Normalization of diastolic dysfunction in type 2 diabetics after exercise training

Purpose: The purpose of this study was to evaluate the impact of aerobic exercise training on left ventricular diastolic dysfunction (LVDD) and exercise capacity in subjects with type 2 diabetes. Methods: Twenty-three sedentary subjects with well-controlled type 2 diabetes, free of coronary disease and having different degrees of LVDD, participated in the study. Subjects were treated with oral hypoglycemic agents and/or diet. Eleven subjects (EX) (age: 58 +/- 5 yr; mean +/- SD) underwent a 3-month aerobic exercise training program using a cycle ergometer, whereas a control group (CONT) of 12 subjects (57 +/- 6 yr) maintained their activities of daily living. Exercise capacity and LVDD, using echocardiography, were evaluated before and after the 3-month exercise program. Results: At baseline, anthropometric data were similar between the groups, except for body mass index (BMI), which was higher in CONT (31 +/- 3 vs 28 +/- 3 kg center dot m(-2); P < 0.05). There were no significant differences in glycemic control (HbA(Ic): 6.4 +/- 1.2 vs 5.8 +/- 1.3%; P = 0.2) or maximal oxygen uptake (26.7 +/- 5.9 vs 28.6 +/- 3.9 mL center dot kg(-1)center dot min(-1); P = 0.4) between groups. Normalization of LVDD was observed in 5 of 11 EX subjects, (P < 0.0001) of whom four had grade I LVDD before exercise training. No change in diastolic function was observed in the CONT group. After exercise training, maximal oxygen uptake increased in the EX group (28.6 +/- 3.9 vs 32.7 +/- 5.7 mL center dot kg(-1)center dot min(-1); P < 0.05), whereas there was no change in the CONT group (26.7 +/- 5.9 vs 27.3 +/- 6.2 mL center dot kg(-1)center dot min(-1); P = 0.58). In both groups, there was no significant change in BMI. Conclusions: Along with an improvement in exercise capacity, aerobic exercise training has the potential to reverse LVDD in patients with well-controlled, uncomplicated type 2 diabetes.