Research
Hormonal
Subclinical diabetic cardiac myopathy, characterized by reduced systolic and diastolic reserve during exercise, contributes to reduced exercise tolerance in T2DM.
Your heart may not pump as efficiently during exercise as a non-diabetic's, even if it looks normal at rest. This 'subclinical' dysfunction limits how much oxygen your muscles can use. Exercise training may help improve this cardiac reserve over time.
ModerateSupportsMEDIUM confidence
In asymptomatic T2DM, the use of standard echocardiography, tissue Doppler imaging, and speckle tracking technology during maximal exercise allowed the demonstration of a subtle myocardial dysfunction during exercise, which was not evident at rest [40].
Why this rating
Evidence is mixed; some studies show impaired Doppler indices while others do not, and associations do not prove causality.
Source
Type 2 diabetes and reduced exercise tolerance: a review of the literature through an integrated physiology approach
Lorenzo Nesti et al. · Cardiovascular Diabetology · 2020
DOI 10.1186/s12933-020-01109-1
narrative_reviewCited 141×
Read the paper DOI resolved against Crossref · corpus check 2026-06-10
More from this paper
- Type 2 diabetes is associated with a 20-30% reduction in peak oxygen uptake (VO2peak) and reduced exercise tolerance, independent of known cardiovascular risk factors or overt cardiovascular disease.Good
- Skeletal muscle mitochondrial dysfunction and reduced capillary density contribute to early fatigue and reduced peripheral oxygen extraction in T2DM.Moderate
- Endothelial dysfunction and impaired vasodilation during exercise reduce muscle blood flow and oxygen diffusion in T2DM.Moderate
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