title: Re-evaluation of exercise prescription for Japanese type 2 diabetic patients by ventilatory threshold.
abstract: Prescription of aerobic exercise for Type 2 diabetes mellitus (Type 2 DM) in clinical practice is frequently based on exercise intensity at maximum heart rate (60<HR(max)<79%), heart rate reserve (50<HR(reserve)<74%), and rating of perceived exertion (12<RPE<13). We examined these parameters in Japanese males with Type 2 DM at ventilatory threshold (VT) to investigate the exercise capacity of Type 2 DM patients and re-evaluate the exercise prescription. Fifty-six Japanese Type 2 DM males without autonomic neuropathy [age, 53.5+/-7.7 years; body mass index (BMI), 23.7+/-3.6 kg/m(2)] were enrolled and compared with 56 age- and BMI-matched healthy Japanese males. VT was determined breath by breath during exercise test using a ramp protocol and rates of oxygen consumption (VO(2)), work rate (WR), HR, DeltaHR, %HR(max), %HR(reserve), and RPE were measured at VT. Type 2 DM patients had significantly lower VO(2) (3.6+/-0.4 metabolic equivalents (METs)) and WR (62+/-14 W) than controls (VO(2), 3.9+/-0.6 METs; WR, 74+/-13 W). %HR(reserve), (32.6+/-7.7%) was also significantly lower compared with controls (37.6+/-8.3%), while %HR(max), was not different. RPE was also similar in diabetics (12.4+/-1.5) and controls (12.9+/-1.2), however, it was significantly lower in diabetic patients aged 60-69 years (11.8+/-2.0) and those with distal symmetric sensory neuropathy (12.2+/-1.0). Our results indicate reduced exercise capacity in Japanese Type 2 DM males and the exercise intensity of 60%HR(max), 30%HR(reserve), and RPE 12 is recommended in elderly diabetics and those with diabetic sensory neuropathy.
authors.affiliation: Department of Medicine III, Okayama University Medical School, 2-5-1 Shikata-cho, 700-8558, Okayama, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Kunitomi
authors.forename: K
authors.initials: K
authors.lastname: Takahashi
authors.forename: J
authors.initials: J
authors.lastname: Wada
authors.forename: H
authors.initials: H
authors.lastname: Suzuki
authors.forename: N
authors.initials: N
authors.lastname: Miyatake
authors.forename: S
authors.initials: S
authors.lastname: Ogawa
authors.forename: S
authors.initials: S
authors.lastname: Ohta
authors.forename: H
authors.initials: H
authors.lastname: Sugimoto
authors.forename: K
authors.initials: K
authors.lastname: Shikata
authors.forename: H
authors.initials: H
authors.lastname: Makino
mesh_terms: D001794:Blood Pressure; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology* / Q000628:therapy*; D003929:Diabetic Neuropathies / Q000503:physiopathology; D015444:Exercise; D006442:Glycated Hemoglobin / Q000032:analysis; D006339:Heart Rate; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D010465:Perception; D005082:Physical Exertion; D012016:Reference Values
chemical_list: D006442:Glycated Hemoglobin