Aerobic Exercise Capacity and Pulmonary Function in Athletes With and Without Type 1 Diabetes

Komatsu, William Ricardo; Neto, Turíbio Leite de Barros; Chacra, Antônio Roberto; Dib, Sérgio Atala

doi:10.2337/dc10-0769

Cited by 28 publications

(38 citation statements)

References 10 publications

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“…Komatsu et al observed that individuals with type 1 diabetes were characterized by the same aerobic capacity as non-diabetic subjects if they were in training, although the anaerobic threshold was lower than non-diabetic athletes [85]. This could suggest that highly trained individuals with diabetes and good glycemic control can achieve the same cardiopulmonary exercise response as trained subjects without diabetes.…”

Section: Cardiopulmonary Exercise Testmentioning

confidence: 85%

The Diabetic Lung - A New Target Organ?

Pitocco

Fuso²,

Conte³

et al. 2012

Rev Diabet Stud

142

112

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■ AbstractSeveral abnormalities of the respiratory function have been reported in patients with type 1 and type 2 diabetes. These abnormalities concern lung volume, pulmonary diffusing capacity, control of ventilation, bronchomotor tone, and neuroadrenergic bronchial innervation. Many hypotheses have emerged, and characteristic histological changes have been described in the "diabetic lung", which could explain this abnormal respiratory function. Given the specific abnormalities in diabetic patients, the lung could thus be considered as a target organ in diabetes. Although the practical implications of these functional changes are mild, the presence of an associated acute or chronic pulmonary and/or cardiac disease could determine severe respiratory derangements in diabetic patients. Another clinical consequence of the pulmonary involvement in diabetes is the accelerated decline in respiratory function. The rate of decline in respiratory function in diabetics has been found to be two-to-three times faster than in normal non-smoking subjects, as reported in longitudinal studies. This finding, together with the presence of anatomical and biological changes similar to those described in the aging lung, indicates that the "diabetic lung" could even be considered a model of accelerated aging. This review describes and analyses the current insight into the relationship of diabetes and lung disease, and suggests intensifying research into the lung as a possible target organ in diabetes.

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Section: Cardiopulmonary Exercise Testmentioning

confidence: 85%

The Diabetic Lung - A New Target Organ?

Pitocco

Fuso²,

Conte³

et al. 2012

Rev Diabet Stud

142

112

View full text Add to dashboard Cite

show abstract

“…In addition, T1DM seems accelerating the respiratory ageing. Tables 1E and 2E describe, respectively, the five international and the four African published studies [10,14,17,[19][20][21][22][23][24]. The above studies have controversial conclusions and used limited methodology:…”

Section: Discussionmentioning

confidence: 97%

“…Inclusion of T1DM patients with a high difference in disease duration [17]. The DM duration varied from three (range: 0.5-13 Yrs) [17] to 15 ± 7 Yrs [10]. This could be a source of misinterpretation, since it was suggested that the longer the duration of T1DM is, the greater the lung function impairment will be [24].…”

Section: Discussion Of the Methodologymentioning

confidence: 99%

“…In addition, the majority of these studies [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] used limited methodology: combination of the two types of DM [14,[19][20][21][22]; inclusion of T1DM patients with a high difference in disease duration [17]; inclusion of both controlled and uncontrolled T1DM [21]; lack of control groups such as healthy-subjects [17,19]; measurements of expiratory flows only [14,17,20,21,24], without measurement of lung volumes and/or lung-hyperinflation; non-application [10,17,21,22,24] of the latest lung function international recommendations [28][29][30], no report of the applied lung function guidelines [14,19,20,23]; use of unspecified spirometric norms [10,…”

Section: Introductionmentioning

confidence: 99%

“…That was hence the first results in the literature suggesting that the lung may be a ''target organ'' of T1DM. Since then, studies analysing T1DM ventilatory mechanics and/or pulmonary exchanger are more numerous with controversial conclusions: no effect [9][10][11][12][13], abnormal data [14][15][16][17][18][19][20][21][22][23][24][25][26][27] with conflicting reports on the nature of spirometric alterations: restrictive [14][15][16][17] and/or large-airways obstructive [16,17]-ventilatory-defects (respectively, RVD, and LAOVD) and/or decreased DLCO [14,15,18,23,26], and normal spirometry data but decreased DLCO [27]. In addition, the majority of these studies [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23]…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Lung function in poorly controlled type 1 North African diabetic patients: A case-control study

Slim

Khalaf

Latiri

et al. 2015

Egyptian Journal of Chest Diseases and Tuberculosis

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Aim: To compare the lung function parameters of poorly controlled type-1-diabetesmellitus (T1DM) patients with age-; height and sex-matched healthy-non-smokers (HNS).Population and methods: Subjects aged 35-60 Yrs who have a poorly controlled T1DM (glycated-Haemoglobin level >7%) with a disease history of more than 10 Yrs (n = 14) and HNS subjects (n = 14) were recruited. Clinical, anthropometric and fasting biological data were This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Aging; Case-control study collected. Plethysmographic data (flows, volumes, estimated-lung-age (ELA), lung-capacity-totransfer-carbon-monoxide (DLCO)) were measured. Large-airway-obstructive-ventilatory-defect (LAOVD) was defined as first-second-forced-expiratory-volume (FEV 1 )/forced-vital-capacity (FVC) below the lower-limit-of-normal (LLN). Restrictive-ventilatory-defect (RVD) was defined as total-lung-capacity (TLC) < LLN. Lung-hyperinflation was defined as residual-volume (RV) > upper-limit-of-normal. Student t-test and chi-2 test were used to compare plethysmographic data and profiles of the two groups.Results: The two groups were matched in chronological-lung-age (CLA) (respectively 47 ± 7 vs. 50 ± 8 Yrs) and sex (7 males and 7 females in each group) and height. Compared to the HNS group, the T1DM one had significantly lower FEV 1 , FVC, slow-vital-capacity and maximal-midexpiratory-flow (respectively 99 ± 11% vs. 83 ± 11%, 99 ± 9% vs. 86 ± 11%, 80 ± 8% vs. 67 ± 15% and 98 ± 23% vs. 72 ± 23%), had significantly higher TLC and RV (respectively, 105 ± 20% vs. 123 ± 24% and 108 ± 22% vs. 131 ± 24%) and had significantly higher percentage of subjects with lung-hyperinflation (7.1% vs. 43.0%). Both groups had similar percentages of LAOVD and RVD and similar corrected DLCO values. ELA of the T1DM group (57 ± 10 Yrs) was significantly higher than CLA.Conclusion: Poorly controlled T1DM seems to alter ventilatory mechanics without effect on the alveolo-capillary-membrane. In addition, it accelerates the respiratory ageing.

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Exercise and Type 1 Diabetes (T1DM)

Galassetti

Riddell

2013

Comprehensive Physiology

113

118

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Physical exercise is firmly incorporated in the management of type 1 diabetes (T1DM), due to multiple recognized beneficial health effects (cardiovascular disease prevention being preeminent). When glycemic values are not excessively low or high at the time of exercise, few absolute contraindications exist; practical guidelines regarding amount, type, and duration of age-appropriate exercise are regularly updated by entities such as the American Diabetes Association and the International Society for Pediatric and Adolescent Diabetes. Practical implementation of exercise regimens, however, may at times be problematic. In the poorly controlled patient, specific structural changes may occur within skeletal muscle fiber, which is considered by some to be a disease-specific myopathy. Further, even in well-controlled patients, several homeostatic mechanisms regulating carbohydrate metabolism often become impaired, causing hypo- or hyperglycemia during and/or after exercise. Some altered responses may be related to inappropriate exogenous insulin administration, but are often also partly caused by the "metabolic memory" of prior glycemic events. In this context, prior hyperglycemia correlates with increased inflammatory and oxidative stress responses, possibly modulating key exercise-associated cardio-protective pathways. Similarly, prior hypoglycemia correlates with impaired glucose counterregulation, resulting in greater likelihood of further hypoglycemia to develop. Additional exercise responses that may be altered in T1DM include growth factor release, which may be especially important in children and adolescents. These multiple alterations in the exercise response should not discourage physical activity in patients with T1DM, but rather should stimulate the quest for the identification of the exercise formats that maximize beneficial health effects.

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Aerobic Exercise Capacity and Pulmonary Function in Athletes With and Without Type 1 Diabetes

Cited by 28 publications

References 10 publications

The Diabetic Lung - A New Target Organ?

The Diabetic Lung - A New Target Organ?

Lung function in poorly controlled type 1 North African diabetic patients: A case-control study

Exercise and Type 1 Diabetes (T1DM)

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