Abstract
OBJECTIVE-To determine whether adolescents with type 1 diabetes have left ventricular functional changes at rest and during acute exercise and whether these changes are affected by metabolic control and diabetes duration.
RESEARCH DESIGN AND METHODS-The study evaluated 53 adolescents with type 1 diabetes and 22 control adolescents. Baseline data included peak exercise capacity and body composition by dual-energy X-ray absorptiometry. Left ventricular functional parameters were obtained at rest. and during acute exercise using magnetic resonance imaging.
RESULTS-Compared with nondiabetic control subjects, adolescents with type 1 diabetes had lower exercise capacity (44.7 +/- 09 vs. 48.5 +/- 1.4 mL/kg fat-free mass [FFM]/min, P < 0.05). Stroke volume was reduced in the diabetes group at rest (1.86 +/- 0.04 vs. 2.05 +/- 0.07 mL/kg FFM; P = 0.02) and during acute exercise (1.89 +/- 0.04 vs. 2.17 +/- 0.06 mL/kg FFM; P = 0.01). Diabetic adolescents also had reduced end-diastolic volume at rest (2.94 +/- 0.06 vs. 3.26 +/- 0.09 mL/kg FFM, P = 0.01) and during acute exercise (2.78 +/- 0.05 vs. 3.09 +/- 0.08 mL/kg FFM; P = 0.01). End-systolic volume was lower in the diabetic group at rest (1.08 +/- 0.03 vs. 1.21 +/- 0.04 mL/kg FFM, P = 0.01) but not during acute exercise. Exercise capacity and resting and exercise stroke volumes were correlated with glycemic control but not with diabetes duration.
CONCLUSIONS-Adolescents with type 1 diabetes have reduced exercise capacity and display alterations in cardiac function compared with nondiabetic control subjects, associated with reduced stroke volume during exercise. Diabetes Care 35:2089-2094, 2012