The aim of the present study was to examine if diabetes in the absence of neuropathy affects the exercising capacity of IDDM patients, and whether regular, intense training has a beneficial effect on endothelial function. Five groups of subjects were studied: 23 healthy control subjects who exercised regularly (age 33 ± 6 years), 23 nonneuropathic type 1 diabetic patients who exercised regularly (age 33 ± 6 years, IDDM duration 11 ± 8 years), 7 neuropathic type 1 diabetic patients who exercised regularly (age 36 ± 7 years, IDDM duration 22 ± 8 years), 18 healthy subjects who did not exercise regularly (age 34 ± 7 years), and 5 nonneuropathic type 1 diabetic patients who did not exercise regularly (age 31 ± 4 years, IDDM duration 20 ± 3 years). All groups were matched for age, sex, and body weight. No differences existed in the energy expenditure per week in physical activity among the three exercising groups or between the two nonexercising groups. The maximal oxygen uptake was similar between control and diabetic nonneuropathic exercisers, and among diabetic neuropathic exercisers, control nonexercisers, and diabetic nonexercisers; however, a significant difference existed between the first two and the last three groups (P < 0.0001). A stepwise increase was found in the resting heart rate among the groups, ranging from the lowest in control exercisers to the highest in diabetic nonexercisers, but the maximal heart rate was lower only in diabetic neuropathic exercisers compared with all other groups (P < 0.05). Assessments of endothelial function in both macro- and microcirculation were performed in 12 control exercisers, 10 diabetic nonneuropathic exercisers, 5 diabetic neuropathic exercisers, 17 control nonexercisers, and 4 diabetic nonexercisers. When all diabetic patients were considered as one group and all control subjects as another, the microcirculation endothelial function in the diabetic group was reduced compared with the control subjects (91 ± 49 vs. 122 ± 41% flux increase over baseline; P < 0.05). In contrast, no differences existed among the three diabetic groups or between the two control groups. Similarly, in macro-circulation, a reduced response during reactive hyperemia was observed in the diabetic patients compared with control subjects (7.0 ± 4.5 vs. 11.2 ± 6.6% diameter increase; P < 0.05), whereas again no difference existed among the three diabetic groups or between the two control groups. These data suggest that diabetes per se does not affect aerobic exercise capacity (Vo2max) in physically active individuals, but is reduced in the presence of neuropathy. In addition, regular exercise training involving the lower extremities does not improve the endothelial function in the micro- and macrocirculation of the nonexercised upper extremity in type 1 diabetic patients.
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November 01 1997
Aerobic Exercise Capacity Remains Normal Despite Impaired Endothelial Function in the Micro- and Macrocirculation of Physically Active IDDM Patients
Aristidis Veves;
Aristidis Veves
Department of Medicine, Microcirculation Laboratory and Deaconess-Joslin Foot Center, Beth Israel Deaconess Medical Center
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Rola Saouaf;
Rola Saouaf
Department of Radiological Sciences, Harvard Medical School, Sargent College of Health and Rehabilitation Sciences
Boston, Massachusetts
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Valerie M Donaghue;
Valerie M Donaghue
Division of Podiatry, Microcirculation Laboratory and Deaconess-Joslin Foot Center, Beth Israel Deaconess Medical Center
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Catherine A Mullooly;
Catherine A Mullooly
Joslin Diabetes Center, Microcirculation Laboratory and Deaconess-Joslin Foot Center, Beth Israel Deaconess Medical Center
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Joy A Kistler;
Joy A Kistler
Joslin Diabetes Center, Microcirculation Laboratory and Deaconess-Joslin Foot Center, Beth Israel Deaconess Medical Center
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John M Giurini;
John M Giurini
Division of Podiatry, Microcirculation Laboratory and Deaconess-Joslin Foot Center, Beth Israel Deaconess Medical Center
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Edward S Horton;
Edward S Horton
Joslin Diabetes Center, Microcirculation Laboratory and Deaconess-Joslin Foot Center, Beth Israel Deaconess Medical Center
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Roger A Fielding
Roger A Fielding
Department of Health Sciences, Boston University, Sargent College of Health and Rehabilitation Sciences
Boston, Massachusetts
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Address correspondence and reprint requests to Dr. Aristidis Veves, Deaconess-Joslin Foot Center, One Deaconess Rd., Boston, MA 02215. E-mail: aveves@nedhmail.nedh.harvard.edu.
Diabetes 1997;46(11):1846–1852
Article history
Received:
March 25 1997
Revision Received:
June 20 1997
Accepted:
June 20 1997
Citation
Aristidis Veves, Rola Saouaf, Valerie M Donaghue, Catherine A Mullooly, Joy A Kistler, John M Giurini, Edward S Horton, Roger A Fielding; Aerobic Exercise Capacity Remains Normal Despite Impaired Endothelial Function in the Micro- and Macrocirculation of Physically Active IDDM Patients. Diabetes 1 November 1997; 46 (11): 1846–1852. https://doi.org/10.2337/diab.46.11.1846
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