Document Detail


Type 2 diabetes mellitus and exercise impairment.
MedLine Citation:
PMID:  23299658     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Limitations in physical fitness, a consistent finding in individuals with both type I and type 2 diabetes mellitus, correlate strongly with cardiovascular and all-cause mortality. These limitations may significantly contribute to the persistent excess cardiovascular mortality affecting this group. Exercise impairments in VO2 peak and VO2 kinetics manifest early on in diabetes, even with good glycemic control and in the absence of clinically apparent complications. Subclinical cardiac dysfunction is often present but does not fully explain the observed defect in exercise capacity in persons with diabetes. In part, the cardiac limitations are secondary to decreased perfusion with exercise challenge. This is a reversible defect. Similarly, in the skeletal muscle, impairments in nutritive blood flow correlate with slowed (or inefficient) exercise kinetics and decreased exercise capacity. Several correlations highlight the likelihood of endothelial-specific impairments as mediators of exercise dysfunction in diabetes, including insulin resistance, endothelial dysfunction, decreased myocardial perfusion, slowed tissue hemoglobin oxygen saturation, and impairment in mitochondrial function. Both exercise training and therapies targeted at improving insulin sensitivity and endothelial function improve physical fitness in subjects with type 2 diabetes. Optimization of exercise functions in people with diabetes has implications for diabetes prevention and reductions in mortality risk. Understanding the molecular details of endothelial dysfunction in diabetes may provide specific therapeutic targets for the remediation of this defect. Rat models to test this hypothesis are under study.
Authors:
Jane E B Reusch; Mark Bridenstine; Judith G Regensteiner
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Reviews in endocrine & metabolic disorders     Volume:  14     ISSN:  1573-2606     ISO Abbreviation:  Rev Endocr Metab Disord     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-03-04     Completed Date:  2013-09-04     Revised Date:  2014-07-17    
Medline Journal Info:
Nlm Unique ID:  100940588     Medline TA:  Rev Endocr Metab Disord     Country:  United States    
Other Details:
Languages:  eng     Pagination:  77-86     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Animals
Diabetes Mellitus, Type 2 / pathology,  physiopathology*
Endothelium, Vascular / pathology*,  physiopathology
Exercise / physiology*
Humans
Muscle, Skeletal / pathology,  physiopathology
Physical Fitness / physiology
Grant Support
ID/Acronym/Agency:
K12 HD057022/HD/NICHD NIH HHS; P01 HL014985/HL/NHLBI NIH HHS; R01 DK064741/DK/NIDDK NIH HHS; T32 HL007171/HL/NHLBI NIH HHS; UL1 TR000154/TR/NCATS NIH HHS
Comments/Corrections

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