Influence of the Degree of Metabolic Control on Physical Fitness in Type I Diabetic Adolescents

Abstract

Seventeen type I male diabetic adolescents and 17 control subjects matched for age, height, and weight were submitted to maximal exercise on a bicycle ergometer. The diabetic subjects were divided into two groups according to their degree of metabolic control using total glycosylated hemoglobin (HbA1): group 1, diabetics with HbA1 less than 8.5% (n = 9) and group 2, diabetics with HbA1 greater than 8.5% (n = 8). Oxygen uptake, pulmonary ventilation, and heart rate were recorded at rest and at maximal load. Glucose, lactate, and free fatty acids were determined in blood before and after exercise. Maximal work load and oxygen uptake were significantly lower in the two diabetic groups than in the healthy controls. An inverse relationship was observed between HbA1 concentration and the maximal work load (r = -0.63; P less than 0.01). It can be concluded that diabetic adolescents should obtain the best possible degree of metabolic control to improve their performances.

Altered energetic properties in skeletal muscle of men with well-controlled insulin-dependent (type 1) diabetes

“…The higher glycolytic flux and lower oxidative capacity reported here are consistent with the greater lactate generation and reduced V O 2 max seen in age-and activity-matched type 1 diabetic patients (34,48). These results suggest a shift in muscle metabolic profile of muscle in type 1 diabetics patients similar to the increased glycolytic-to-oxidative enzyme activity ratio seen in muscle fibers of obese and type 2 diabetic individuals (19).…”

“…Assays of a key glycolytic enzyme, phosphofructokinase, showed no difference between type 1 diabetic patients and control subjects (45). However, measurements during exercise provide evidence that the lower oxidative and higher glycolytic fluxes found in obesity and type 2 diabetes are also common to type 1 diabetes; specifically, V O 2 max is reduced (34) and blood lactate levels are elevated (48) in exercising type 1 patients compared with age-and activity-matched control subjects. In addition, an increased glycolytic flux in a rodent model of uncontrolled type 1 diabetes was apparent from a greater drop in muscle pH during stimulation, indicative of increased lactate generation compared with control muscle (6).…”

Altered Exercise Gas Exchange as Related to Microalbuminuria in Type 2 Diabetic Patients

“…Impaired exercise capacity in terms of peak V o 2 or WR has been documented in both type 1 diabetes 7,11,13-15 and type 2 diabetes 16 to be related to longstanding disease, 11 higher total glycosylated hemoglobin A 1 , 14 higher body mass index, female sex, older age, higher resting systolic BP, higher pack-years of smoking, and African-American race. 17 In type 1 diabetes, Jensen et al 6 found that peak V o 2 of normal control subjects and patients with normoalbuminuria was similar.…”

Decreased Satellite Cell Number and Function in Humans and Mice With Type 1 Diabetes Is the Result of Altered Notch Signaling

“…Although skeletal muscle is a largely resilient tissue that is capable of adapting to changing conditions, the skeletal muscle of individuals with T1D exhibits a decline in physiological function and performance compared with healthy skeletal muscle, including significant impairments to its reparative capacities (2)(3)(4)(5)(6)(7).…”