In a new study, researchers found adults with type 2 diabetes that have no history, signs, or symptoms of heart problems may have severely limited exercise capacity.
Such limitations place them at an impending risk of developing heart failure.
The research was conducted by a team at the National Institute for Health Research (NIHR) Leicester Biomedical Research Centre.
The team examined the hearts of 247 people who had been diagnosed with type 2 diabetes between 2.5 and 10 years ago.
A control group of 78 people without type 2 diabetes was also recruited to act as a comparison.
Over one-third of volunteers were from a black or South Asian background, making the sample representative of the local community.
Using state-of-the-art cardiac magnetic resonance imaging (MRI) and ultrasound, the researchers spotted subtle impairments in the blood flow to the heart muscle and in the ability of the heart to fill with, and circulate blood around, the body of those volunteers with type 2 diabetes.
Participants also had their fitness levels measured using cardiopulmonary exercise testing—a non-invasive method used to assess the performance of the heart and lungs during exercise, usually carried out on an exercise bike.
The results showed that even when factoring in age, sex, ethnicity, and smoking status, subtle heart impairments contributed to strikingly poor fitness in the volunteers with type 2 diabetes.
This suggests that early heart disease is already present in this population, despite the absence of clinical indicators, such as angina and shortness of breath.
The team says if they can target these subtle heart impairments with treatments to increase blood supply to the heart, they may help to improve fitness levels and reduce the risk of heart failure in people with type 2 diabetes.
While a close association has been found between changes in the heart’s blood supply and filling ability with exercise capacity, more research is needed to understand whether one causes the other.
One author of the study is Dr. Gaurav Gulsin, BHF Clinical Research Training Fellow at the University of Leicester.
The study is published in Diabetes Care.
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