Normalization of diastolic dysfunction in type 2 diabetics after exercise training.

Abstract

The purpose of this study was to evaluate the impact of aerobic exercise training on left ventricular diastolic dysfunction (LVDD) and exercise capacity in subjects with type 2 diabetes. Twenty-three sedentary subjects with well-controlled type 2 diabetes, free of coronary disease and having different degrees of LVDD, participated in the study. Subjects were treated with oral hypoglycemic agents and/or diet. Eleven subjects (EX) (age: 58 +/- 5 yr; mean +/- SD) underwent a 3-month aerobic exercise training program using a cycle ergometer, whereas a control group (CONT) of 12 subjects (57 +/- 6 yr) maintained their activities of daily living. Exercise capacity and LVDD, using echocardiography, were evaluated before and after the 3-month exercise program. At baseline, anthropometric data were similar between the groups, except for body mass index (BMI), which was higher in CONT (31 +/- 3 vs 28+/- 3 kg x m(-2); P < 0.05). There were no significant differences in glycemic control (HbA1c: 6.4 +/- 1.2 vs 5.8 +/- 1.3%; P = 0.2) or maximal oxygen uptake (26.7 +/- 5.9 vs 28.6 +/- 3.9 mL x kg(-1) x min(-1); P = 0.4) between groups. Normalization of LVDD was observed in 5 of 11 EX subjects, (P < 0.0001) of whom four had grade 1 LVDD before exercise training. No change in diastolic function was observed in the CONT group. After exercise training, maximal oxygen uptake increased in the EX group (28.6 +/- 3.9 vs 32.7 +/- 5.7 mL x kg(-1) x min(-1); P < 0.05), whereas there was no change in the CONT group (26.7 +/- 5.9 vs 27.3 +/- 6.2 mL x kg(-1) x min(-1); P = 0.58). In both groups, there was no significant change in BMI. Along with an improvement in exercise capacity, aerobic exercise training has the potential to reverse LVDD in patients with well-controlled, uncomplicated type 2 diabetes.