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Gas exchange during exercise in diabetic children
E Baraldi1, C Monciotti, M Filippone
1Department of Pediatrics, University of Padova, Italy.
Insights
Children with type 1 diabetes exhibit reduced exercise capacity. Even with good metabolic control, diabetic adolescents show lower peak oxygen uptake and O2 pulse during exercise tests compared to healthy peers.
Area of Science:
- Pediatric Endocrinology
- Exercise Physiology
- Metabolic Disorders
Background:
- Type 1 diabetes mellitus (T1DM) affects children and adolescents, requiring careful management.
- Understanding the impact of T1DM on physical capacity is crucial for comprehensive care.
Purpose of the Study:
- To assess the cardiorespiratory and metabolic responses to exercise in children with T1DM.
- To compare exercise performance in T1DM adolescents with age- and sex-matched healthy controls.
Main Methods:
- Evaluated 33 children with T1DM (aged 9-15) on insulin therapy and 47 healthy controls.
- Conducted pulmonary function tests and progressive treadmill exercise tests.
- Monitored gas exchange, ventilation, heart rate, and calculated O2 pulse.
Main Results:
- Diabetic adolescents had significantly lower peak oxygen uptake (VO2 peak) and achieved it earlier than controls.
- O2 pulse was significantly lower throughout the exercise test in the T1DM group.
- No differences observed in baseline VO2, anaerobic threshold, minute ventilation, or spirometry.
Conclusions:
- Well-controlled adolescents with T1DM demonstrate reduced working capacity.
- Cardiorespiratory fitness may be impaired in pediatric T1DM despite adequate metabolic control.
Abstract:
The purpose of this study was to evaluate the cardiorespiratory and metabolic response to exercise in 33 children, aged 9 to 15 years, affected by type I diabetes mellitus, in comparison with 47 age-, sex-, weight-, and height-matched healthy children. All diabetic children were on a mixed split-dose insulin regimen, consisting of both regular and long-acting insulin in the morning and evening. The last insulin injection was administered on average 6 hours before the test. The mean duration of diabetes mellitus was 5.0 +/- 3.1 years. The metabolic control was evaluated on the basis of HbA1 levels (mean, 8.9 +/- 1.8%). Pulmonary function tests and progressive exercise tests on the treadmill were performed. Gas exchange, ventilation, and heart rate (HR) were monitored during the tests. The O2 pulse (VO2/HR) was calculated. There was no difference in the baseline oxygen uptake (VO2) between the diabetic children and the control group. VO2 peak was significantly lower (P less than 0.01) in the diabetic adolescents (41.2 +/- 5.9 mL/min/kg) compared to control subjects (46.3 +/- 9.6 mL/min/kg) and it was achieved at an earlier (P less than 0.01) time of run (7.5 +/- 1.8 vs. 9.1 +/- 2.8 min). Anaerobic threshold and minute ventilation were similar in the two groups. The O2 pulse throughout the test was significantly lower (ANOVA, P less than 0.001) in the diabetic group compared to the controls. No differences were found in resting and post-exercise spirometric values. In conclusion, our study shows that well-controlled diabetic adolescents have a reduced working capacity.(ABSTRACT TRUNCATED AT 250 WORDS)