title: Differential Patterns of Impaired Cardiorespiratory Fitness and Cardiac Autonomic Dysfunction in Recently Diagnosed Type 1 and Type 2 Diabetes.
abstract: Both impaired cardiorespiratory fitness (CRF) and heart rate variability (HRV) are predictors of mortality, but their relative roles in recent-onset diabetes are unknown. We determined to which extent CRF and HRV are reduced and interrelated in recent-onset diabetes.
  
  
  
  Participants from the German Diabetes Study with type 1 (n = 163) or type 2 (n = 188) diabetes with known diabetes duration <1 year and two age-matched glucose-tolerant control groups (n = 40 each) underwent spiroergometry and HRV assessment during a hyperinsulinemic-euglycemic clamp.
  
  
  
  Compared with control subjects, patients with type 2 diabetes showed reduced VO2max(median [1st-3rd quartiles] 19.3 [16.5-22.9] vs. 25.6 [20.7-29.9] mL/kg body weight/min; P < 0.05), diminished VCO2max(23.0 [19.1-26.8] vs. 30.9 [24.5-34.4] mL/kg body weight/min; P < 0.05), blunted heart rate recovery after 2 min (-29.0 [-35.0 to -23.0] vs. -36.0 [-42.8 to -28.0] beats/min; P < 0.05), and reduced HRV in four of nine indices, whereas patients with type 1 diabetes had unaltered CRF but reduced HRV in three of nine indices (P < 0.05), indicating diminished vagal and sympathetic HRV modulation. HRV measures correlated with VO2maxin patients with type 1 diabetes (r >0.34; P < 0.05) but not in those with type 2 diabetes.
  
  
  
  CRF is reduced in recently diagnosed type 2 diabetes but preserved in type 1 diabetes, whereas cardiac autonomic function is reduced in both diabetes types but is strongly associated with CRF only in type 1 diabetes. These results support the therapeutic concept of promoting physical fitness in the early course of diabetes.
authors.affiliation: Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany.|German Center for Diabetes Research, München-Neuherberg, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Röhling
authors.affiliation: Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany.|German Center for Diabetes Research, München-Neuherberg, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Strom
authors.affiliation: Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
authors.forename: Gidon
authors.initials: G
authors.lastname: Bönhof
authors.affiliation: Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
authors.forename: Sonja
authors.initials: S
authors.lastname: Püttgen
authors.affiliation: Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany.|German Center for Diabetes Research, München-Neuherberg, Germany.
authors.forename: Kálmán
authors.initials: K
authors.lastname: Bódis
authors.affiliation: Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany.|German Center for Diabetes Research, München-Neuherberg, Germany.|Department of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany.
authors.forename: Karsten
authors.initials: K
authors.lastname: Müssig
authors.affiliation: Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany.|German Center for Diabetes Research, München-Neuherberg, Germany.|Department of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany.
authors.forename: Julia
authors.initials: J
authors.lastname: Szendrödi
authors.affiliation: Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany.|German Center for Diabetes Research, München-Neuherberg, Germany.
authors.forename: Daniel
authors.initials: D
authors.lastname: Markgraf
authors.affiliation: German Center for Diabetes Research, München-Neuherberg, Germany.|Institute of Clinical Biochemistry and Pathobiochemistry, German Diabetes Center, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Lehr
authors.affiliation: Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany.|German Center for Diabetes Research, München-Neuherberg, Germany.|Department of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Roden
authors.affiliation: Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany dan.ziegler@ddz.uni-duesseldorf.de.|German Center for Diabetes Research, München-Neuherberg, Germany.|Department of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany.
authors.forename: Dan
authors.initials: D
authors.lastname: Ziegler
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001341:Autonomic Nervous System / Q000503:physiopathology*; D001342:Autonomic Nervous System Diseases / Q000150:complications / Q000175:diagnosis*; D000072599:Cardiorespiratory Fitness; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000175:diagnosis*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000175:diagnosis*; D017097:Electric Impedance; D005260:Female; D005858:Germany; D006442:Glycated Hemoglobin; D006331:Heart Diseases / Q000150:complications / Q000175:diagnosis*; D006339:Heart Rate; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D003404:Creatinine; D006442:Glycated Hemoglobin