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Stewart T, Caffrey DG, Gilman RH, Mathai SC, Lerner A, Hernandez A, Pinto ME, Huaylinos Y, Cabrera L, Wise RA, Miranda JJ, Checkley W. Can a simple test of functional capacity add to the clinical assessment of diabetes? Diabet Med 2016; 33:1133-9. [PMID: 26599981 PMCID: PMC4955604 DOI: 10.1111/dme.13032] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/17/2015] [Indexed: 01/06/2023]
Abstract
AIM To identify impairment in functional capacity associated with complicated and non-complicated diabetes using the 6-min walk distance test. METHODS We enrolled 111 adults, aged ≥40 years, with Type 2 diabetes from a hospital facility and 150 healthy control subjects of similar age and sex from a community site in Lima, Peru. All participants completed a 6-min walk test. RESULTS The mean age of the 261 participants was 58.3 years, and 43.3% were male. Among those with diabetes, 67 (60%) had non-complicated diabetes and 44 (40%) had complications such as peripheral neuropathy, retinopathy or nephropathy. The mean unadjusted 6-min walk distances were 376 m and 394 m in adults with and without diabetes complications, respectively, vs 469 m in control subjects (P<0.001). In multivariable regression, the subjects with diabetes complications walked 84 m less far (95% CI -104 to -63 m) and those without complications walked 60 m less far (-77 to -42 m) than did control subjects. When using HbA1c level as a covariate in multivariable regression, participants walked 13 m less far (-16.9 to -9.9 m) for each % increase in HbA1c . CONCLUSIONS The subjects with diabetes had lower functional capacity compared with healthy control subjects with similar characteristics. Differences in 6-min walk distance were even apparent in the subjects without diabetes complications. Potential mechanisms that could explain this finding are early cardiovascular disease or deconditioning.
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Affiliation(s)
- T Stewart
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - D G Caffrey
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - R H Gilman
- Program in Disease Control and Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- A.B. PRISMA, Lima, Peru
| | - S C Mathai
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - A Lerner
- Program in Disease Control and Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - A Hernandez
- Division of Endocrinology, Department of Medicine, Hospital Nacional Cayetano Heredia, Lima, Peru
| | - M E Pinto
- Division of Endocrinology, Department of Medicine, Hospital Nacional Cayetano Heredia, Lima, Peru
- Department of Medicine, School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Y Huaylinos
- Division of Endocrinology, Department of Medicine, Hospital Nacional Cayetano Heredia, Lima, Peru
| | | | - R A Wise
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - J J Miranda
- Department of Medicine, School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - W Checkley
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
- Program in Disease Control and Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
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