Physical inactivity promotes insulin resistance and increases the risk of diabetes and cardiovascular disease. Clustering based on simple clinical measures has been introduced for identifying diabetes subgroups with different risk of complications. However, little is known about physical fitness and cardiovascular risk factors in these clusters. We hypothesized that the insulin resistant diabetes (SIRD) cluster would associate with lower physical fitness and increased cardiovascular risk factors. Cycling spiroerogometry, physical activity questionnaire (Baecke index) and cardiovascular risk scores (Framingham Risk Scores (FRS) and triglycerides to high-density lipoproteins (TG:HDL) ratio) were analyzed in 746 participants with newly diagnosed diabetes of the German Diabetes Study (GDS). SIRD showed lower VO2max compared to the severe autoimmune diabetes (SAID), moderate age-related (MARD) and moderate obesity-related (MOD) clusters (all p<0.01) but was not different to the severe insulin deficient (SIDD) cluster (p= 0.87). Further, Baecke index was lower in SIRD [7.3 (6.8-8.4)] than SAID [8.5 (7.6-9.5)] and MARD [8.4 (7.3-9.4)] and SIRD had the highest TG:HDL ratio compared to all other groups (p<0.05) after adjustments for age, sex and BMI. This was underlined by a strong association between estimates of insulin resistance (HOMA-IR) and TG:HDL ratio (r= 0.59 p= <.0001) across all groups. Finally, SIRD showed higher FRS [33.1 (25.3-54.9)%] compared to MOD [16.2 (7.4-24.4)%], SAID [3.9 (1.6-9.4)%] and SIDD [12.4 (4.7-34.9)%].

In conclusion, SIRD and MARD showed lowest physical fitness and SIRD was least physically active and has the highest risk scores for diabetes-related cardiovascular diseases.


N. Saatmann: None. O. P. Zaharia: None. K. Strassburger: None. D. Pesta: None. V. Burkart: None. J. Szendroedi: None. M. Roden: Advisory Panel; Self; Allergan plc, Bristol-Myers Squibb Company, Novo Nordisk A/S, Research Support; Self; Boehringer Ingelheim International GmbH, Danone Nutricia, Sanofi-Aventis Deutschland GmbH.

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