Differences in Physiological Responses to Cardiopulmonary Exercise Testing in Adults With and Without Type 1 Diabetes: A Pooled Analysis.

Eckstein, Max L; Farinha, Juliano Boufleur; McCarthy, Olivia; West, Daniel J; Yardley, Jane E; Bally, Lia; Zueger, Thomas; Stettler, Christoph; Boff, Winston; Reischak-Oliveira, Alvaro; Riddell, Michael C; Zaharieva, Dessi P; Pieber, Thomas R; Müller, Alexander; Birnbaumer, Philipp; Aziz, Faisal; Brugnara, Laura; Haahr, Hanne; Zijlstra, Eric; Heise, Tim; ... (2021). Differences in Physiological Responses to Cardiopulmonary Exercise Testing in Adults With and Without Type 1 Diabetes: A Pooled Analysis. Diabetes care, 44(1), pp. 240-247. American Diabetes Association 10.2337/dc20-1496

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OBJECTIVE

To investigate physiological responses to cardiopulmonary exercise (CPX) testing in adults with type 1 diabetes compared with age-, sex-, and BMI-matched control participants without type 1 diabetes.

RESEARCH DESIGN AND METHODS

We compared results from CPX tests on a cycle ergometer in individuals with type 1 diabetes and control participants without type 1 diabetes. Parameters were peak and threshold variables of VO2, heart rate, and power output. Differences between groups were investigated through restricted maximum likelihood modeling and post hoc tests. Differences between groups were explained by stepwise linear regressions (P < 0.05).

RESULTS

Among 303 individuals with type 1 diabetes (age 33 [interquartile range 22; 43] years, 93 females, BMI 23.6 [22; 26] kg/m2, HbA1c 6.9% [6.2; 7.7%] [52 (44; 61) mmol/mol]), VO2peak (32.55 [26.49; 38.72] vs. 42.67 ± 10.44 mL/kg/min), peak heart rate (179 [170; 187] vs. 184 [175; 191] beats/min), and peak power (216 [171; 253] vs. 245 [200; 300] W) were lower compared with 308 control participants without type 1 diabetes (all P < 0.001). Individuals with type 1 diabetes displayed an impaired degree and direction of the heart rate-to-performance curve compared with control participants without type 1 diabetes (0.07 [-0.75; 1.09] vs. 0.66 [-0.28; 1.45]; P < 0.001). None of the exercise physiological responses were associated with HbA1c in individuals with type 1 diabetes.

CONCLUSIONS

Individuals with type 1 diabetes show altered responses to CPX testing, which cannot be explained by HbA1c. Intriguingly, the participants in our cohort were people with recent-onset type 1 diabetes; heart rate dynamics were altered during CPX testing.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Endocrinology, Diabetology and Clinical Nutrition

UniBE Contributor:

Bally, Lia Claudia; Züger, Thomas Johannes and Stettler, Christoph

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0149-5992

Publisher:

American Diabetes Association

Language:

English

Submitter:

Laura Goetschi

Date Deposited:

11 Jan 2021 09:31

Last Modified:

12 Jan 2021 18:55

Publisher DOI:

10.2337/dc20-1496

PubMed ID:

33184152

BORIS DOI:

10.48350/149892

URI:

https://boris.unibe.ch/id/eprint/149892

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