Hormonal
Cardiac autonomic neuropathy and altered autonomic tone contribute to impaired heart rate adjustment and reduced exercise tolerance in T2DM.
Your nervous system's control over your heart rate may be impaired, leading to slower heart rate adjustments during exercise. This is more common in those with longer disease duration or poor blood sugar control. Monitoring heart rate during exercise can be helpful.
A reduced sympathetic innervation of the heart, as observed in diabetic cardiac autonomic neuropathy [80], can reduce the response of the heart to the sympathetic stimuli and thus lead to several resting and exercising anomalies in heart rhythm, heart rate adjustments, and exercising cardiac output adjustments [14], possibly negatively impacting on VO2peak and O2 kinetics.
Why this rating
Evidence is mixed; some studies show heart rate abnormalities, while others in well-controlled, young T2DM subjects do not.
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
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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