Abstract
AimThe present study assessed the effect of high intensity interval training on cardiac function during prolonged submaximal exercise in patients with type 2 diabetes.MethodsTwenty-six patients with type 2 diabetes were randomized to a 12 week of high intensity interval training (3 sessions/week) or standard care control group. All patients underwent prolonged (i.e. 60 min) submaximal cardiopulmonary exercise testing (at 50% of previously assess maximal functional capacity) with non-invasive gas-exchange and haemodynamic measurements including cardiac output and stroke volume before and after the intervention.ResultsAt baseline (prior to intervention) there was no significant difference between the intervention and control group in peak exercise oxygen consumption (20.3 ± 6.1 vs. 21.7 ± 5.5 ml/kg/min, p = 0.21), and peak exercise heart rate (156.3 ± 15.0 vs. 153.8 ± 12.5 beats/min, p = 0.28). During follow-up assessment both groups utilized similar amount of oxygen during prolonged submaximal exercise (15.0 ± 2.4 vs. 15.2 ± 2.2 ml/min/kg, p = 0.71). However, cardiac function i.e. cardiac output during submaximal exercise decreased significantly by 21% in exercise group (16.2 ± 2.7–12.8 ± 3.6 L/min, p = 0.03), but not in the control group (15.7 ± 4.9–16.3 ± 4.1 L/min, p = 0.12). Reduction in exercise cardiac output observed in the exercise group was due to a significant decrease in stroke volume by 13% (p = 0.03) and heart rate by 9% (p = 0.04).ConclusionFollowing high intensity interval training patients with type 2 diabetes demonstrate reduced cardiac output during prolonged submaximal cardiopulmonary exercise testing. Ability of patients to maintain prolonged increased metabolic demand but with reduced cardiac output suggests cardiac protective role of high intensity interval training in type 2 diabetes.Trial registrationISRCTN78698481. Registered 23 January 2013, retrospectively registered.
Highlights
Diabetes is one of the major risk factors of cardiovascular complications
The aim of the present study was to define the effect of high intensity interval exercise training on cardiac function during prolonged submaximal exercise in patients with type 2 diabetes
Cardiac function during prolonged submaximal exercise, represented by cardiac output, decreased significantly by 21% in exercise group (16.2 ± 2.7–12.8 ± 3.6 L/min, p = 0.03), but not in the control group (15.7 ± 4.9–16.3 ± 4.1 L/min, p = 0.12, Table 3; Fig. 2)
Summary
Diabetes is one of the major risk factors of cardiovascular complications. Patients with type 2 diabetes are at significantly increased risk for cardiovascular morbidity and mortality compared with age-matched healthy control subjects [1, 2]. The high risk of cardiovascular mortality and morbidity in diabetes is associated with alteration in cardiac function and structure [3, 4]. Extended author information available on the last page of the article of medication and dietary intervention, exercise has been widely known for many years to be the basis of treating patients with type 2 diabetes and preventing further complications as well as reduce cardiovascular morbidity and mortality [5]. Evidence showed that substituting moderate intensity exercise with some vigorous exercise is more effective in terms of reducing high blood glucose and improving cardiorespiratory fitness [7]
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