Impaired whole-body heat loss in type 1 diabetes during exercise in the heat: a cause for concern?

  • Sean R. Notley
  • Martin P. Poirier
  • Jane E. Yardley
  • Ronald J. Sigal
  • Glen P. KennyEmail author
Research Letter

To the Editor: Although regular exercise is recommended for type 1 diabetes management [1], exercise in hot conditions may pose a health concern [2]. This is primarily because even patients without neuropathy display impaired cutaneous vasodilation [3] and sweating [4], especially during vigorous exercise [5], which may increase dry heat gain by reducing blood-borne heat delivery to the skin and attenuate evaporative heat loss. The resulting reductions in total heat loss (dry + evaporative heat loss) can elevate heat illness risk by exacerbating body heat storage and the subsequent increase in body core temperature [6]. However, since those previous studies [3, 4, 5] measured cutaneous vasodilation and sweating at only a handful of small surfaces (~1–3 cm2) on the body, it remains unclear whether such impairments translate into clinically meaningful decrements in whole-body total heat loss (i.e. from all body surfaces). We therefore used our unique direct air calorimeter (the gold...


Body core temperature Calorimetry Diabetes Exercise Heat stress Thermoregulation 



We thank S. Dervis, formerly from the Human and Environmental Physiology Research Unit (, who performed data collection.

Contribution statement

SRN and GPK conceptualised and designed the research; MPP performed data collection. SRN performed statistical analysis, prepared figures and drafted manuscript; SRN, GPK, JEY and RJS interpreted results; all authors edited, revised and approved the final version. GPK is the guarantor of this work and, as such, had full access to all the data and takes responsibility for the integrity of the data and the accuracy of the data analysis.


This project was supported by the Canadian Institutes of Health Research (grant no. 286363; funds held by GPK and RJS). SRN is supported by a Postdoctoral Fellowship from HEPRU. MPP was supported by an NSERC Canada Alexander Graham Bell Graduate Scholarship (CGS-D). GPK is supported by a University of Ottawa Research Chair.

Duality of interest

The authors declare that there is no duality of interest associated with this manuscript.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Sean R. Notley
    • 1
  • Martin P. Poirier
    • 1
  • Jane E. Yardley
    • 2
    • 3
  • Ronald J. Sigal
    • 1
    • 4
    • 5
    • 6
    • 7
  • Glen P. Kenny
    • 1
    • 7
    Email author
  1. 1.Human and Environmental Physiology Research Unit, School of Human Kinetics, 125 University, Room 367, Montpetit HallUniversity of OttawaOttawaCanada
  2. 2.Augustana FacultyUniversity of AlbertaCamroseCanada
  3. 3.Alberta Diabetes InstituteEdmontonCanada
  4. 4.Department of MedicineUniversity of CalgaryCalgaryCanada
  5. 5.Department of Community Health SciencesUniversity of CalgaryCalgaryCanada
  6. 6.Department of Cardiac SciencesUniversity of CalgaryCalgaryCanada
  7. 7.Clinical Epidemiology ProgramOttawa Hospital Research InstituteOttawaCanada

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