P.044 Effect of Mild Increase of Physical Activity on Microvasculary Reactivity in Obese Subjects with Diabetes Mellitus Type 2

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 modifications leads to the improvement of endothelial dysfunction and microvasculary reactivity, in healthy subjects it has already been proven experimentally.

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 [4,4–5,4] to 6,1x [5,7–6,8], p< 0.01, shorten half time to reach maximum perfusion from 4,1 [2,7–5,4] s to 3,1 [2,4–4,0] s, p < 0.05. The increased perfusion lasted after following four weeks of habitual activity in smaller extent (microvasculary reactivity increase after heating 5.2 [4.8–6.1] s, half time to reach maximum perfusion 3.8 [2.7–5.0], 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.