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Type 2 diabetes exaggerates exercise effort and impairs exercise performance in older women.

Huebschmann AG, Kohrt WM, Herlache L, Wolfe P, Daugherty S, Reusch JE, Bauer TA, Regensteiner JG - BMJ Open Diabetes Res Care (2015)

Bottom Line: RPE was not significantly greater in T2DM versus controls (30 W: Control, 10.4±3.2, T2DM, 11.7±2.3, p=0.08; 35% VO2peak: Control, 11.1±0.5, T2DM, 12.1±0.5, p=0.21).Greater RPE was associated with higher lactate, higher heart rate, and a hypertension diagnosis (p<0.05 at 30 W and 35% VO2peak).NCT00785005.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine; Division of General Internal Medicine , University of Colorado (CU) School of Medicine (SOM) , Aurora, Colorado , USA ; Center for Women's Health Research , Aurora, Colorado , USA.

ABSTRACT

Objective: Type 2 diabetes mellitus (T2DM) is associated with high levels of disability and mortality. Regular exercise prevents premature disability and mortality, but people with T2DM are generally sedentary for reasons that are not fully established. We previously observed that premenopausal women with T2DM report greater effort during exercise than their counterparts without diabetes, as measured by the Rating of Perceived Exertion (RPE) scale. We hypothesized that RPE is greater in older women with T2DM versus no T2DM.

Research design and methods: We enrolled overweight, sedentary women aged 50-75 years with (n=26) or without T2DM (n=28). Participants performed submaximal cycle ergometer exercise at 30 W and 35% of individually-measured peak oxygen consumption (35% VO2peak). We assessed exercise effort by RPE (self-report) and plasma lactate concentration.

Results: VO2peak was lower in T2DM versus controls (p=0.003). RPE was not significantly greater in T2DM versus controls (30 W: Control, 10.4±3.2, T2DM, 11.7±2.3, p=0.08; 35% VO2peak: Control, 11.1±0.5, T2DM, 12.1±0.5, p=0.21). However, lactate was greater in T2DM versus controls (p=0.004 at 30 W; p<0.05 at 35% VO2peak). Greater RPE was associated with higher lactate, higher heart rate, and a hypertension diagnosis (p<0.05 at 30 W and 35% VO2peak).

Conclusions: Taken together, physiological measures of exercise effort were greater in older women with T2DM than controls. Exercise effort is a modifiable and thereby targetable end point. In order to facilitate regular exercise, methods to reduce exercise effort in T2DM should be sought.

Trial number: NCT00785005.

No MeSH data available.


Related in: MedlinePlus

Conceptual model of perceived effort during exercise.
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BMJDRC2015000124F1: Conceptual model of perceived effort during exercise.

Mentions: According to our conceptual model (figure 1), we considered the following physiological variables as potential predictors of exercise effort: heart rate during exercise, VO2peak and τ2. In addition, we assessed metabolic and vascular factors that we hypothesized were likely to impair the physiological response to exercise in people with T2DM: Homeostasis Model Assessment of Insulin Resistance (HOMA-IR),34 markers of endothelial dysfunction such as a diagnosis of hypertension and arterial stiffness expressed as pulse-wave velocity35 (SphygmaCor CP system, AtCor Medical). HOMA-IR was calculated per standard convention from blood glucose and insulin measurements collected during a 12 h fast.34 We also measured glucose levels during the 8 min of exercise as an additional potential predictor of effort. A diagnosis of hypertension was obtained by self-report and validated during the medical history and physical examination by the study physician/PI (AGH). Pulse-wave velocity was assessed after a 4 h fast and prior to any exercise testing performed in the same study visit.


Type 2 diabetes exaggerates exercise effort and impairs exercise performance in older women.

Huebschmann AG, Kohrt WM, Herlache L, Wolfe P, Daugherty S, Reusch JE, Bauer TA, Regensteiner JG - BMJ Open Diabetes Res Care (2015)

Conceptual model of perceived effort during exercise.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4597414&req=5

BMJDRC2015000124F1: Conceptual model of perceived effort during exercise.
Mentions: According to our conceptual model (figure 1), we considered the following physiological variables as potential predictors of exercise effort: heart rate during exercise, VO2peak and τ2. In addition, we assessed metabolic and vascular factors that we hypothesized were likely to impair the physiological response to exercise in people with T2DM: Homeostasis Model Assessment of Insulin Resistance (HOMA-IR),34 markers of endothelial dysfunction such as a diagnosis of hypertension and arterial stiffness expressed as pulse-wave velocity35 (SphygmaCor CP system, AtCor Medical). HOMA-IR was calculated per standard convention from blood glucose and insulin measurements collected during a 12 h fast.34 We also measured glucose levels during the 8 min of exercise as an additional potential predictor of effort. A diagnosis of hypertension was obtained by self-report and validated during the medical history and physical examination by the study physician/PI (AGH). Pulse-wave velocity was assessed after a 4 h fast and prior to any exercise testing performed in the same study visit.

Bottom Line: RPE was not significantly greater in T2DM versus controls (30 W: Control, 10.4±3.2, T2DM, 11.7±2.3, p=0.08; 35% VO2peak: Control, 11.1±0.5, T2DM, 12.1±0.5, p=0.21).Greater RPE was associated with higher lactate, higher heart rate, and a hypertension diagnosis (p<0.05 at 30 W and 35% VO2peak).NCT00785005.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine; Division of General Internal Medicine , University of Colorado (CU) School of Medicine (SOM) , Aurora, Colorado , USA ; Center for Women's Health Research , Aurora, Colorado , USA.

ABSTRACT

Objective: Type 2 diabetes mellitus (T2DM) is associated with high levels of disability and mortality. Regular exercise prevents premature disability and mortality, but people with T2DM are generally sedentary for reasons that are not fully established. We previously observed that premenopausal women with T2DM report greater effort during exercise than their counterparts without diabetes, as measured by the Rating of Perceived Exertion (RPE) scale. We hypothesized that RPE is greater in older women with T2DM versus no T2DM.

Research design and methods: We enrolled overweight, sedentary women aged 50-75 years with (n=26) or without T2DM (n=28). Participants performed submaximal cycle ergometer exercise at 30 W and 35% of individually-measured peak oxygen consumption (35% VO2peak). We assessed exercise effort by RPE (self-report) and plasma lactate concentration.

Results: VO2peak was lower in T2DM versus controls (p=0.003). RPE was not significantly greater in T2DM versus controls (30 W: Control, 10.4±3.2, T2DM, 11.7±2.3, p=0.08; 35% VO2peak: Control, 11.1±0.5, T2DM, 12.1±0.5, p=0.21). However, lactate was greater in T2DM versus controls (p=0.004 at 30 W; p<0.05 at 35% VO2peak). Greater RPE was associated with higher lactate, higher heart rate, and a hypertension diagnosis (p<0.05 at 30 W and 35% VO2peak).

Conclusions: Taken together, physiological measures of exercise effort were greater in older women with T2DM than controls. Exercise effort is a modifiable and thereby targetable end point. In order to facilitate regular exercise, methods to reduce exercise effort in T2DM should be sought.

Trial number: NCT00785005.

No MeSH data available.


Related in: MedlinePlus