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Differences in Physiological Responses to Cardiopulmonary Exercise Testing in Adults With and Without Type 1 Diabetes: A Pooled Analysis

Max L. Eckstein, Juliano Boufleur Farinha, Olivia McCarthy, Daniel J. West, Jane E. Yardley, Lia Bally, Thomas Zueger, Christoph Stettler, Winston Boff, Alvaro Reischak-Oliveira, Michael C. Riddell, Dessi P. Zaharieva, Thomas R. Pieber, Alexander Müller, Philipp Birnbaumer, Faisal Aziz, Laura Brugnara, Hanne Haahr, Eric Zijlstra, Tim Heise, Harald Sourij, Michael Roden, Peter Hofmann, Richard Bracken Orcid Logo, Dominik Pesta, Othmar Moser

Diabetes Care, Volume: 44, Issue: 1, Pages: 240 - 247

Swansea University Author: Richard Bracken Orcid Logo

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DOI (Published version): 10.2337/dc20-1496

Abstract

OBJECTIVE To investigate physiological responses to cardiopulmonary exercise (CPX) testing in adults with type 1 diabetes compared with age-, sex-, and BMI-matched control participants without type 1 diabetes.RESEARCH DESIGN AND METHODS We compared results from CPX tests on a cycle ergometer in indi...

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Published in: Diabetes Care
ISSN: 0149-5992 1935-5548
Published: American Diabetes Association 2021
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URI: https://cronfa.swan.ac.uk/Record/cronfa56214
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Abstract: OBJECTIVE To investigate physiological responses to cardiopulmonary exercise (CPX) testing in adults with type 1 diabetes compared with age-, sex-, and BMI-matched control participants without type 1 diabetes.RESEARCH DESIGN AND METHODS We compared results from CPX tests on a cycle ergometer in individuals with type 1 diabetes and control participants without type 1 diabetes. Parameters were peak and threshold variables of VO2, heart rate, and power output. Differences between groups were investigated through restricted maximum likelihood modeling and post hoc tests. Differences between groups were explained by stepwise linear regressions (P < 0.05).RESULTS Among 303 individuals with type 1 diabetes (age 33 [interquartile range 22; 43] years, 93 females, BMI 23.6 [22; 26] kg/m2, HbA1c 6.9% [6.2; 7.7%] [52 (44; 61) mmol/mol]), VO2peak (32.55 [26.49; 38.72] vs. 42.67 ± 10.44 mL/kg/min), peak heart rate (179 [170; 187] vs. 184 [175; 191] beats/min), and peak power (216 [171; 253] vs. 245 [200; 300] W) were lower compared with 308 control participants without type 1 diabetes (all P < 0.001). Individuals with type 1 diabetes displayed an impaired degree and direction of the heart rate-to-performance curve compared with control participants without type 1 diabetes (0.07 [−0.75; 1.09] vs. 0.66 [−0.28; 1.45]; P < 0.001). None of the exercise physiological responses were associated with HbA1c in individuals with type 1 diabetes.CONCLUSIONS Individuals with type 1 diabetes show altered responses to CPX testing, which cannot be explained by HbA1c. Intriguingly, the participants in our cohort were people with recent-onset type 1 diabetes; heart rate dynamics were altered during CPX testing.
College: Faculty of Science and Engineering
Issue: 1
Start Page: 240
End Page: 247

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