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  • Continuous, non-invasive measurement of the haemodynamic response to submaximal exercise in patients with diabetes mellitus: evidence of impaired cardiac reserve and peripheral vascular response

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Original article
Diabetes, lipids and metabolism
Continuous, non-invasive measurement of the haemodynamic response to submaximal exercise in patients with diabetes mellitus: evidence of impaired cardiac reserve and peripheral vascular response
  1. D Joshi1,
  2. A Shiwalkar1,
  3. M R Cross2,
  4. S K Sharma3,
  5. A Vachhani1,
  6. C Dutt1
  1. 1
    Torrent Research Centre, Village Bhat, Gandhinagar, Gujarat, India
  2. 2
    Veeda Clinical Research, Old Convent of Notre Dame, Derriford, Plymouth, UK
  3. 3
    Veeda Clinical Research, Ambawadi Ahmedabad, Gujarat, India
  1. Correspondence to Dr Chaitanya Dutt, Torrent Research Center, PO Bhat, District of Gandhinagar 382428, Gujarat, India; cdutt{at}torrentpharma.com

Abstract

Background: Reduced exercise capacity in diabetics has been attributed to limitations in cardiac function and microvascular dysfunction leading to impaired oxygen supply and nutritive perfusion to exercising muscles.

Objective: To study changes in cardiac function and microvascular utilisation during exercise in diabetic individuals compared to age-matched controls.

Methods: Diabetics with glycosylated haemoglobin (HbA1c) <8 (n = 31), diabetics with HbA1c ⩾8 (n = 38) and age-matched non-diabetic controls (n = 32) performed exercise at 50 W for 10 minutes followed by recovery, with continuous monitoring of cardiac function by impedance cardiography and regional flow and oxygen saturation by laser Doppler and white light spectroscopy.

Results: In the diabetics, cardiac reserve during exercise and cardiac overshoot during recovery are significantly reduced because of reduction in capacity to increase stroke volume. Regional flow to the exercising muscle is reduced and there is also disproportionately greater desaturation of the regional flow. Abnormalities in cardiac function and regional perfusion are related to the severity of diabetes.

Conclusion: Cardiac response to exercise is attenuated significantly in diabetic individuals. Simultaneously, there is impairment in the regional distribution. These changes could be the harbinger of reduced exercise capacity in diabetics.

https://doi.org/10.1136/hrt.2009.177113

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    Footnotes

    • Funding The study was funded by Torrent Pharmaceutical Limited.

    • Competing interests DJ, AS, AV and CD are employees of Torrent Pharmaceutical Limited, Ahmedabad, and MRS and SKS are employees of Veeda UK and Veeda India, respectively.

    • Work was carried out at Discovery Biology, Torrent Research Centre, Village Bhat, Gandhinagar 382428, Gujarat, India and Clinical Pharmacology Unit, Veeda Clinical Research, Shivalik Plaza-A, Near IIM, Ambawadi Ahmedabad 380015, Gujarat, India.

    • Provenance and Peer review Not commissioned; externally peer reviewed.