Editorial Type:
Article Category: Research Article
 | 
Online Publication Date: Mar 01, 2017

Postexercise Hemodynamics in Patients With Type 2 Diabetes: Effect of Exercise Intensity and Duration

PhD, ACSM-RCEP,
MS,
PhD, and
DO
Page Range: 1 – 8
DOI: 10.31189/2165-6193-6.1.1
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Background: For individuals with type 2 diabetes (T2D), the hemodynamic response to regular exercise is critical for regulating blood glucose, protecting vascular function, and reducing cardiovascular disease risk, but the hemodynamic responses to differing doses of acute exercise in T2D are unclear. We aimed to compare postexercise (PE) hemodynamics in patients with T2D in response to 4 doses of dynamic exercise.

Methods: Eight subjects with well-controlled T2D (42–64 years old.; hemoglobin A1c: 6.6% ± 0.9%) participated in 4 study days, during which they exercised on a cycle ergometer at 4 different combinations of exercise duration and intensity: 30 min at 40% V˙O2peak (30@40), 30 min at 60% V˙O2peak (30@60), 60 min at 40% V˙O2peak (60@40), and 60 min at 60% V˙O2peak (60@60). Heart rate, arterial pressure, and femoral blood flow (Doppler ultrasound) were measured pre-exercise and every 15 min through 120 min PE. Femoral vascular conductance was calculated as flow/pressure.

Results: Compared with pre-exercise baseline, femoral blood flow and femoral vascular conductance were higher through at least 105 min of recovery in all conditions (all P < .05), except for the 30@40 trial. Compared with the pre-exercise measures, systolic blood pressure was lower through at least 75 min of recovery in all conditions (all P < .05), except for the 30@40 trial.

Conclusion: These results suggest that exercise must be at least moderate in intensity or prolonged in duration (>30 min) to promote sustained PE elevations in skeletal muscle blood flow and reductions in systolic blood pressure in patients with T2D.

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Copyright: Copyright © 2017 Clinical Exercise Physiology Association
FIGURE 1.
FIGURE 1.

Time-course of postexercise changes in systolic (SBP; panel A), diastolic (DBP; panel B), and mean arterial pressure (MAP; panel C) compared with pre-exercise baseline values. Responses to 4 different doses of cycling exercise are shown (30 min at 40% V˙O2peak, 30 min at 60% V˙O2peak, 60 min at 40% V˙O2peak, and 60 min at 60% V˙O2peak). * P < .05 vs. pre-exercise baseline time point within exercise dose (n = 8). Symbols indicating statistical significance are color coded to match the relevant exercise dose.


FIGURE 2.
FIGURE 2.

Time-course of postexercise changes in heart rate (HR; panel A), femoral blood flow (FBF; panel B), and femoral vascular conductance (FVC; panel C) compared with pre-exercise baseline values. Responses to 4 different doses of cycling exercise are shown (30 min at 40% V˙O2peak, 30 min at 60% V˙O2peak, 60 min at 40% V˙O2peak, and 60 min at 60% V˙O2peak). * P < .05 vs. baseline time point within exercise dose (n = 8). Symbols indicating statistical significance are color coded to match the relevant exercise dose.


Contributor Notes

1Department of Health Sciences, Salisbury University, Salisbury, Maryland

2Department of Medical Pharmacology & Physiology, University of Missouri School of Medicine, Columbia, Missouri

3Peninsula Regional Medical Group, Peninsula Regional Medical Center, Salisbury, Maryland

Source of Funding: This research was supported by the Salisbury University Faculty Mini-Grant.

Address for correspondence: Thomas K. Pellinger, PhD, 319-B Devilbiss Hall, 1101 Camden Avenue, Salisbury University, Salisbury, MD 21801-6860; (410) 677 0144; fax (410) 548 9185; e-mail: tkpellinger@salisbury.edu.