Regional Cerebral Hemodynamic Response to Incremental Exercise Is Blunted in Poorly Controlled Patients With Uncomplicated Type 1 Diabetes
Article Figures & Tables
Figures
- Figure 1
NIRS recordings made of the left-side prefrontal cortex. A and B: Change in THb. C and D: Change in O2Hb. E and F: Change in HHb. The 0 indicates the baseline value before incremental exercise. ▲, T1D-A; △, CON-A; ■, T1D-I; □, CON-I. Post hoc analyses for group effect significantly different from healthy controls: *P < 0.05, **P < 0.01. Post hoc analyses for time effect significantly different from rest: †P < 0.05, ††P < 0.01, †††P < 0.001.
- Figure 2
A and B: Breath-by-breath recordings of Petco2 during incremental exercise. The 0 indicates the baseline value before incremental exercise. ▲, T1D-A; △, CON-A; ■, T1D-I; □, CON-I. Post hoc analyses for time effect significantly different from rest: †P < 0.05, ††P < 0.01, †††P < 0.001. NS, not significant.
Tables
- Table 1
Participant characteristics
CON-A (n = 8) T1D-A (n = 8) CON-I (n = 10) T1D-I (n = 10) Anthropometric and demographic data Male/female sex 7/1 7/1 6/4 6/4 Age (years) 29.6 ± 4.5 30.1 ± 6.8 25.8 ± 5.9 26.1 ± 7.8 BMI (kg · m−2) 23.5 ± 2.4 22.7 ± 3.4 23.8 ± 1.9 23.2 ± 1.9 Fat mass (%) 16.8 ± 3.7 18.2 ± 5.9 19.6 ± 5.4 19.9 ± 7.5 Smoking status Smoker 1 1 2 2 Nonsmoker 7 7 8 8 HbA1c (%) 5.3 ± 0.2 6.8 ± 0.7‡‡‡** 5.3 ± 0.3 9.0 ± 0.7*** HbA1c (mmol/mol) 34 ± 2.2 51 ± 7.7‡‡‡** 34 ± 3.3 75 ± 7.7*** Diabetes duration (years) — 4.3 ± 3.5‡‡‡ — 10.7 ± 3.7 Age at disease diagnosis — 24.8 ± 8.1‡ — 15.4 ± 9.4 Insulin delivery (MDI/CSII) — 4/4 — 4/6 Insulin dose (units · kg−1 · day−1) — 0.48 ± 0.14‡‡‡ — 0.78 ± 0.12 Accelerometry (min · day−1) Light + moderate + vigorous 87.1 ± 26.5 72.9 ± 23.1 70.1 ± 18.9 76.5 ± 19.6 Data are mean ± SD or n. Fat mass was measured by DXA; HbA1c recorded just before exercise. CSII, continuous subcutaneous insulin infusion; MDI, multiple daily injections.
Significantly different from their respective CON group (Wilcoxon test):
↵**P < 0.01,
↵***P < 0.001.
Significantly different from T1D-I:
↵‡P < 0.05,
↵‡‡‡P < 0.001.
- Table 2
Cardiopulmonary and metabolic data of participants during incremental maximal exercise
CON-A T1D-A Main effect by ANOVA CON-I T1D-I Main effect by ANOVA Aerobic fitness VO2max (mL · min−1 · kg−1) 41.7 ± 6.9 39.6 ± 8.5 — 40.3 ± 7.3 34.6 ± 7.1* — MAP (W) 222 ± 28 197 ± 30 — 224 ± 54 186 ± 46 — HRmax (bpm) 189.4 ± 8.6 190.6 ± 11.5 — 189.2 ± 10.2 186.7 ± 11.9 — RERmax 1.1 ± 0.1 1.1 ± 0.1 — 1.1 ± 0.1 1.2 ± 0.1 — Blood lactate max (mmol · L−1) 11.9 ± 5.1 12.7 ± 2.6 — 12.9 ± 4.5 13.9 ± 2.3 — RPE at max 19.0 ± 0.6 18.7 ± 0.8 — 18.8 ± 0.5 19.1 ± 0.7 — Factors possibly influencing prefrontal cortex hemodynamics and oxygenation O2 arterial content Pao2 (mmHg) Rest 97.8 ± 10.5 92.1 ± 4.3 Exercise: P < 0.01 98.4 ± 5.4 90.2 ± 8.3 Exercise: P < 0.01 Group: NS Group: NS Max 110.8 ± 15.4† 97.7 ± 4.9 Interaction: NS 105.6 ± 5.8† 104.2 ± 15.6††† Interaction: NS Sao2 (%) Rest 98.1 ± 0.4 98.2 ± 1.0 Exercise: P < 0.05 98.3 ± 0.8 98.3 ± 0.7 Exercise: P < 0.01 Group: NS Group: NS Max 97.3 ± 2.1 96.7 ± 1.3† Interaction: NS 97.2 ± 1.1† 97.3 ± 0.7 Interaction: NS Hb (g · dL−1) Rest 15.0 ± 0.8 15.7 ± 1.1 Exercise: P < 0.001 14.7 ± 1.6 14.8 ± 1.1 Exercise: P < 0.01 Group: P < 0.05 Group: NS Max 15.7 ± 1.1 17.7 ± 2.0 Interaction: NS 15.7 ± 1.9 15.9 ± 0.9† Interaction: NS Cao2 (mL · 100 mL−1) Rest 20.4 ± 1.1 21.5 ± 1.4 Exercise: P = 0.07 20.1 ± 2.1 20.3 ± 1.5 Exercise: P < 0.01 Group: P < 0.05 Group: NS Max 21.5 ± 1.4 23.8 ± 2.6† Interaction: NS 21.2 ± 2.5 21.6 ± 1.8† Interaction: NS Exercise-influenced metabolic vasoactive stimuli Paco2 (mmHg) Rest 39.0 ± 2.2 38.8 ± 2.4 Exercise: P < 0.001 37.3 ± 3.9 39.4 ± 2.8 Exercise: P < 0.001 Group: NS Group: NS Max 28.3 ± 3.2††† 29.6 ± 2.4††† Interaction: NS 30.7 ± 4.6††† 31.9 ± 3.7††† Interaction: NS Arterial pH Rest 7.41 ± 0.02 7.39 ± 0.05 Exercise: P < 0.001 7.43 ± 0.02 7.43 ± 0.01 Exercise: P < 0.001 Group: NS Group: NS Max 7.27 ± 0.07 7.25 ± 0.04 Interaction: NS 7.26 ± 0.08 7.27 ± 0.05 Interaction: NS [K+] (mmol · L−1) Rest 4.84 ± 0.36 5.15 ± 0.38 Exercise: P < 0.01 4.80 ± 0.57 5.10 ± 0.91 Exercise: P < 0.05 Group: NS Group: NS Max 5.62 ± 0.61 6.61 ± 0.90 Interaction: NS 5.52 ± 1.11 5.49 ± 0.69 Interaction: NS Diabetes-influenced metabolic variables Plasma glucose (mmol · L−1) Rest 5.4 ± 0.4 6.2 ± 1.8 Exercise: P < 0.001 4.3 ± 1.4 7.5 ± 3.4 Exercise: P < 0.001 Group: NS Group: P < 0.05 Max 6.3 ± 0.8† 6.8 ± 1.7 Interaction: NS 6.8 ± 1.4 9.1 ± 2.4††* Interaction: NS Serum free insulin (mIU · L−1) Rest 10.8 ± 5.6 34.3 ± 49.2 Exercise: NS 12.5 ± 9.8 31.7 ± 33.9 Exercise: NS Group: NS Group: NS Max 10.3 ± 4.3 35.5 ± 43.8 Interaction: NS 9.6 ± 6.8 43.4 ± 49.0 Interaction: NS Data are mean ± SD unless otherwise indicated. Hb, hemoglobin; HR, heart rate; MAP, maximal aerobic power; Max, at exhaustion from the incremental exercise; NS, not significant; RER, respiratory exchange ratio; Rest, at rest just before the exercise; RPE, rating of perceived exertion.
Wilcoxon test (variables only indicated at max) significantly different from their respective CON group:
↵*P < 0.05.
Main effects from ANOVA: exercise, exercise effect; group, group effect; interaction, exercise × group interaction. ANOVA post hoc analyses significantly different from their respective CON group:
*P < 0.05.
Significantly different from rest:
↵†P < 0.05,
↵††P < 0.01,
↵†††P < 0.001.
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