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Exercise, Blood Flow, and the Skeletal Muscle Microcirculation in Diabetes Mellitus

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Diabetes and Exercise

Part of the book series: Contemporary Diabetes ((CDI))

Abstract

Aerobic exercise capacity is impaired in both type 1 diabetes (T1DM) and type 2 diabetes (T2DM), and this impairment is predictive of future morbidity and mortality. Although the precise etiology of impaired exercise capacity in diabetes remains unclear, several distinct lines of evidence indicate that reduced delivery of oxygen by the cardiovascular system plays a causal role. Cardiac output is often but not always reduced in diabetes. This change is sufficient but not necessary for reduced exercise capacity. Skeletal muscle blood flow is also often but not always reduced in diabetes. This change is also sufficient but not necessary for reduced exercise capacity. In addition, a growing number of animal and simulation studies show that heterogeneous distribution of blood flow within the microcirculation contributes to oxygen delivery limitations in diabetes. Once again, this change is sufficient but not necessary for reduced exercise capacity. In this chapter, we discuss each of these changes in cardiovascular function and their likely causes, beginning with the heart and gradually progressing to capillary level. We then conclude our overview by interpreting the causality or lack thereof of each diabetes-related pathological change as it relates to reduced oxygen delivery to the skeletal muscle.

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Authors and Affiliations

  1. Department of Bioengineering, University of Colorado Anschutz Medical Campus, Bioscience 2, 12705 E Montview Ave., Suite 100, Aurora, CO, 80045, USA

    P. Mason McClatchey MS, PhD

  2. Department of Medicine, Division of General Internal Medicine, University of Colorado School of Medicine, 12631 E. 17th Ave., Mailstop B-180, Aurora, CO, 80045, USA

    Timothy A. Bauer PhD, MS

  3. Department of Medicine, Division of General Internal Medicine and Center for Women’s Health Research, University of Colorado School of Medicine, 12631 E. 17th Ave., Mailstop B-180, Aurora, CO, 80045, USA

    Judith G. Regensteiner PhD, MA, BA

  4. Department of Medicine, Division of Endocrinology, Metabolism, and Diabetes and Center for Women’s Health Research, University of Colorado, Aurora, CO, USA

    Jane E. B. Reusch MD

  5. Department of Medicine, Denver Veterans Administration Medical Center (DVAMC), Denver, CO, USA

    Jane E. B. Reusch MD

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  1. P. Mason McClatchey MS, PhD
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  2. Timothy A. Bauer PhD, MS
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  3. Judith G. Regensteiner PhD, MA, BA
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Correspondence to P. Mason McClatchey MS, PhD .

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Editors and Affiliations

  1. Department of Medicine, Division of Endocrinology Metabolism and Diabetes and Center for Women’s Health Research, University of Colorado, Aurora, Colorado, USA

    Jane E. B. Reusch, MD

  2. Department of Medicine, Division of General Internal Medicine and Center for Women’s Health Research, University of Colorado School of Medicine, Aurora, Colorado, USA

    Judith G. Regensteiner, PhD, MA, BA

  3. Clinical and Research Exercise Physiology, Johns Hopkins Bayview Medical Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

    Kerry J. Stewart, Ed.D., FAHA, MAACVPR, FACSM

  4. Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA

    Aristidis Veves, MD, DSc

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McClatchey, P.M., Bauer, T.A., Regensteiner, J.G., Reusch, J.E.B. (2018). Exercise, Blood Flow, and the Skeletal Muscle Microcirculation in Diabetes Mellitus. In: Reusch, MD, J., Regensteiner, PhD, MA, BA, J., Stewart, Ed.D., FAHA, MAACVPR, FACSM , K., Veves, MD, DSc, A. (eds) Diabetes and Exercise. Contemporary Diabetes. Humana Press, Cham. https://doi.org/10.1007/978-3-319-61013-9_11

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