Can a simple test of functional capacity add to the clinical assessment of diabetes?

Abstract

Aim To identify impairment in functional capacity associated with complicated and non-complicated diabetes using the 6-min walk distance test. Methods We enrolled 111 adults, aged ≥40 years, with Type 2 diabetes from a hospital facility and 150 healthy control subjects of similar age and sex from a community site in Lima, Peru. All participants completed a 6-min walk test. Results The mean age of the 261 participants was 58.3 years, and 43.3% were male. Among those with diabetes, 67 (60%) had non-complicated diabetes and 44 (40%) had complications such as peripheral neuropathy, retinopathy or nephropathy. The mean unadjusted 6-min walk distances were 376 m and 394 m in adults with and without diabetes complications, respectively, vs 469 m in control subjects (P<0.001). In multivariable regression, the subjects with diabetes complications walked 84 m less far (95% CI -104 to -63 m) and those without complications walked 60 m less far (-77 to -42 m) than did control subjects. When using HbA1c level as a covariate in multivariable regression, participants walked 13 m less far (-16.9 to -9.9 m) for each % increase in HbA1c. Conclusions The subjects with diabetes had lower functional capacity compared with healthy control subjects with similar characteristics. Differences in 6-min walk distance were even apparent in the subjects without diabetes complications. Potential mechanisms that could explain this finding are early cardiovascular disease or deconditioning.

The effects of Internet-based exercise compared with supervised group exercise in people with type 2 diabetes: a randomized controlled study

“…Even so, the six-minute walking distance was improved in both training groups, consistent with previous findings. 31 However, the changes in physical activity level and functional capacity were significant in only the Internet-based exercise group compared to the controls. These results may be related to each other, and it can be considered that increased physical activity may also enhance functional capacity.…”

Variations in subclinical left ventricular dysfunction, functional capacity, and clinical outcomes in different heart failure aetiologies

“…This is a simple, safe test of functional capacity that is a well‐established diagnostic procedure in cardiovascular and pulmonary disease, which has prognostic value 24. A systematic review25 to investigate the reliability between 6MWT and other methods to assess functional capacity showed that 6MWT has moderate to good ability to predict VO 2 in chronic HF, especially in those patients who are unable to walk >490 m. Compared with healthy controls, patients with T2DM have lower 6MWD 26. The results of this study show that, compared with that in other‐SAHF, functional capacity in T2DM‐SAHF was more impaired.…”

Factores asociados a velocidad de marcha lenta en adultos mayores de un distrito en Lima, Perú

“…Desde el punto de vista clínico, la diabetes tipo 2 es un factor asociado y demostrado que afecta la velocidad de la marcha pues la función de caminar requiere de la contribución de varios sistemas y, siendo la diabetes una condición de afectación multisistémica, se produce un deterioro progresivo de diversos órganos y sistemas indispensables para una correcta caminata (27) . Un estudio demostró que la diabetes estaba asociada a una menor densidad y calidad muscular y menor fuerza en la rodilla y el tobillo (28) y también a una menor distancia de recorrido en 6 min (29) . Asimismo, se considera que la presencia del estado proinflamatorio como consecuencia de la resistencia a la insulina, producirá una reducción en la fuerza y poder muscular, lo cual, aunado a la neuropatía periférica, explicarían aún más la presencia de una velocidad de la marcha lenta en adultos mayores diabéticos (30) .…”