Introduction: Sudomotor impairment (SI) is common in people with diabetic peripheral neuropathy (DPN) and could potentially influence the effects of exercise. Exercise is known to improve outcomes such as physical fatigue (PF); however, the impact of SI on PF is not clear. Thus, our objective was to examine the impact of sudomotor function on PF change after 16-weeks of moderate intensity aerobic exercise (AEx).

Methods: People with DPN (n=17) who participated in 16-weeks of AEx were included in this secondary analysis. Sudomotor function was evaluated at baseline via a quantitative sudomotor axon reflex test and classified as normal (n=6), mild (n=6), moderate (n=3), or severe (n=2). Self-reported PF was assessed at baseline and post-intervention via a fatigue questionnaire. A Kruskal-Wallis test evaluated the impact of baseline sudomotor function on change in PF after exercise. Dunn’s tests were used to evaluate multiple comparisons. Association between sudomotor function and PF change was evaluated via a Spearman’s correlation. Alpha was set at 0.05.

Results: Changes in PF are reported as negative (↓in PF) and positive (↑in PF) values. Median PF changes of -29%, -30%, 0%, and 14% were observed for normal, mild, moderate, and severe groups, respectively with a significant between-group difference (p=0.039). Pairwise comparisons revealed significant differences between normal and moderate (p=0.025), normal and severe (p=0.047), and mild and moderate (p=0.04) groups. A moderate correlation between SI and PF change (r=0.630, p=0.007) was observed.

Conclusions: Our results indicate that change in PF following 16-weeks of AEx may be influenced by SI. SI can limit the body’s ability to dissipate heat during exercise, potentially exacerbating PF through disruptions in the thermoregulatory negative feedback loop. This could influence response to exercise, and future research should examine the effects of underlying mechanisms of SI on PF in this population.


C.M. Gray: None. A. Yahya: None. A.M. Alenazi: None. M. Alshehri: None. J.L. Rucker: None. M. Pasnoor: Advisory Panel; Self; Alexion Pharmaceuticals, Inc., Terumo BCT. Consultant; Self; Momenta Pharmaceuticals. P. Kluding: None.


National Center for Advancing Translation Sciences (UL1TR000001); Eunice Kennedy Shriver National Institute of Child Health and Human Development (T32HD057850)

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