Quality of life, physical activity levels, exercise capacity, and chronotropic incompetence in patients with type 1 diabetes mellitus.

PURPOSE: Hyperglycemia in Type 1 diabetes mellitus (T1DM) leads to endothelial and vascular dysfunction, affecting various bodily functions, including psychological well-being, exercise capacity, and pulmonary function. This study investigates the impact of T1DM on quality of life, physical activity, exercise capacity, chronotropic response, pulmonary function, muscle strength, endurance, fatigue, and dyspnea.

METHODS

In a cross-sectional study, 27 patients with T1DM and 26 healthy controls were compared. Quality of life World Health Organization (WHO) index, physical activity (metabolic holter), maximal exercise capacity (incremental shuttle walking test (ISWT)), chronotropic incompetence, pulmonary function (spirometer), muscle strength (dynamometer), respiratory muscle strength (mouth pressure device) and endurance (threshold loading test), fatigue (Fatigue Severity scale (FSS)), dyspnea (modified Medical Research Council scale (MMRC)) were evaluated.

RESULTS

WHO index, physical activity levels, chronotropic index, pulmonary function, MIP, MEP, respiratory muscle endurance, FSS, and MMRC scores were similar between groups (p > 0.05). ISWT distance was clinically decreased in patients (p > 0.05). Quadriceps femoris muscle strength was reduced in patients (p < 0.05). 76 % of T1DM patients were inactive based on step counts, and 100 % were less active according to MET values. Also, 11.53 % exhibited chronotropic incompetence, 61.53 % reported severe fatigue, and 15.38 % experienced dyspnea.

CONCLUSION

Maximal exercise capacity decreased clinically in patients with T1DM, while respiratory muscle strength, endurance, and quality of life remain preserved. Muscle strength declines, with 28 % showing restrictive pulmonary function abnormalities. Thus, directing T1DM patients to exercise training and providing physical activity counseling are recommended.

CLINICAL TRIALS NUMBER: NCT04819815, 2022-03-22.