Glycemic Status Affects Cardiopulmonary Exercise Response in Athletes with Type I Diabetes

• Autores: James C. Baldi, Nicholas A. Cassuto, William T. Foxx-Lupo, Courtney M. Wheatley, Eric M. Snyder
• Localización: Medicine & Science in Sports & exercise: Official Journal of the American College of Sports Medicine, ISSN 0195-9131, Vol. 42, Nº. 8, 2010, págs. 1454-1459
• Idioma: inglés
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• Resumen

  • Purpose: This study aimed to (a) examine the influence of type I diabetes on the cardiopulmonary exercise response in trained subjects and (b) determine whether glycemic control affects these responses.

    Methods: The cardiopulmonary responses to maximal incremental cycle ergometry were compared in 12 Ironman triathletes with type I diabetes and 10 age- and sex-matched control subjects without diabetes. Athletes with type I diabetes were then stratified into low- (glycosylated hemoglobin (HbA1c) < 7%, n = 5) and high-HbA1c (HbA1c > 7%, n = 7) groups for comparison. Cardiac output, stroke volume, arterial blood pressure, and calculated systemic vascular resistance along with airway function were measured at rest and during steady-state exercise.

    Results: During peak exercise HR, stroke volume and cardiac output were not different between the groups with and without diabetes; however, forced expiratory flow at 50% of the forced vital capacity was lower in subjects with diabetes (P < 0.05). Within the group with diabetes, HbA1c was lower in the low-HbA1c versus high-HbA1c group (6.5 +/- 0.3 vs 7.8 +/- 0.4, respectively; P < 0.05), but training volume was not different. At rest, the low-HbA1c group had greater cardiac output and lower systemic vascular resistance than the high-HbA1c group, and all pulmonary function measurements were greater in the low-HbA1c group (P < 0.05). During peak exercise, the V[spacing dot above]O2, workload, HR, stroke volume, and cardiac output were greater in the low-HbA1c versus the high-HbA1c group (P < 0.05). In addition, all indices of pulmonary function were higher in the low-HbA1c group (P < 0.05). Finally, within the subjects with diabetes, there was a weak inverse correlation between HbA1c and exercise training volume (r2 = -0.352) and stroke volume (r2 = -0.339). These data suggest that highly trained individuals with type I diabetes can achieve the same cardiopulmonary exercise responses as trained subjects without diabetes, but these responses are reduced by poor glycemic control