oxygen uptake were measured at rest and at 15, 30 and 45 min post-exercise. Venous blood samples were collected at 15 and 45 minutes of the recovery period for further analysis of PKA, BK and DesArg(9)-BK. Nitrite plus nitrate (NOx) was analyzed at 15 minutes post exercise. The ND group presented post-exercise hypotension (PEH) of systolic blood pressure and mean arterial pressure on the 90% LT session but T2D group did not. Plasma NOx increased ~24.4% for ND and ~13.8% for T2D group 15 min after the exercise session. Additionally, only ND individuals showed increases in PKA and BK in response to exercise and only T2D group showed increased DesArg(9)-BK production. It was concluded that T2D individuals presented lower PKA, BK and NOx release as well as higher DesArg(9)-BK production and reduced PEH in relation to ND participants after a single exercise session.

The influence of body weight on chosen physiological parameters in wrestling

In this study, the authors attempted to determine whether the dynamics of blood lactate and glucose in wrestling depend on the weight class. Blood lactate and glucose curves during and after a wrestling match were determined. We also explained the dynamics of blood lactate and glucose in the context of recent glucose and lactate metabolism research. A sample of 60 youth wrestlers (15–20 years) were divided into three weight groups. Each athlete participated in one wrestling match. During the fight, the athletes’ heart rate, glucose, and blood lactate were measured. The differences in body mass between the athletes did not affect the dynamics of lactate and glucose in wrestling competition (Fisher LSD test). We established that lactate and glucose dynamics are the same for all weight groups (Fisher LSD-Lactate 1 < 2 < 3 = 4 > 5, Fisher LSD-Glucose 1 = 2 < 3 < 4 < 5). Understanding lactate and glucose metabolism in wrestling is important for wrestling coaches because they need to evaluate a wrestler’s anaerobic energy status.

Cycling above rather than below lactate threshold is more effective for nitric oxide release and post-exercise blood pressure reduction in individuals with type-2 diabetes

The purposes of this study were to analyze and compare the effects of exercise performed in different intensities, above and below lactate threshold (LT) on post-exercise blood pressure (BP) and nitric oxide (NO) responses in individuals with type 2 diabetes (T2D). For this, 11 T2D underwent the following sessions: 1) control session; 2) 20-min of moderate cycling (80% LT); and 3) 20-min of high intensity cycling (120%LT) on a cycle ergometer. Plasma NO and BP measurements were carried out at rest and at 15 and 45 min of post-sessions. When compared to rest, only the exercise session performed at 120%LT elicited an increase of NO (from 7.2 to 9.5 µM, p<0.05), as well as a decrease in systolic BP (from 126.6±7.9 to 118.7±3.9 mmHg, p<0.05) during the post-exercise period. In conclusion, the results suggest that NO release and post-exercise BP decrease are intensity-dependent for individuals with T2D.

Reprodutibilidade do protocolo de lactato mínimo com intensidade do esforço prévio individualizado pela PSE

Introdução: O protocolo de lactato mínimo (LM) é precedido de um esforço máximo para indução a hiperlactatemia. Objetivo: Verificar a reprodutibilidade de um teste de LM com indução à hiperlactatemia realizada em teste incremental com cargas individualizadas através da percepção subjetiva de esforço (PSE). Metodologia: A amostra foi composta por 20 estudantes fisicamente ativos (25,4 ± 4,1 anos; 14,1 ± 5,0 % gordura), submetidos a dois testes de LM com metodologia idêntica. A indução a hiperlactatemia foi realizada por um teste com quatro estágios, com duração de três minutos cada e cargas individualizadas pela PSE (níveis 10, 13, 16 e o último estágio 17-20 até a exaustão voluntária). Após oito minutos de recuperação o teste progressivo começou com carga inicial de 75 W e incrementos de 25 W a cada três minutos, até a exaustão. Resultados: As intensidades de LM 1 (155,0 ± 23,8 W) e LM 2 (157,5 ± 27,0 W) não diferiram estatisticamente (p = 0,795) e de uma maneira geral apresentaram boa reprodutibilidade (CCI = 0,79) e concordância [-2,5 W de média da diferença e ± 41,8 W de abas]. Conclusão: O teste de LM, com cargas para hiperlactatemia individualizadas pela PSE, se mostrou reprodutível em indivíduos fisicamente ativos.

Noninvasive method to estimate anaerobic threshold in individuals with type 2 diabetes

BACKGROUND

While several studies have identified the anaerobic threshold (AT) through the responses of blood lactate, ventilation and blood glucose others have suggested the response of the heart rate variability (HRV) as a method to identify the AT in young healthy individuals. However, the validity of HRV in estimating the lactate threshold (LT) and ventilatory threshold (VT) for individuals with type 2 diabetes (T2D) has not been investigated yet.

AIM

To analyze the possibility of identifying the heart rate variability threshold (HRVT) by considering the responses of parasympathetic indicators during incremental exercise test in type 2 diabetics subjects (T2D) and non diabetics individuals (ND).

METHODS

Nine T2D (55.6 ± 5.7 years, 83.4 ± 26.6 kg, 30.9 ± 5.2 kg.m2(-1)) and ten ND (50.8 ± 5.1 years, 76.2 ± 14.3 kg, 26.5 ± 3.8 kg.m2(-1)) underwent to an incremental exercise test (IT) on a cycle ergometer. Heart rate (HR), rate of perceived exertion (RPE), blood lactate and expired gas concentrations were measured at the end of each stage. HRVT was identified through the responses of root mean square successive difference between adjacent R-R intervals (RMSSD) and standard deviation of instantaneous beat-to-beat R-R interval variability (SD1) by considering the last 60 s of each incremental stage, and were known as HRVT by RMSSD and SD1 (HRVT-RMSSD and HRVT-SD1), respectively.

RESULTS

No differences were observed within groups for the exercise intensities corresponding to LT, VT, HRVT-RMSSD and HHVT-SD1. Furthermore, a strong relationship were verified among the studied parameters both for T2D (r = 0.68 to 0.87) and ND (r = 0.91 to 0.98) and the Bland & Altman technique confirmed the agreement among them.

CONCLUSION

The HRVT identification by the proposed autonomic indicators (SD1 and RMSSD) were demonstrated to be valid to estimate the LT and VT for both T2D and ND.