scholarly journals Differences in physiological responses to cardio-pulmonary exercise testing in adults with type 1 diabetes and controls without type 1 diabetes – a pooled analysis

2020 ◽  
Author(s):  
Max L. Eckstein ◽  
Juliano Boufleur Farinha ◽  
Olivia McCarthy ◽  
Daniel J. West ◽  
Jane E. Yardley ◽  
...  
Keyword(s):  
Heart Rate ◽  
Type 1 Diabetes ◽  
Oxygen Uptake ◽  
Physiological Responses ◽  
Peak Oxygen Uptake ◽  
Pooled Analysis ◽  
Cycle Ergometer ◽  
Recent Onset ◽  
Design And Methods

<b>OBJECTIVE</b> <p>To investigate physiological responses to cardio-pulmonary exercise (CPX) testing in adults with type 1 diabetes compared to age-, sex- and body mass index- (BMI) matched controls without type 1 diabetes.</p> <p><b>RESEARCH DESIGN AND METHODS</b></p> <p>We compared results from CPX tests on a cycle ergometer in individuals with type 1 diabetes and controls without type 1 diabetes. Parameters were peak and threshold variables of oxygen uptake, heart rate and power output. Differences between groups were investigated via restricted maximum likelihood modelling and post-hoc tests. Differences between groups were explained by stepwise linear regressions (p<0.05). </p> <p><b>RESULTS</b></p> <p>Among 303 individuals with type 1 diabetes (age 33 [22; 43] years, 93 females, BMI 23.6 [22; 26] kg/m<sup>2</sup>, HbA<sub>1c</sub> 6.9 [6.2; 7.7]%; 52 [44; 61] mmol/mol), peak oxygen uptake (32.55 [26.49; 38.72] vs. 42.67 ± 10.44) (mL/kg/min), peak heart rate (179 [170; 187] vs. 184 [175; 191]) (bpm) and peak power (216 [171; 253] vs. 245 [200; 300]) (Watt) were lower in comparison to 308 controls 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 against controls 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 HbA<sub>1c</sub> in individuals with type 1 diabetes.</p> <p><b>CONCLUSIONS</b></p> <p>Individuals with type 1 diabetes show altered responses to CPX testing, which cannot be explained by HbA<sub>1c</sub>. Intriguingly, the participants in our cohort consisted of people with recent-onset type 1 diabetes, heart rate dynamics were altered during CPX testing. </p>

scholarly journals Differences in physiological responses to cardio-pulmonary exercise testing in adults with type 1 diabetes and controls without type 1 diabetes – a pooled analysis

2020 ◽  
Author(s):  
Max L. Eckstein ◽  
Juliano Boufleur Farinha ◽  
Olivia McCarthy ◽  
Daniel J. West ◽  
Jane E. Yardley ◽  
...  
Keyword(s):  
Heart Rate ◽  
Type 1 Diabetes ◽  
Oxygen Uptake ◽  
Physiological Responses ◽  
Peak Oxygen Uptake ◽  
Pooled Analysis ◽  
Cycle Ergometer ◽  
Recent Onset ◽  
Design And Methods

<b>OBJECTIVE</b> <p>To investigate physiological responses to cardio-pulmonary exercise (CPX) testing in adults with type 1 diabetes compared to age-, sex- and body mass index- (BMI) matched controls without type 1 diabetes.</p> <p><b>RESEARCH DESIGN AND METHODS</b></p> <p>We compared results from CPX tests on a cycle ergometer in individuals with type 1 diabetes and controls without type 1 diabetes. Parameters were peak and threshold variables of oxygen uptake, heart rate and power output. Differences between groups were investigated via restricted maximum likelihood modelling and post-hoc tests. Differences between groups were explained by stepwise linear regressions (p<0.05). </p> <p><b>RESULTS</b></p> <p>Among 303 individuals with type 1 diabetes (age 33 [22; 43] years, 93 females, BMI 23.6 [22; 26] kg/m<sup>2</sup>, HbA<sub>1c</sub> 6.9 [6.2; 7.7]%; 52 [44; 61] mmol/mol), peak oxygen uptake (32.55 [26.49; 38.72] vs. 42.67 ± 10.44) (mL/kg/min), peak heart rate (179 [170; 187] vs. 184 [175; 191]) (bpm) and peak power (216 [171; 253] vs. 245 [200; 300]) (Watt) were lower in comparison to 308 controls 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 against controls 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 HbA<sub>1c</sub> in individuals with type 1 diabetes.</p> <p><b>CONCLUSIONS</b></p> <p>Individuals with type 1 diabetes show altered responses to CPX testing, which cannot be explained by HbA<sub>1c</sub>. Intriguingly, the participants in our cohort consisted of people with recent-onset type 1 diabetes, heart rate dynamics were altered during CPX testing. </p>

Physiological Responses to Specific Maximal Exercise Tests for Cross-Country Skiing

1993 ◽  
Vol 18 (4) ◽  
pp. 359-365 ◽  
Author(s):  
Phillip B. Watts ◽  
Jon Eric Sulentic ◽  
Kip M. Drobish ◽  
Timothy P. Gibbons ◽  
Victoria S. Newbury ◽  
...  
Keyword(s):  
Heart Rate ◽  
Oxygen Uptake ◽  
Blood Lactate ◽  
Maximal Exercise ◽  
Physiological Responses ◽  
Peak Oxygen Uptake ◽  
Open Circuit ◽  
Exercise Tests ◽  
Double Poling ◽  
Cross Country

The present study attempted to quantify differences in peak physiological responses to pole-striding (PS), double poling on roller skis (DP), and diagonal striding on roller skis (DS) during maximal exercise. Six expert cross-country ski racers (3 M, 3 F) with a mean age of 20.2 ± 1.3 yrs served as subjects. Testing was conducted on a motorized ski treadmill with a tracked belt surface. Expired air was analyzed continuously via an automated open-circuit system and averaged each 20 s. Heart rate was monitored via telemetry and arterialized blood was collected within 1 min of test termination and analyzed immediately for lactate. Peak values for heart rate and blood lactate did not differ among techniques. Peak oxygen uptake was higher for PS and DS versus DP whereas no difference was found between PS and DS. The VO2 peak for DP was 77 and 81% of VO2 peak for PS and DS, respectively. It was concluded that despite similar peak heart rate and blood lactate values, DP elicits a lower VO2 peak than DS or PS and that PS responses appear to closely reflect those of DS. Key words: exercise testing, maximum oxygen uptake, roller skiing, specificity of exercise, x-c skiing

scholarly journals Diabetic Ketoacidosis and Related Events With Sotagliflozin Added to Insulin in Adults With Type 1 Diabetes: A Pooled Analysis of the inTandem 1 and 2 Studies

2020 ◽  
Author(s):  
Anne L. Peters ◽  
Darren K. McGuire ◽  
Thomas Danne ◽  
Jake A. Kushner ◽  
Helena W. Rodbard ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Diabetic Ketoacidosis ◽  
Risk Mitigation ◽  
Pooled Analysis ◽  
Once Daily ◽  
Adjusted Incidence Rate ◽  
Beta Hydroxybutyrate ◽  
Design And Methods ◽  
Adjusted Incidence

<b>Objective: </b>To evaluate incidence and risk factors for diabetic ketoacidosis (DKA) and related adverse events (AEs) in adults with type 1 diabetes treated with sotagliflozin adjunctive to insulin. <p><b>Research Design and Methods: </b>Data from two identically designed, 52-week, randomized studies were pooled and analyzed for DKA, changes in beta-hydroxybutyrate (BHB), and percentage of patients with BHB >0.6 and >1.5 mmol/L; patients were administered placebo, sotagliflozin 200 mg, or sotagliflozin 400 mg once daily. </p> <p><b>Results:</b> A total of 191 ketosis-related AEs were reported; 98 underwent adjudication. Of these, 37 (36 patients) were adjudicated as DKA, with an exposure-adjusted incidence rate of 0.2, 3.1, and 4.2 events per 100 patient-years for placebo, sotagliflozin 200 mg, and sotagliflozin 400 mg. No patient died from a DKA event. From a baseline BHB of ~0.13 mmol/L, sotagliflozin treatment led to a small median increase over 52 weeks (≤0.05 mmol/L at all time points). Approximately 47% and 7% of sotagliflozin-treated patients had ≥1 BHB measurement >0.6 mmol/L and >1.5 mmol/L (vs 20% and 2% of placebo-treated patients). Subsequent to the implementation of a risk mitigation plan, annualized DKA incidence was lower versus pre-implementation in both the sotagliflozin 200-mg and 400-mg groups. </p> <p><b>Conclusion:</b> In patients with type 1 diabetes, confirmed DKA incidence increased when sotagliflozin was added to insulin compared with insulin alone. A lower incidence of DKA was observed following the implementation of an enhanced risk mitigation plan, suggesting that this risk can be managed with patient education.</p>

scholarly journals Diabetic Ketoacidosis and Related Events With Sotagliflozin Added to Insulin in Adults With Type 1 Diabetes: A Pooled Analysis of the inTandem 1 and 2 Studies

2020 ◽  
Author(s):  
Anne L. Peters ◽  
Darren K. McGuire ◽  
Thomas Danne ◽  
Jake A. Kushner ◽  
Helena W. Rodbard ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Diabetic Ketoacidosis ◽  
Risk Mitigation ◽  
Pooled Analysis ◽  
Once Daily ◽  
Adjusted Incidence Rate ◽  
Beta Hydroxybutyrate ◽  
Design And Methods ◽  
Adjusted Incidence

<b>Objective: </b>To evaluate incidence and risk factors for diabetic ketoacidosis (DKA) and related adverse events (AEs) in adults with type 1 diabetes treated with sotagliflozin adjunctive to insulin. <p><b>Research Design and Methods: </b>Data from two identically designed, 52-week, randomized studies were pooled and analyzed for DKA, changes in beta-hydroxybutyrate (BHB), and percentage of patients with BHB >0.6 and >1.5 mmol/L; patients were administered placebo, sotagliflozin 200 mg, or sotagliflozin 400 mg once daily. </p> <p><b>Results:</b> A total of 191 ketosis-related AEs were reported; 98 underwent adjudication. Of these, 37 (36 patients) were adjudicated as DKA, with an exposure-adjusted incidence rate of 0.2, 3.1, and 4.2 events per 100 patient-years for placebo, sotagliflozin 200 mg, and sotagliflozin 400 mg. No patient died from a DKA event. From a baseline BHB of ~0.13 mmol/L, sotagliflozin treatment led to a small median increase over 52 weeks (≤0.05 mmol/L at all time points). Approximately 47% and 7% of sotagliflozin-treated patients had ≥1 BHB measurement >0.6 mmol/L and >1.5 mmol/L (vs 20% and 2% of placebo-treated patients). Subsequent to the implementation of a risk mitigation plan, annualized DKA incidence was lower versus pre-implementation in both the sotagliflozin 200-mg and 400-mg groups. </p> <p><b>Conclusion:</b> In patients with type 1 diabetes, confirmed DKA incidence increased when sotagliflozin was added to insulin compared with insulin alone. A lower incidence of DKA was observed following the implementation of an enhanced risk mitigation plan, suggesting that this risk can be managed with patient education.</p>

A pilot program for physical exercise promotion in adults with type 1 diabetes: the PEP-1 program

2014 ◽  
Vol 39 (4) ◽  
pp. 465-471 ◽  
Author(s):  
Anne-Sophie Brazeau ◽  
Véronique Gingras ◽  
Catherine Leroux ◽  
Corinne Suppère ◽  
Hortensia Mircescu ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Physical Exercise ◽  
Oxygen Uptake ◽  
Physical Inactivity ◽  
Peak Oxygen Uptake ◽  
Control Group ◽  
Pilot Program ◽  
Exercise Promotion

Physical inactivity is highly common in adults with type 1 diabetes (T1D) as specific barriers (i.e., hypoglycemia) may prevent them from being active. The objective of this study was to examine the efficacy of the Physical Exercise Promotion program in type 1 diabetes (PEP-1) program, a group program of physical activity (PA) promotion (intervention) compared with an information leaflet (control), to improve total energy expenditure (TEE) in adults with T1D after 12 weeks. TEE was measured with a motion sensor over a 7-day period at inclusion, after the program (12 weeks) and 1-year after inclusion. The 12 weekly sessions of the program included a 30-min information session (glycemic control and PA) and 60 min of PA. A total of 48 adults, aged 18 to 65 years with a reported PA practice <150 min per week, were recruited (45.8% men; aged 44.6 ± 13.3 years; 8.0% ± 1.1% glycated hemoglobin (A1c)) and randomized in this pilot trial. Ninety percent of participants completed the program and 88% completed the 1-year follow-up. No change was observed for TEE and A1c in both groups. After the 12-week program, the mean peak oxygen uptake increased (14%; p = 0.003) in the intervention group; however, at the 1-year follow-up, it was no longer different from baseline. In the control group, no difference was observed for the peak oxygen uptake. These results suggest that the PEP-1 pilot program could increase cardiorespiratory fitness. However, this benefit is not sustained over a long-term period. The PEP-1 program did not increase TEE in patients with T1D and other strategies remain necessary to counteract physical inactivity in this population.

Physiological Responses of Endurance-Trained Male Wheelchair Athletes to a 10-Kilometer Treadmill Time Trial

2002 ◽  
Vol 19 (4) ◽  
pp. 496-508 ◽  
Author(s):  
Ian G. Campbell ◽  
Clyde Williams ◽  
Henryk K.A. Lakomy
Keyword(s):  
Heart Rate ◽  
Oxygen Uptake ◽  
Respiratory Exchange Ratio ◽  
Physiological Responses ◽  
Time Trial ◽  
Peak Oxygen Uptake ◽  
Moderate Correlation ◽  
Wheelchair Athletes ◽  
Dependent Variables ◽  
The Relationship

The purpose was to examine selected physiological responses of endurance-trained male wheelchair athletes in different Paralympic racing classes (T2, n = 3; T3, n = 8; T4, n = 7) during a 10-km treadmill time trial (TM:10-km). Peak oxygen uptake (V̇O2 peak) was determined, and a TM:10-km was completed on a motorized treadmill. From this, % V̇O2peak utilized and the relationship between V̇O2peak and TM:10-km were established. During the TM:10-km, the following dependent variables were examined: propulsion speed, oxygen uptake, respiratory exchange ratio, and heart rate. The results showed athletes utilize a high % V̇O2peak (78.4 –13.6%) during the TM:10-km. There was a moderate correlation (r = -.57, p < .01) between VO2peak and TM:10-km. No physiological differences were found between the paraplegic racing classes (T3, T4), which suggests that there is some justification in amalgamating these racing classes for endurance events.

scholarly journals OR08-06 Increased Carotid Intima Media Thickness in Pediatric Type 1 Diabetes Is Associated with Disease Duration

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Michal Cohen ◽  
Meirav Oren ◽  
Raya Gendelman ◽  
Hiba Yaseen ◽  
Ram Weiss ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Type 1 Diabetes ◽  
Endothelial Function ◽  
Disease Duration ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Recent Onset ◽  
Control Subjects

Abstract Background & Objective Patients with type-1-diabetes (T1D) are at risk of long-term micro and macrovascular complications causing significant morbidity and mortality. Overt complications are not common in childhood; however, subclinical impairments in endothelial function, may be found. Better understanding of the timeline for the appearance of diabetic complications and identifying individuals at increased risk is key for developing prevention strategies. We aimed to study endothelial function and it’s determinants in adolescents with T1D at different time points from diagnosis. Methods Forty adolescents 11-20 years of age with T1D followed at our pediatric diabetes clinic and 18 healthy control subjects were included. Two groups of patients were recruited based on time from T1D diagnosis; 20 individuals were diagnosed 2-4 months prior to the study visit and 20 at least 7 years prior to the visit. Investigations included: i) medical and demographic data ii) anthropometrics iii) fasting blood samples iv) EndoPAT testing of endothelial function and heart rate variability (Itamar Medical Ltd., Israel) v) Carotid intima media thickness (CIMT). Results Mean age differed slightly between groups being 14.1±2.0years in individuals with recent-onset T1D, 16.2±2.5 in those with prolonged T1D, and 14.8±2.3 in the control group (p=0.02). There were no significant differences in pubertal stage or in BMI z-score between groups. Thirty-three (57%) females participated. No patient suffered from diabetic complications. Mean CIMT was significantly higher in individuals with prolonged T1D (0.49±0.07mm) compared to control subjects (0.43±0.05mm; p=0.013) and did not differ significantly between patients with recent-onset T1D (0.45±0.07mm) and controls. This difference remained significant when age and sex were included in the model. EndoPAT measures of endothelial function and heart rate variability did not differ significantly between groups. Mean HbA1c at the time of the visit differed between groups (6.7%±0.7, 9.6%±1.8, 5.4%±0.3, p&lt;0.001). However, the average of HbA1c reflecting the 6-7 months prior to the visit did not differ significantly between subjects with recent onset T1D (9.8%±1.3) and those with prolonged T1D (9.5%±1.7). LDL was higher in subjects with prolonged T1D (114±28mg/dl) compared to either controls (93±26mg/dl) or recent onset T1D (88±19mg/dl),p=0.002. Diastolic blood pressure was higher in subjects with prolonged T1D (70±6mmHg) than in controls (61±6, p=0.007). Conclusions Our results demonstrate disease duration to be an important factor in the development of subclinical arterial damage in the pediatric age group. Early in the course of T1D, CIMT results were similar in patients and control subjects, suggesting an important window for prevention. Larger studies could shed light on the precise timeline of endothelial impairment.

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

Diabetes Care ◽  
2020 ◽  
Vol 44 (1) ◽  
pp. 240-247
Author(s):  
Max L. Eckstein ◽  
Juliano Boufleur Farinha ◽  
Olivia McCarthy ◽  
Daniel J. West ◽  
Jane E. Yardley ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Exercise Testing ◽  
Physiological Responses ◽  
Cardiopulmonary Exercise Testing ◽  
Pooled Analysis ◽  
Cardiopulmonary Exercise

A 33-yr follow-up of peak oxygen uptake and related variables of former physical education students

1997 ◽  
Vol 82 (6) ◽  
pp. 1844-1852 ◽  
Author(s):  
Per-Olof Åstrand ◽  
Ulf Bergh ◽  
Åsa Kilbom
Keyword(s):  
Heart Rate ◽  
Physical Education ◽  
Oxygen Uptake ◽  
Aerobic Power ◽  
Pulmonary Ventilation ◽  
Peak Oxygen Uptake ◽  
Cycle Ergometer ◽  
Education Students ◽  
Physical Education Students

Åstrand, Per-Olof, Ulf Bergh, and Åsa Kilbom. A 33-yr follow-up of peak oxygen uptake and related variables of former physical education students. J. Appl. Physiol. 82(6): 1844–1852, 1997.—In 1949, 27 female and 26 male physical education students were studied at a mean age of 22 and 25 yr, respectively. They were restudied in 1970 and 1982. Measurements included oxygen uptake, heart rate, and pulmonary ventilation during submaximal and maximal exercise on a cycle ergometer and treadmill. After 21 yr, peak aerobic power was significantly reduced, from 2.90 to 2.18 l/min and from 4.09 to 3.28 l/min for women and men, respectively. After another 12 yr, the 1970 maxima were not reduced further. From 1949 to 1982 there was a decrease in peak heart rate from 196 to 177 beats/min in women and from 190 to 175 beats/min in men ( P < 0.05). Highest pulmonary ventilation did not change significantly. At an oxygen uptake of 1.5 l/min, the heart rate was the same in 1949 as in 1982. In conclusion, the physical fitness level of the subjects was well above average for these ages. From 1970 to 1982 there was no decline in the average peak aerobic power, a finding possibly related to increased habitual physical activity.

Relations between Perceptual and Physiological Response during Incremental Exercise Followed by an Extended Bout of Submaximal Exercise on a Cycle Ergometer

2003 ◽  
Vol 96 (2) ◽  
pp. 653-663 ◽  
Author(s):  
Shinichi Demura ◽  
Yoshinori Nagasawa
Keyword(s):  
Heart Rate ◽  
Oxygen Uptake ◽  
Perceived Exertion ◽  
Regression Coefficient ◽  
Physiological Responses ◽  
Constant Load ◽  
Cycle Ergometer ◽  
Cycling Exercise ◽  
Recovery Stage ◽  
Highly Correlated

The purpose of this study was to examine the relations of ratings of perceived exertion (RPE) of the legs, chest, and overall body with physiological responses (heart rate and oxygen uptake) both during incremental cycling exercise and the recovery stage (submaximal light exercise after total exhaustion). Subjects were 10 healthy university males ages 18 to 23 years ( M age = 20.5 yr., SD= 1.4 yr.) who performed incremental cycling exercise until exhaustion after 1-min. rest and unloaded cycling for 2 min. They then continued to exercise at a constant load of 30 Watts (used for cooling down; recovery stage) for a total of 25 min. Oxygen uptake and heart rate were measured, and three types of RPE were done; Respiratory (chest; RPE-R), Peripheral (legs; RPE-P), and Overall (overall body; RPE-O) during the exercise and recovery stage. All variables during exercise and RPE-R and RPE-P during recovery stage showed significant linear changes. RPE-O and physiological exercise intensity (oxygen uptake and heart rate) in the recovery stage showed significant curvilinear changes (quadratic). RPE-P were significantly higher than RPE-R both during exercise and the recovery stage and the variables highly correlated ( r ≥.88, p <.05). At the point of exhaustion, RPE-P and RPE-O almost reached a peak, but RPE-R did not. In the exercise period until exhaustion, the regression coefficient of RPE-R (.38) was significantly lower than that of RPE-P (.56) and RPE-O (.50), and RPE-R increased according to an increase of the incremental load, but the amount was significantly lower than those of RPE-P and RPE-O. In the recovery stage after exhaustion, the regression coefficient of RPE-O (−1.35) was significantly greater than that of RPE-P (−1.07). A decrease in RPE-O corresponded to a decrease in heart rate and oxygen uptake, but RPE-P did not, and the recovery of RPE-P tended to be late. The results suggest that relations for the physiological responses of heart rate, oxygen uptake, and RPE, and between each RPE in the recovery stage differed from those during exercise until exhaustion.

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