BOSTON Indicators of cardiac dysfunction may
emerge as early as adolescence in patients with type 2 diabetes, according to
In a study conducted at the University of Auckland in
New Zealand, Teresa Pinto, MD, and colleagues observed significant
differences in cardiac function between overweight and normal-weight
adolescents with and without type 2 diabetes. For instance, during exercise,
adolescents without type 2 diabetes achieved higher maximum heart rates, had
higher cardiac output indexed for fat free mass and experienced greater
increases in systolic volume. Similarly, adolescents with type 2 diabetes had
significantly lower end-diastolic volume indexed for fat free mass at rest and
during exercise that did not increase as substantially in these children vs.
those without diabetes during exercise. Femoral artery flow per minute and the
net forward volume indexed for fat free mass were also lower after exercise in
the group with type 2 diabetes.
Although this study did not determine the reason
for [the diastolic dysfunction observed], we know that with diabetes the heart
can become stiffer limiting its ability to stretch and expand, Pinto, a
pediatric endocrinologist at Dalhousie University IWK Health Centre in Canada,
said in a press release.
The researchers used MRIs taken at rest and during
exercise to gauge cardiac function and employed DXA scans to measure body
composition. The study included 13 adolescents with type 2 diabetes, 27
overweight and obese adolescents without diabetes and 19 nonobese adolescents
without diabetes, all aged 12 to 20 years.
During a press conference, Pinto noted that further
studies are needed to more closely examine the potential for exercise training
and pharmacologic treatment in improving cardiovascular outcomes in adolescents
At this point in time, the findings of the
diastolic dysfunction in this particular study certainly suggest that when we
are counseling around exercise that perhaps a more gradual approach needs to be
taken with these individuals
but we dont know the long-term
complications, Pinto said during the press conference. by
Disclosure: This study was supported by Novo Nordisk and the
Canadian Pediatric Endocrine Group Scholarship.
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