Evidence map›Paper›PMID 40924726›Full record

ArticlePloS one2025

Exploring the limits of exercise capacity in adults with type II diabetes.

Matthijs Michielsen, Youri Bekhuis, Jomme Claes, Elise Decorte, Camille De Wilde, Tin Gojevic, Louise Costalunga, Sara Amyay, Varvara Lazarou, Daphni Daraki and 7 more

Abstract read
In one paragraph

Article in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Matthijs MichielsenDepartment of Rehabilitation Sciences, KU Leuven, Leuven, Belgium.ORCID https://orcid.org/0000-0001-9816-7359
Youri BekhuisDepartment of Cardiovascular Sciences, KU Leuven, Leuven, Belgium.ORCID https://orcid.org/0000-0003-3903-5051
Jomme ClaesDepartment of Rehabilitation Sciences, KU Leuven, Leuven, Belgium.
Elise DecorteDepartment of Rehabilitation Sciences, KU Leuven, Leuven, Belgium.
Camille De WildeDepartment of Rehabilitation Sciences, KU Leuven, Leuven, Belgium.
Tin GojevicFaculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium.
Louise CostalungaDepartment of Rehabilitation Sciences, KU Leuven, Leuven, Belgium.
Sara AmyayDepartment of Rehabilitation Sciences, KU Leuven, Leuven, Belgium.
Varvara LazarouDepartment of Rehabilitation Sciences, KU Leuven, Leuven, Belgium.
Daphni DarakiDepartment of Rehabilitation Sciences, KU Leuven, Leuven, Belgium.
Eleftheria KounalakiDepartment of Rehabilitation Sciences, KU Leuven, Leuven, Belgium.
Panagiotis ChatzinikolaouDepartment of Physical Education and Sports Sciences at Serres, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Kaatje GoetschalckxDepartment of Cardiovascular Diseases, UZ Leuven, Leuven, Belgium.
Dominique HansenFaculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium.
Guido ClaessenDepartment of Cardiovascular Sciences, KU Leuven, Leuven, Belgium.
Marieke De CraemerDepartment of Rehabilitation Sciences, Ghent University, Gent, Belgium.
Véronique CornelissenDepartment of Rehabilitation Sciences, KU Leuven, Leuven, Belgium.ORCID https://orcid.org/0000-0002-0578-4954

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThis study investigates the mechanisms behind exercise capacity in adults with type 2 diabetes mellitus (T2DM), focusing on central and peripheral components, as described by the Fick equation.

methodsA cross-sectional study of 141 adults with T2DM was conducted, using cardiopulmonary exercise testing, near-infrared spectroscopy (NIRS) and exercise echocardiography. Participants with sufficient-quality NIRS data were stratified into tertiles based on percentage predicted VO₂peak. Group comparisons and stepwise regression were used to examine the contributions of central and peripheral components to VO₂peak.

resultsSixty-seven participants had insufficient quality NIRS data. Those with lower-quality data were more likely to be female (p < 0.001) and had a lower exercise capacity (p < 0.001). Among participants with good-quality NIRS data, those in the lowest fitness tertile were older (p < 0.01), had a longer diabetes duration (p = 0.04), lower eGFR (p < 0.001) and more frequent use of beta-blockers (p = 0.02) and diuretics (p = 0.04). Significant differences were observed in peak cardiac output (p < 0.001) and NIRS-derived parameters across fitness groups. Multivariate regression identified cardiac output as the strongest predictor of VO₂peak, while peripheral oxygen extraction did not improve model performance.

conclusionCardiac output is the primary determinant of exercise capacity in adults with T2DM. This suggests that muscle perfusion may be the main limiting factor in relatively fit individuals with T2DM. However, cardiac output and local muscle perfusion are not directly equivalent, as mechanical factors, such as intramuscular pressure during high-intensity exercise, may prevent maximal perfusion.

Indexed as

Diabetes Mellitus, Type 2ExerciseExercise ToleranceAdultAgedCardiac OutputCross-Sectional StudiesEchocardiographyExercise TestFemaleHumansMaleMiddle AgedOxygen ConsumptionSpectroscopy, Near-Infrared

Identifiers

PMID40924726
PMCPMC12419639

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.