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Selected Publication:
Linhart, C.
Association of diabetes-specific markers and functional capacity in people with type 1 diabetes
Humanmedizin; [ Diplomarbeit ] Medizinische Universitaet Graz; 2022. pp. 64
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- Authors Med Uni Graz:
- Advisor:
- Aberer Felix
- Moser Othmar
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- Abstract:
- Background: Type 1 diabetes (T1D) is a chronic condition that implicates serious short-term and long-term complications, above all microvascular and macrovascular disease, which contribute to the major morbidity and mortality associated with T1D. Physical activity poses an important cornerstone in the prevention of cardiovascular disease. However, even though it is well established that physical exercise is an effective therapeutic tool, it is not entirely clear whether and how diabetes-specific markers, especially HbA1c, affect functional capacity in people with T1D. Therefore, the objective of this thesis was to focus on the relations between diabetes-specific markers (HbA1c, diabetes duration, C-peptide, anthropometric and demographic measurements) and functional capacity as well as cardiorespiratory markers during cardiopulmonary exercise (CPX) testing. Methods: Data was collected at the Medical University of Graz from 15 individuals with T1D participating in a randomized controlled cross-over trial investigating two different ultra-long-acting basal insulins’ performance around multiple spontaneous 60-minute exercise sessions, during which CPX tests were performed. The laboratory and cardiorespiratory markers obtained from the CPX tests were analyzed for correlations as well as between-group differences regarding the first lactate turn point (LTP1), the second lactate turn point (LTP2) and maximum exertion depending on the participants’ HbA1c, diabetes duration, C-peptide status, age, body mass index (BMI) and sex. Results: No significant correlations were found between HbA1c and maximum oxygen uptake (VO2max), neither for absolute VO2max (“good” HbA1c [≤ 7.5%] group: R = 0.40, p = 0.33, “poor” HbA1c [> 7.5%] group: R = 0.15, p = 0.75) nor relative VO2max (“good” HbA1c: R = 0.24, p = 0.565, “poor” HbA1c: R = 0.10, p = 0.828). Also between-group comparisons (“good” vs. “poor” HbA1c) for mean absolute VO2max (2.71 ± 0.93 vs. 2.82 ± 0.86 L/min, p > 0.999) and relative VO2max (37 ± 9 vs. 34 ± 10 ml/min/kg, p = 0.532) showed no significant differences. Significantly higher relative VO2max values were observed in people with residual pancreatic beta cell function (positive C-peptide) vs. people with negative C-peptide (41 ± 10 vs. 31 ± 5 ml/min/kg, p = 0.032*). Also younger (≤ 41 years) individuals showed significantly higher relative VO2max compared to older (> 41 years) subjects (41 ± 9 vs. 31 ± 6 ml/min/kg, p = 0.030*) as well as correlations for absolute VO2max (R = 0.66, p = 0.074) and relative VO2max (R = 0.84, p = 0.008**). Diabetes duration and BMI did not demonstrate significant influence on absolute and relative VO2max. Conclusion: In this study, blood sugar control had no influence on functional capacity. Participants with residual pancreatic beta cell function and younger participants achieved higher VO2max. Diabetes duration and BMI were no significant performance predictors.