Low Cardiorespiratory Fitness and Physical Inactivity as Predictors of Mortality in Men with Type 2 Diabetes

Mao, Wei; Gibbons, Larry W.; Kampert, James B.; Nichaman, Milton Z.; Blair, Steven N.

doi:10.7326/0003-4819-132-8-200004180-00002

Cited by 596 publications

(423 citation statements)

References 34 publications

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“…Therefore it is believed that patients with type 2 diabetes should be encouraged to participate in regular physical activity [27]. Our results confirm the decline in the level of physical fitness demonstrated by increased energy expenditure across the four groups (Fig.…”

Section: Discussionsupporting

confidence: 86%

Walking performance in people with diabetic neuropathy: benefits and threats

et al. 2006

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Aims/hypothesis Walking is recommended as an adjunct therapy to diet and medication in diabetic patients, with the aim of improving physical fitness, glycaemic control and body weight reduction. Therefore we evaluated walking activity on the basis of capacity, performance and potential risk of plantar injury in the diabetic population before it can be prescribed safely. Subjects, materials and methods Twenty-three subjects with diabetic neuropathy (DMPN) were compared with 23 patients with current diabetic foot ulcers, 16 patients with partial foot amputations and 22 patients with trans-tibial amputations. The capacity for walking was measured using a total heart beat index (THBI). Gait velocity and average daily strides were measured to assess the performance of walking, and its impact on weight-bearing was studied using maximum peak pressure. Results THBI increased (p<0.01) and gait velocity and daily stride count fell (p<0.001 for both) with progression of foot complications. The maximum peak pressures over the affected foot of patients with diabetic foot ulcers (p<0.05) and partial foot amputations (p<0.01) were higher than in the group with DMPN. On the contralateral side, the diabetic foot ulcer group showed higher maximum peak pressure over the total foot (p<0.05), and patients with partial foot amputations (p<0.01) and trans-tibial amputations (p<0.05) showed higher maximum peak pressure over the heel. Conclusions/interpretation Walking capacity and performance decrease with progression of foot complications. Although walking is recommended to improve fitness, it cannot be prescribed in isolation, considering the increased risk of plantar injury. For essential walking we therefore recommend the use of protective footwear. Walking exercise should be supplemented by partial or non-weightbearing exercises to improve physical fitness in diabetic populations.

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Section: Discussionsupporting

confidence: 86%

Walking performance in people with diabetic neuropathy: benefits and threats

et al. 2006

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“…Exercise training is an important adjunct to medical therapy in type 2 diabetes which is associated with improved glucose homeostasis (Marwick et al 2009;Wei et al 2000). In addition, regular exercise training has strong and independent cardioprotective effects, leading to lower cardiovascular morbidity and mortality in type 2 diabetes (Church et al 2004).…”

Section: Introductionmentioning

confidence: 99%

Combined aerobic and resistance exercise training decreases peripheral but not central artery wall thickness in subjects with type 2 diabetes

et al. 2014

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Objective Little is known about the impact of exercise training on conduit artery wall thickness in type 2 diabetes. We examined the local and systemic impact of exercise training on superficial femoral (SFA), brachial (BA), and carotid artery (CA) wall thickness in type 2 diabetes patients and controls.Methods Twenty patients with type 2 diabetes and 10 age-and sex-matched controls performed an 8-week training study involving lower-limb based combined aerobic and resistance exercise training. We examined the SFA to study the local effect of exercise, and also the systemic impact of lower-limb based exercise training on peripheral (i.e. BA) and central (i.e. CA) arteries. Wall thickness (WT), diameter and wall:lumen(W:L)-ratios were examined using automated edgedetection of ultrasound images.Results Exercise training did not alter SFA or CA diameter in type 2 diabetes or controls (all P>0.05). BA diameter was increased after training in type 2 diabetes, but not in controls.Exercise training decreased WT and W:L-ratio in the SFA and BA, but not in CA in type 2 diabetes. Training did not alter WT or W:L-ratio in controls (P>0.05).Conclusion Lower-limb dominant exercise training causes remodelling of peripheral arteries, supplying active and inactive vascular beds, but not central arteries in type 2 diabetes.

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“…While more than a half century of evidence from epidemiological, experimental and clinical trials pinpoints a positive correlation between dietary intake and disease risk, it has only recently been recognised that a physically inactive lifestyle rapidly initiates maladaptations that cause chronic disease [8][9][10]. Indeed, low cardiorespiratory fitness is a powerful and independent predictor of mortality in people with diabetes [11,12], even after controlling for traditional risk factors such as age, hyperlipidaemia, smoking and hypertension.…”

Section: Introductionmentioning

confidence: 99%