Diastolic Function is Reduced in Adolescents With Type 1 Diabetes in Response to Exercise
- Silmara Gusso, PHD1⇓,
- Teresa E. Pinto, MD2,
- James C. Baldi, PHD3,
- Elizabeth Robinson, MSC4,
- Wayne S. Cutfield, MD1 and
- Paul L. Hofman, MD1
- 1Liggins Institute, University of Auckland, Auckland, New Zealand
- 2Health Centre, Dalhousie University IWK, Halifax, Nova Scotia, Canada
- 3Department of Medicine, University of Otago, Dunedin, New Zealand
- 4Department of Epidemiology and Biostatistics, University of Auckland, Auckland, New Zealand
- Corresponding author: Silmara Gusso, .
OBJECTIVE To determine whether adolescents with type 1 diabetes have left ventricular functional changes at rest and during acute exercise and whether these changes are affected by metabolic control and diabetes duration.
RESEARCH DESIGN AND METHODS The study evaluated 53 adolescents with type 1 diabetes and 22 control adolescents. Baseline data included peak exercise capacity and body composition by dual-energy X-ray absorptiometry. Left ventricular functional parameters were obtained at rest and during acute exercise using magnetic resonance imaging.
RESULTS Compared with nondiabetic control subjects, adolescents with type 1 diabetes had lower exercise capacity (44.7 ± 09 vs. 48.5 ± 1.4 mL/kg fat-free mass (FFM)/min; P < 0.05). Stroke volume was reduced in the diabetes group at rest (1.86 ± 0.04 vs. 2.05 ± 0.07 mL/kg FFM; P = 0.02) and during acute exercise (1.89 ± 0.04 vs. 2.17 ± 0.06 mL/kg FFM; P = 0.01). Diabetic adolescents also had reduced end-diastolic volume at rest (2.94 ± 0.06 vs. 3.26 ± 0.09 mL/kg FFM; P = 0.01) and during acute exercise (2.78 ± 0.05 vs. 3.09 ± 0.08 mL/kg FFM; P = 0.01). End-systolic volume was lower in the diabetic group at rest (1.08 ± 0.03 vs. 1.21 ± 0.04 mL/kg FFM; P = 0.01) but not during acute exercise. Exercise capacity and resting and exercise stroke volumes were correlated with glycemic control but not with diabetes duration.
CONCLUSIONS Adolescents with type 1 diabetes have reduced exercise capacity and display alterations in cardiac function compared with nondiabetic controls, associated with reduced stroke volume during exercise.
- Received December 1, 2011.
- Accepted April 18, 2012.
- © 2012 by the American Diabetes Association.
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