title: Can a simple test of functional capacity add to the clinical assessment of diabetes?
abstract: To identify impairment in functional capacity associated with complicated and non-complicated diabetes using the 6-min walk distance test.
  
  
  
  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.
  
  
  
  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 .
  
  
  
  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.
authors.affiliation: Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
authors.forename: T
authors.initials: T
authors.lastname: Stewart
authors.affiliation: Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
authors.forename: D G
authors.initials: DG
authors.lastname: Caffrey
authors.affiliation: Program in Disease Control and Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.|A.B. PRISMA, Lima, Peru.
authors.forename: R H
authors.initials: RH
authors.lastname: Gilman
authors.affiliation: Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
authors.forename: S C
authors.initials: SC
authors.lastname: Mathai
authors.affiliation: Program in Disease Control and Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
authors.forename: A
authors.initials: A
authors.lastname: Lerner
authors.affiliation: Division of Endocrinology, Department of Medicine, Hospital Nacional Cayetano Heredia, Lima, Peru.
authors.forename: A
authors.initials: A
authors.lastname: Hernandez
authors.affiliation: Division of Endocrinology, Department of Medicine, Hospital Nacional Cayetano Heredia, Lima, Peru.|Department of Medicine, School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru.
authors.forename: M E
authors.initials: ME
authors.lastname: Pinto
authors.affiliation: Division of Endocrinology, Department of Medicine, Hospital Nacional Cayetano Heredia, Lima, Peru.
authors.forename: Y
authors.initials: Y
authors.lastname: Huaylinos
authors.affiliation: A.B. PRISMA, Lima, Peru.
authors.forename: L
authors.initials: L
authors.lastname: Cabrera
authors.affiliation: Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
authors.forename: R A
authors.initials: RA
authors.lastname: Wise
authors.affiliation: Department of Medicine, School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru.|CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru.
authors.forename: J J
authors.identifier: 0000-0002-4738-5468
authors.initials: JJ
authors.lastname: Miranda
authors.affiliation: Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.|Program in Disease Control and Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
authors.forename: W
authors.initials: W
authors.lastname: Checkley
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000378:metabolism / Q000503:physiopathology*; D003928:Diabetic Nephropathies / Q000209:etiology; D003929:Diabetic Neuropathies / Q000209:etiology; D003930:Diabetic Retinopathy / Q000209:etiology; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010568:Peru; D000070857:Walk Test
chemical_list: D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human