Abstract
Microangiopathy, well known in diabetic patients as a cause of late complications,
develops mainly due to chronic exposition to elevated glucose and triglyceride level.
Physical training acts as a protective factor even if no changes in metabolic parameters
are observed. It's supposed, that lifestyle modification leads to the improvement
of endothelial dysfunction and microvasculary reactivity, in healthy subjects it has
already been proven experimentally.
Aim: Determine if mild, short time and metabolically indifferent increase of physical
activity changes microvasculary reactivity in obese diabetic patients and how long
these findings persist after return to habitual lifestyle. In 8 patients with type
2 diabetes mellitus was measured microvasculary reactivity and perfusion of skin in
lower limbs by laser-doppler flowmetry and transcutaneous oximetry. First before the
study, second after 3-week's period of habitual physical activity, third after 3-week's
period of mild increased physical activity and finally after next 3-week's period
of habitual activity. Training intensity was objectified (non sport-practiced subjects)
by pedometers. Results were evaluated by Friedman and pair Wilcoxon test. After mild
aerobic activity (walk about 800 [560–1400] meters/day) microvasculary reactivity
was increased in both tests (increase after heating from 4,9x [4,4 D 5,4] to 6,1x
[5,7 D 6,8], p<0.01, shorten half time to reach maximum perfusion from 4,1 [2,7 D
5,4] s to 3,1 [2,4 D 4,0] s, p<0.05. The increased perfusion lasted after following
four weeks of habitual activity in smaller extent (microvascular reactivity increase
after heating 5.2 [4.8 D 6.1] s, half time to reach maximum perfusion 3.8 [2.7 D 5.0],
this increase was not significant in comparison with habitual activity in the first
period). Metabolic and anthropometric parameters and transcutaneous oxygen tension
didn’t change significantly.
Key words
obesity - diabetes - autoimmunity - peripheral arterial disease - cardiovascular incidences
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1 All authors have no personal bias or any relationship with mentioned companies.
Correspondence
M. KrcmaMD
1st Department of Internal Medicine
University Hospital Plzen
Alej Svobody 80
304 60 Plzen
eMail: krcmam@fnplzen.cz
