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Reduced exercise arteriovenous O2 difference in Type 2 diabetes.

James C Baldi1, James L Aoina, Helen C Oxenham

  • 1Departments of Sport and Exercise Science and Cardiovascular Research, School of Medicine, University of Auckland, Auckland, New Zealand. j.baldi@auckland.ac.nz

Journal of Applied Physiology (Bethesda, Md. : 1985)
|February 7, 2003
PubMed
Summary

Type 2 diabetes lowers maximal oxygen consumption (Vo(2 max)) due to reduced oxygen extraction (a-v O(2) difference), not cardiac output (Q(max)). This impacts exercise capacity in diabetic individuals.

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Area of Science:

  • Cardiovascular Physiology
  • Metabolic Disease Research
  • Exercise Science

Background:

  • Maximal oxygen consumption (Vo(2 max)) is demonstrably lower in individuals with Type 2 diabetes compared to sedentary, non-diabetic individuals.
  • The underlying physiological mechanisms contributing to this reduced exercise capacity in Type 2 diabetes remain incompletely understood.

Purpose of the Study:

  • To investigate whether diminished maximal cardiac output (Q(max)) or impaired peripheral oxygen extraction (arterial-mixed venous O(2) difference) accounts for the lower Vo(2 max) observed in Type 2 diabetic patients.
  • To compare exercise physiology parameters between Type 2 diabetic patients and matched non-diabetic controls.

Main Methods:

  • A bicycle ergometer exercise test was administered to 11 Type 2 diabetic patients and 12 non-diabetic controls, matched for age and body composition.

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  • Measurements included maximal oxygen consumption (Vo(2 max)), submaximal and maximal cardiac output (Q(max)), and arterial-mixed venous O(2) difference (a-v O(2)) at maximal exercise.
  • Participants had a minimum of 2 years of inactivity prior to the study.

    • Main Results:

    • Type 2 diabetic patients exhibited significantly lower maximal workload, Vo(2 max), and maximal a-v O(2) difference compared to controls (P < 0.05).
    • Maximal cardiac output (Q(max)) was comparable between groups (11.2 L/min vs. 10.0 L/min, P > 0.05), though generally low in both.
    • Vo(2 max) in diabetic patients showed a linear correlation with the maximal a-v O(2) difference, but not with Q(max).

    Conclusions:

    • A reduced maximal arterial-mixed venous O(2) difference, reflecting impaired peripheral oxygen extraction, is a key contributor to the decreased maximal oxygen consumption in Type 2 diabetic patients.
    • Maximal cardiac output does not appear to be the primary limiting factor for Vo(2 max) in this cohort of Type 2 diabetic individuals.