title: "Metabolic and cardiovascular response to exercise in patients with type 1 diabetes".
abstract: OBJECTIVE
  Physical activity is an effective therapeutic tool for cardiovascular risk prevention. However, exercise aerobic capacity of patients with type 1 diabetes (T1DM) has not been thoroughly investigated. Aim of the present study is to evaluate exercise aerobic capacity in patients with T1DM compared to a normal control population.
  
  
  METHODS
  This observational study included 17 T1DM patients and 17 matched healthy volunteers. Cardiopulmonary exercise test (CPET) was conducted on an electronically-braked cycle ergometer. Blood samples were collected for evaluation of glycemia and lactate levels.
  
  
  RESULTS
  Mean oxygen uptake at peak exercise (V'O2,peak) was significantly lower in T1DM subjects (V'O2,peakT1DM 2200 ± 132ml/min vs V'O2,peakHealthy subjects of 2659 ± 120 ml/min p = 0.035). Cardiovascular response analysis did not show statistically significant differences. Respiratory exchange ratio (RER) was significantly higher in healthy subjects at peak exercise and at the first minute of recovery (p = 0.022, p = 0.024). Peak exercise lactate levels were significantly higher in healthy subjects. There was no statistical correlation between CPET results and diabetes-related parameters.
  
  
  CONCLUSIONS
  Patients affected by T1DM have a worse exercise tolerance than normal subjects. The two groups differed by RER which can be greatly influenced by the substrate type utilized to produce energy. Because of the impaired carbohydrate utilization, T1DM subjects may use a larger amount of lipid substrates, such hypothesis could be strengthened by the lower lactate levels found in T1DM group at peak exercise. The lack of correlation between exercise tolerance and disease-related variables suggests that the alterations found could be independent from the glycemic levels.
authors.affiliation: Department of Public Health and Infectious Diseases, Sapienza University of Rome, Viale dell' Università 37, 00185, Rome, Italy. irene.turinese@uniroma1.it.
authors.forename: I
authors.initials: I
authors.lastname: Turinese
authors.affiliation: Department of Public Health and Infectious Diseases, Sapienza University of Rome, Viale dell' Università 37, 00185, Rome, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Marinelli
authors.affiliation: Department of Public Health and Infectious Diseases, Sapienza University of Rome, Viale dell' Università 37, 00185, Rome, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Bonini
authors.affiliation: Department of Public Health and Infectious Diseases, Sapienza University of Rome, Viale dell' Università 37, 00185, Rome, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Rossetti
authors.affiliation: Department of Public Health and Infectious Diseases, Sapienza University of Rome, Viale dell' Università 37, 00185, Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Statuto
authors.affiliation: Department of Experimental Medicine, "Sapienza" University of Rome, Viale del Policlinico 151, 00185, Rome, Italy.
authors.forename: T
authors.initials: T
authors.lastname: Filardi
authors.affiliation: Department of Clinical Medicine, "Sapienza" University of Rome, Viale dell' Università 37, 00185, Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Paris
authors.affiliation: Department of Experimental Medicine, "Sapienza" University of Rome, Viale del Policlinico 151, 00185, Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Lenzi
authors.affiliation: Department of Experimental Medicine, "Sapienza" University of Rome, Viale del Policlinico 151, 00185, Rome, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Morano
authors.affiliation: Department of Public Health and Infectious Diseases, Sapienza University of Rome, Viale dell' Università 37, 00185, Rome, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Palange
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D003922:Diabetes Mellitus, Type 1 / Q000378:metabolism* / Q000503:physiopathology; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test / Q000379:methods*; D017079:Exercise Tolerance / Q000502:physiology*; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D010101:Oxygen Consumption / Q000502:physiology
chemical_list: D001786:Blood Glucose
keywords: Cardiopulmonary exercise test; Diabetes mellitus; Exercise physiology; Physical activity