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Exercise responses in patients with IDDM
A M Nugent1, I C Steele, F al-Modaris
1Department of Medicine, Royal Victoria Hospital, Belfast, Northern Ireland, U.K.
Diabetes Care
|December 24, 1997
Summary
This study found no exercise response impairment in long-standing diabetes patients, suggesting left ventricular ejection fraction changes are hemodynamic adaptations, not diabetic cardiomyopathy.
Area of Science:
- Cardiology
- Endocrinology
- Exercise Physiology
Background:
- Diabetic cardiomyopathy is a concern in individuals with diabetes mellitus.
- Assessing exercise responses can reveal cardiac dysfunction.
Purpose of the Study:
- To investigate hemodynamic, respiratory, and metabolic responses during exercise in patients with insulin-dependent diabetes mellitus (IDDM).
- To detect potential diabetic cardiomyopathy by analyzing exercise parameters and cardiac function.
Main Methods:
- Compared 8 IDDM patients (diabetes duration >10 years) with 8 control subjects.
- Utilized progressive incremental and steady-state bicycle exercise tests.
- Measured gas exchange, blood glucose, lactate, metabolites, catecholamines, cardiac output (CO2 rebreathing), and ejection fractions (radionuclide first-pass method).
Main Results:
- Similar peak oxygen consumption, heart rate, and double product between groups.
- Diabetic subjects had higher glucose levels but comparable lactate, catecholamine, and fat metabolite levels.
- Left ventricular ejection fraction showed a similar trend of decrease from rest to peak exercise in both diabetic and control groups, with no significant difference observed.
Conclusions:
- No evidence of impaired exercise response in long-standing IDDM.
- The observed decrease in left ventricular ejection fraction during peak exercise in diabetics may be a hemodynamic adaptation rather than a sign of diabetic cardiomyopathy.