The predictors of exercise capacity impairment in diabetic patients

• Main Authors: Florina Frîngu, Gabriel Guşetu, Adriana Iosip, Diana Gurzău, Gabriela Dogaru, Dumitru Zdrenghea, Dana Pop
• Format: Article
• Language: English
• Published: Romanian Association of Balneology, Editura Balneara 2017-05-01
• Series: Balneo Research Journal
• Subjects: : diabetes mellitus; exercise performance; diastolic dysfunction; exercise testing
• Online Access: http://bioclima.ro/Balneo138.pdf

Background. The exercise capacity is a key issue in a diabetic patient’s management, due to its well-known beneficial effects in terms of glycemic control, cardiovascular risk reduction and quality of life improvement. However the exercise capacity of diabetic patients is decreased many times and its determinants are sometimes less known. Our study aimed to assess the effort capacity in a cohort of diabetic patients and to find the main causative factors of its impairment. Method: 61 patients with type-2 diabetes mellitus were enrolled and underwent and transthoracic echocardiography and a cycloergometer exercise testing. Exercise performance was calculated and the influence of clinical data and ultrasound parameters was assessed. Sedentary status of each patient was established from total time/week of at least moderate physical activity. Results: the study group consisted of 48.4 % women, mean age 61.4 (±8.4) years. Disease median duration was 5 years and 21.3 % of the patients presented neuropathy, 4.5 % retinopathy and 6.5 % nephropathy. Exercise capacity was moderately and severe decreased (<5 METs) in 37.7 % of patients and in this subgroup the diastolic dysfunction, sedentary behavior and old age has a significantly higher prevalence. Interestingly, by multivariate regression, the sedentary lifestyle was the main determinant of decreased effort capacity (beta-coefficient 1.37, p<0.001), suggesting the potential benefits of physical training in these patients. Conclusion. Our study found a decreased effort capacity in at least one third of the patients and this is mainly due to sedentary lifestyle and deconditioning, the diastolic dysfunction also contributes to decreased effort capacity in diabetic patients.