Research
Energy balance
Skeletal muscle mitochondrial dysfunction and reduced capillary density contribute to early fatigue and reduced peripheral oxygen extraction in T2DM.
Your muscles may have fewer capillaries and less efficient mitochondria, making it harder to use oxygen during exercise. This leads to early fatigue. Resistance and aerobic training can help improve muscle capillary density and mitochondrial function.
ModerateSupportsMEDIUM confidence
One small study [25] found that insulin resistance, reduced muscle type 1 fiber content, and reduced muscle capillary density were the major contributor to the limited exercise capacity of patients with T2DM. In addition, impaired skeletal muscle mitochondrial function (measured as phosphocreatine recovery after exercise) has been reported in T2DM as well as in obese individuals [52].
Why this rating
Based on small studies and indirect measures; no study simultaneously measured mitochondrial function and exercise capacity.
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
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- 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
- Subclinical diabetic cardiac myopathy, characterized by reduced systolic and diastolic reserve during exercise, contributes to reduced exercise tolerance in T2DM.Moderate
- Endothelial dysfunction and impaired vasodilation during exercise reduce muscle blood flow and oxygen diffusion in T2DM.Moderate
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