Cardiovascular Endurance and Heart Rate Variability in Adolescents With Type 1 or Type 2 Diabetes

Faulkner, Melissa Spezia; Quinn, Laurie; Rimmer, James H.; Rich, Barry H.

doi:10.1177/1099800405275202

Cited by 40 publications

(46 citation statements)

References 57 publications

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“…Autonomic neuropathy has been described early after the diagnosis of type 2 diabetes [4] and reduced maximal heart rate has been reported in type 2 diabetic adults [9]. Of particular interest, type 2 diabetic female adolescents may have lower heart rate variability than type 1 diabetic adolescents [4]. In this context, we believe our finding of lower peak heart rate indicates that type 2 diabetic adolescents, like their adult counterparts, may have an impaired autonomic response to exercise.…”

Section: Discussionmentioning

confidence: 51%

“…An alternative explanation is that autonomic dysfunction, which appears in diabetic adults [8], occurs in type 2 diabetic adolescents. Autonomic neuropathy has been described early after the diagnosis of type 2 diabetes [4] and reduced maximal heart rate has been reported in type 2 diabetic adults [9]. Of particular interest, type 2 diabetic female adolescents may have lower heart rate variability than type 1 diabetic adolescents [4].…”

Section: Discussionmentioning

confidence: 99%

“…Although many recognised consequences of diabetes in adults have been studied extensively, little is known about the effect of type 2 diabetes mellitus on the cardiovascular function of adolescents as this has traditionally been an adult disease [2]. A recent report suggests that adolescents with type 2 diabetes mellitus have lower maximal aerobic capacity compared with non-diabetic adolescents [3] and reduced exercise tolerance compared with adolescents with type 1 diabetes [4]. However, there are limited data on cardiac function, in particular cardiac output and stroke volume, and the relative contributions of central (cardiac) and peripheral cardiovascular impairment on exercise capacity in adolescent diabetic patients remain unclear.…”

Section: Introductionmentioning

confidence: 99%

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Impaired stroke volume and aerobic capacity in female adolescents with type 1 and type 2 diabetes mellitus

et al. 2008

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Aim/hypothesis This study was designed to determine whether type 2 diabetic adolescents have reduced aerobic capacity and to investigate the role of cardiac output and arteriovenous oxygen difference (a−vO 2 ) in their exercise response. Methods Female adolescents (age 12-18 years) with type 2 diabetes mellitus (n=8) and type 1 diabetes mellitus (n=12) and obese (n=10) and non-obese (n=10) non-diabetic controls were recruited for this study. Baseline data included maximal aerobic capacity (cycle ergometer) and body composition. Cardiac output and a−vO 2 were determined at rest and during submaximal exercise. Results Diabetic groups had lower aerobic capacity than nondiabetic groups (p<0.05). Adolescents with type 2 diabetes had lower aerobic capacity than the type 1 diabetic group. Maximal heart rate was lower in the type 2 diabetic group (p <0.05). Exercise stroke volume was 30-40% lower at 100 and 120 beats per min in the diabetic than in the nondiabetic groups (p<0.05). The a−vO 2 value was not different in any condition. Conclusions and interpretation Type 2 diabetic adolescents have reduced aerobic capacity and reduced heart rate response to maximal exercise. Furthermore, type 2 and type 1 diabetic adolescent girls have a blunted exercise stroke volume response compared with non-diabetic controls. Central rather than peripheral mechanisms contribute to the reduced aerobic capacity in diabetic adolescents. Although of short duration, type 2 diabetes in adolescence is already affecting cardiovascular function in adolescents.

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Section: Discussionmentioning

confidence: 51%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Impaired stroke volume and aerobic capacity in female adolescents with type 1 and type 2 diabetes mellitus

et al. 2008

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“…12 In accordance with this study, our findings report a significant reduction in HF (136.7±123.5) and an alteration in LF/HF (0.73±0.35) which suggests a significant cardiovagal inhibition and sympathovagal imbalance in the diabetic group when compared with the nondiabetic population. In a comparative study conducted among diabetics and controls, Mirza M observed both sympathetic and parasympathetic dysfunction with parasympathetic dominance in diabetic group 13,14 Furthermore, present study also revealed a nonsignificant decrease in HF among the diabetics without microalbuminuria whereas a statistically significant decrease among the diabetics with microalbuminuria. This finding proved that there exists a significant cardiovagal inhibition in the diabetics with microalbuminuria.…”

Section: Discussionmentioning

confidence: 53%

Comparison of microalbuminuria and heart rate variability in prediction of cardiovascular complications in diabetic population: a pilot study

2017

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INTRODUCTIONThe magnitude of non-communicable diseases (cardiovascular diseases, diabetes, malignancies and chronic respiratory diseases) has brought about a negative socioeconomic impact and sufferings to the mankind. 1 36 million deaths have been reported every year due to diabetes and its complications. Moreover, 9 million people succumb to death prematurely.2 Improved and effective medications have increased the lifespan of diabetic population. Hence there is a need to identify and intervene at the earliest in order to prevent complications and provide them a better quality of living. Microalbuminuria is considered as an early marker. It ABSTRACT Background: Microalbuminuria is considered as an early marker and strongly associated with risk of cardiovascular complications in diabetic patients. Autonomic imbalance due to micro vascular damage to parasympathetic and sympathetic fibers results in reduced heart rate variability; also predicts increased risk for cardiovascular events in diabetics. Hence it is necessary to identify an early and effective predictor of diabetic micro vascular complications. Objective of the study was to compare heart rate variability of controls with type 2 diabetes with and without microalbuminuria. Methods: This comparative study was conducted among individuals without diabetes, hypertension and dyslipidemia (controls) and Type II diabetics with and without microalbuminuria (cases). Cases and controls were subjected to general clinical examination; microalbuminuria and HbA1C were noted. heart rate variability was assessed using digital physiograph. Frequency (HF, LF, LF/HF ratio) domain readings were noted. Results: Mann Whitney U test was employed to analyze nonparametric data. Diabetics with microalbuminuria when compared with controls showed statistically significant (p-value=0.015) reduction in vagal activity. When compared with diabetics without microalbuminuria (180.4±151.7) they showed reduction in HF with no statistical significance. When diabetic group without microalbuminuria (0.56±0.31) was compared with controls they showed alternation in LF/HF ratio which has no statistical significance. Diabetics with microalbuminuria when compared with controls showed a statistically significant (p-value=0.009) alternation in LF /HF ratio implying an autonomic imbalance. Conclusions: This study shows there is significant vagal inhibition and autonomic imbalance in diabetic patients with microalbuminuria compared to controls. To ascertain the role of HRV as an early predictor of cardiovascular complications we propose to conduct study with a larger sample size in future.

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“…A dose-response relationship was reported between HbA1c and the measures of overall reduced HRV. The studies concluded that chronic and worsening hyperglycemia causes a decrease in all parameters of HRV that determine early cardiac autonomic dysfunction and parasympathetic loss [7][8][9][10]. It has been previously reported that abnormal HRR is associated with impaired glucose tolerance and increasing fasting blood glucose [11][12][13].…”

Section: Check For Updatesmentioning

confidence: 99%

Elevated Hemoglobin A1C is Significantly Associated with Decreased Post-Exercise Heart Rate Recovery in Patients with Diabetes Mellitus

Hasan¹,

Everman²,

Sheikh³

et al. 2017

Int J Diabetes Clin Res

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Heart Rate Recovery (HRR) has been associated with cardiovascular and all-cause mortality in both healthy individuals and those with diabetes. We examined the association between Hemoglobin A1C (HbA1c) and post-exercise HRR in patients with diabetes. Participants who were free from known cardiac disease or severe orthopedic problems referred to an exercise specialist for a fitness assessment. All participants underwent a graded exercise test using a standard Balke-ware protocol. HRR defined as the decrease in heart rate from peak exercise after one minute of a cool down walk at 2 mph and 0% incline. The most recent HbA1c (within three months) recorded for each patient. This study included 411 individuals with diabetes [age 45 ± 10, 269 (65%) males, 375 (91%) with type 2 diabetes, BMI 31 ± 6, 49% with BMI > 30 kg/m 2 ]. The mean HbA1c was 7.3% ± 1.6 (56 mmol/mol). The participants divided into 4 equal cohorts based on the quartiles of HRR. Using multiple logistic regression, adjusting for age, gender, BMI, metabolic equivalent, beta blocker usage, hypertension, and duration of diabetes, there was a significant association between HbA1c and odds of having a HRR in the lowest quartile, such that for every unit increase in HbA1c, there was 13% increase in odds of being in the lowest HRR quartile (adjusted odds ratio 1.125 [1.002, 1.264]). Among diabetic patients without known cardiac disease, poor glycemic control as measured by elevated HbA1c is significantly associated with decreased post-exercise HRR.

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Cardiovascular Endurance and Heart Rate Variability in Adolescents With Type 1 or Type 2 Diabetes

Cited by 40 publications

References 57 publications

Impaired stroke volume and aerobic capacity in female adolescents with type 1 and type 2 diabetes mellitus

Impaired stroke volume and aerobic capacity in female adolescents with type 1 and type 2 diabetes mellitus

Comparison of microalbuminuria and heart rate variability in prediction of cardiovascular complications in diabetic population: a pilot study

Elevated Hemoglobin A1C is Significantly Associated with Decreased Post-Exercise Heart Rate Recovery in Patients with Diabetes Mellitus

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