[Physical work ability in patients with type 1 diabetes]

Physical work ability was assessed in 128 patients with a long duration of type 1 diabetes mellitus and 36 practically healthy people by K. Wasserman stepwise standard loading test with permanent monitoring of the load, oxygen consumption, and respiratory coefficient. Oxygen consumption was calculated per 1 kg body mass, and anaerobic metabolism threshold was determined. The patients were divided into three groups: Group 1 consisting of patients without clinically detectable microangiopathic complications, Group 2 with initial, and Group 3 with advanced manifestations of late diabetic syndrome. Average levels of maximum oxygen consumption, the achieved load, oxygen consumption per 1 kg body mass at the peak of physical load, and anaerobic threshold were significantly lower in all the three groups compared to controls. Respiratory coefficient at the peak of loading testing was significantly higher in diabetic patients than in controls. The study demonstrated that microangiopathic alterations significantly reduced physical work ability in patients with type 1 diabetes mellitus. Nevertheless, this study demonstrated low physical exercise tolerance in a large part of young diabetics without clinically detectable microvascular complications of endocrinopathy. A decrease in maximum oxygen consumption in these patients may be of multi-factor nature and may be a result of both central (hemodynamics) and peripheral (microcirculation, muscular metabolism) mechanisms limiting the function of the gas transport system.