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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

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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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fullrecord <?xml version="1.0"?><rfc1807><datestamp>2021-03-03T13:02:54.5788503</datestamp><bib-version>v2</bib-version><id>56214</id><entry>2021-02-09</entry><title>Differences in Physiological Responses to Cardiopulmonary Exercise Testing in Adults With and Without Type 1 Diabetes: A Pooled Analysis</title><swanseaauthors><author><sid>f5da81cd18adfdedb2ccb845bddc12f7</sid><ORCID>0000-0002-6986-6449</ORCID><firstname>Richard</firstname><surname>Bracken</surname><name>Richard Bracken</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2021-02-09</date><deptcode>STSC</deptcode><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 &lt; 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 &#xB1; 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 &lt; 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 [&#x2212;0.75; 1.09] vs. 0.66 [&#x2212;0.28; 1.45]; P &lt; 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.</abstract><type>Journal Article</type><journal>Diabetes Care</journal><volume>44</volume><journalNumber>1</journalNumber><paginationStart>240</paginationStart><paginationEnd>247</paginationEnd><publisher>American Diabetes Association</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>0149-5992</issnPrint><issnElectronic>1935-5548</issnElectronic><keywords/><publishedDay>1</publishedDay><publishedMonth>1</publishedMonth><publishedYear>2021</publishedYear><publishedDate>2021-01-01</publishedDate><doi>10.2337/dc20-1496</doi><url/><notes/><college>COLLEGE NANME</college><department>Sport and Exercise Sciences</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>STSC</DepartmentCode><institution>Swansea University</institution><apcterm/><lastEdited>2021-03-03T13:02:54.5788503</lastEdited><Created>2021-02-09T10:24:15.7171652</Created><path><level id="1">Faculty of Science and Engineering</level><level id="2">School of Aerospace, Civil, Electrical, General and Mechanical Engineering - Sport and Exercise Sciences</level></path><authors><author><firstname>Max L.</firstname><surname>Eckstein</surname><order>1</order></author><author><firstname>Juliano Boufleur</firstname><surname>Farinha</surname><order>2</order></author><author><firstname>Olivia</firstname><surname>McCarthy</surname><order>3</order></author><author><firstname>Daniel J.</firstname><surname>West</surname><order>4</order></author><author><firstname>Jane E.</firstname><surname>Yardley</surname><order>5</order></author><author><firstname>Lia</firstname><surname>Bally</surname><order>6</order></author><author><firstname>Thomas</firstname><surname>Zueger</surname><order>7</order></author><author><firstname>Christoph</firstname><surname>Stettler</surname><order>8</order></author><author><firstname>Winston</firstname><surname>Boff</surname><order>9</order></author><author><firstname>Alvaro</firstname><surname>Reischak-Oliveira</surname><order>10</order></author><author><firstname>Michael C.</firstname><surname>Riddell</surname><order>11</order></author><author><firstname>Dessi P.</firstname><surname>Zaharieva</surname><order>12</order></author><author><firstname>Thomas R.</firstname><surname>Pieber</surname><order>13</order></author><author><firstname>Alexander</firstname><surname>M&#xFC;ller</surname><order>14</order></author><author><firstname>Philipp</firstname><surname>Birnbaumer</surname><order>15</order></author><author><firstname>Faisal</firstname><surname>Aziz</surname><order>16</order></author><author><firstname>Laura</firstname><surname>Brugnara</surname><order>17</order></author><author><firstname>Hanne</firstname><surname>Haahr</surname><order>18</order></author><author><firstname>Eric</firstname><surname>Zijlstra</surname><order>19</order></author><author><firstname>Tim</firstname><surname>Heise</surname><order>20</order></author><author><firstname>Harald</firstname><surname>Sourij</surname><order>21</order></author><author><firstname>Michael</firstname><surname>Roden</surname><order>22</order></author><author><firstname>Peter</firstname><surname>Hofmann</surname><order>23</order></author><author><firstname>Richard</firstname><surname>Bracken</surname><orcid>0000-0002-6986-6449</orcid><order>24</order></author><author><firstname>Dominik</firstname><surname>Pesta</surname><order>25</order></author><author><firstname>Othmar</firstname><surname>Moser</surname><order>26</order></author></authors><documents><document><filename>56214__19269__42de5598b0d34850a1042f5fbe4f4020.pdf</filename><originalFilename>56214.pdf</originalFilename><uploaded>2021-02-11T12:28:05.2155938</uploaded><type>Output</type><contentLength>819054</contentLength><contentType>application/pdf</contentType><version>Accepted Manuscript</version><cronfaStatus>true</cronfaStatus><copyrightCorrect>true</copyrightCorrect><language>eng</language><licence>http://creativecommons.org/licenses/by-nc-nd/4.0/</licence></document></documents><OutputDurs/></rfc1807>
spelling 2021-03-03T13:02:54.5788503 v2 56214 2021-02-09 Differences in Physiological Responses to Cardiopulmonary Exercise Testing in Adults With and Without Type 1 Diabetes: A Pooled Analysis f5da81cd18adfdedb2ccb845bddc12f7 0000-0002-6986-6449 Richard Bracken Richard Bracken true false 2021-02-09 STSC 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. Journal Article Diabetes Care 44 1 240 247 American Diabetes Association 0149-5992 1935-5548 1 1 2021 2021-01-01 10.2337/dc20-1496 COLLEGE NANME Sport and Exercise Sciences COLLEGE CODE STSC Swansea University 2021-03-03T13:02:54.5788503 2021-02-09T10:24:15.7171652 Faculty of Science and Engineering School of Aerospace, Civil, Electrical, General and Mechanical Engineering - Sport and Exercise Sciences Max L. Eckstein 1 Juliano Boufleur Farinha 2 Olivia McCarthy 3 Daniel J. West 4 Jane E. Yardley 5 Lia Bally 6 Thomas Zueger 7 Christoph Stettler 8 Winston Boff 9 Alvaro Reischak-Oliveira 10 Michael C. Riddell 11 Dessi P. Zaharieva 12 Thomas R. Pieber 13 Alexander Müller 14 Philipp Birnbaumer 15 Faisal Aziz 16 Laura Brugnara 17 Hanne Haahr 18 Eric Zijlstra 19 Tim Heise 20 Harald Sourij 21 Michael Roden 22 Peter Hofmann 23 Richard Bracken 0000-0002-6986-6449 24 Dominik Pesta 25 Othmar Moser 26 56214__19269__42de5598b0d34850a1042f5fbe4f4020.pdf 56214.pdf 2021-02-11T12:28:05.2155938 Output 819054 application/pdf Accepted Manuscript true true eng http://creativecommons.org/licenses/by-nc-nd/4.0/
title Differences in Physiological Responses to Cardiopulmonary Exercise Testing in Adults With and Without Type 1 Diabetes: A Pooled Analysis
spellingShingle Differences in Physiological Responses to Cardiopulmonary Exercise Testing in Adults With and Without Type 1 Diabetes: A Pooled Analysis
Richard Bracken
title_short Differences in Physiological Responses to Cardiopulmonary Exercise Testing in Adults With and Without Type 1 Diabetes: A Pooled Analysis
title_full Differences in Physiological Responses to Cardiopulmonary Exercise Testing in Adults With and Without Type 1 Diabetes: A Pooled Analysis
title_fullStr Differences in Physiological Responses to Cardiopulmonary Exercise Testing in Adults With and Without Type 1 Diabetes: A Pooled Analysis
title_full_unstemmed Differences in Physiological Responses to Cardiopulmonary Exercise Testing in Adults With and Without Type 1 Diabetes: A Pooled Analysis
title_sort Differences in Physiological Responses to Cardiopulmonary Exercise Testing in Adults With and Without Type 1 Diabetes: A Pooled Analysis
author_id_str_mv f5da81cd18adfdedb2ccb845bddc12f7
author_id_fullname_str_mv f5da81cd18adfdedb2ccb845bddc12f7_***_Richard Bracken
author Richard Bracken
author2 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
Dominik Pesta
Othmar Moser
format Journal article
container_title Diabetes Care
container_volume 44
container_issue 1
container_start_page 240
publishDate 2021
institution Swansea University
issn 0149-5992
1935-5548
doi_str_mv 10.2337/dc20-1496
publisher American Diabetes Association
college_str Faculty of Science and Engineering
hierarchytype
hierarchy_top_id facultyofscienceandengineering
hierarchy_top_title Faculty of Science and Engineering
hierarchy_parent_id facultyofscienceandengineering
hierarchy_parent_title Faculty of Science and Engineering
department_str School of Aerospace, Civil, Electrical, General and Mechanical Engineering - Sport and Exercise Sciences{{{_:::_}}}Faculty of Science and Engineering{{{_:::_}}}School of Aerospace, Civil, Electrical, General and Mechanical Engineering - Sport and Exercise Sciences
document_store_str 1
active_str 0
description 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.
published_date 2021-01-01T04:11:00Z
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