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Background  To explore the impact of glycaemic control (HbA 1c ) on functional capacity during cardio-pulmonary exercise testing in people with type 1 diabetes.    Methods  Sixty-four individuals with type 1 diabetes (age: 34 ± 8 years; 13 females, HbA 1c : 7.8 ± 1% (62 ± 13 mmol/mol), duration of diabetes: 17 ± 9 years) performed a cardio-pulmonary cycle ergometer exercise test until volitional exhaustion. Stepwise linear regression was used to explore relationships between HbA 1c  and cardio-respiratory data with p ≤ 0.05. Furthermore, participants were divided into quartiles based on HbA 1c  levels and cardio-respiratory data were analysed by one-way ANOVA. Multiple regression analysis was performed to explore the relationships between changes in time to exhaustion and cardio-respiratory data. Data were adjusted for confounder.    Results  HbA 1c  was related to time to exhaustion and oxygen consumption at the power output elicited at the sub-maximal threshold of the heart rate turn point (r = 0.47, R 2  = 0.22, p = 0.03). Significant differences were found at time to exhaustion between Q I  vs. Q IV  and at oxygen consumption at the power output elicited at the heart rate turn point between Q I  vs. Q II  and Q I  vs. Q IV  (p < 0.05). Changes in oxygen uptake, power output and in oxygen consumption at the power output elicited at the heart rate turn point and at maximum power output explained 55% of the variance in time to exhaustion ( r  = 0.74, R 2  = 0.55, p < 0.01).    Conclusions  Poor glycaemic control is related to less economical use of oxygen at sub-maximal work rates and an earlier time to exhaustion during cardio-pulmonary exercise testing. However, exercise training could have the same potential to counteract the influence of poor glycaemic control on functional capacity.    Trial registration  NCT01704417. Date of registration: October 11, 2012

diabetology and metabolic syndrome

Poor glycaemic control is associated with reduced exercise performance and oxygen economy during cardio-pulmonary exercise testing in people with type 1 diabetes