Research
Hormonal
Endothelial dysfunction and impaired vasodilation during exercise reduce muscle blood flow and oxygen diffusion in T2DM.
Your blood vessels may not dilate properly during exercise, limiting blood flow to your muscles. This is partly due to endothelial dysfunction. Regular exercise can help improve endothelial function over time.
ModerateSupportsMEDIUM confidence
Several mechanisms can be recognised, namely feed-forward mechanisms (early adjustment of muscle blood flow by adenosine, potassium, nitric oxide) and feedback mechanisms (vasodilatory factors secondary to muscle metabolic demand and haemoglobin deoxygenation). In T2DM, while an impairment the feed-forward or muscle metabolic feedback mechanisms remains to be proved, reduced deoxygenation-related feedback mechanisms can be postulated.
Why this rating
Evidence is consistent with reduced muscle blood flow, but the exact mechanisms are complex and not fully proven.
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
- Subclinical diabetic cardiac myopathy, characterized by reduced systolic and diastolic reserve during exercise, contributes to reduced exercise tolerance in T2DM.Moderate
- Skeletal muscle mitochondrial dysfunction and reduced capillary density contribute to early fatigue and reduced peripheral oxygen extraction in T2DM.Moderate
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