Objective: High aerobic fitness may prevent age-related decrements in cutaneous vasodilation while type 2 diabetes may exacerbate this decline. The mechanisms underlying these responses remain unclear, but may be due to an excess of reactive oxygen species. We hypothesized that superoxide scavenging or NADPH oxidase inhibition would improve cutaneous vasodilation in older adults exercising in the heat, particularly in healthy low-fit individuals and those with type 2 diabetes.
Methods: Twenty seven older adults were evenly separated into three groups (healthy low-fit: VO = 24.4 ± 2.4 ml·kg·min, 61 ± 8 years; healthy high-fit: 42.5 ± 9.7 ml·kg·min, 56 ± 6 years; type 2 diabetes: 30.0 ± 7.6, ml·kg·min, 58 ± 7 years). The healthy low-fit and type 2 diabetes groups performed two successive 30-min cycling bouts at 65%VO in the heat (35°C), separated by 30-min rest. The high-fit group cycled at the same absolute heat load (and therefore requirement for heat loss) as their healthy low-fit counterparts during the first exercise bout (Ex1) and at the same relative intensity (65%VO) during the second (Ex2). Forearm cutaneous vascular conductance (CVC) was measured at microdialysis sites perfused with: 1) lactated Ringer's solution (control); 2) 10 mM N-nitro-L-arginine-methyl-ester (L-NAME, nitric oxide synthase inhibitor); 3) 100 μM apocynin (NADPH oxidase inhibitor); 4) 10 μM tempol (superoxide dismutase mimetic), with responses compared at baseline, end-Ex1, and end-Ex2.
Results: In all groups, L-NAME consistently reduced CVC relative to the other treatment sites by ~16-21% during Ex1 and by ~22-27% during Ex2 (all P < 0.05). Conversely, superoxide scavenging and NADPH oxidase inhibition did not influence CVC (all P > 0.05).
Conclusion: Superoxide and NADPH oxidase do not modulate cutaneous vasodilation in healthy low- or high-fit older adults exercising in the heat, regardless of aerobic fitness level or relative exercise intensity employed, nor do they influence cutaneous vasodilation during an exercise-heat stress in those with type 2 diabetes. However, NOS remains an important modulator of cutaneous vasodilation during exercise in all groups.
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http://dx.doi.org/10.1016/j.mvr.2019.103886 | DOI Listing |
PLoS One
January 2025
School of Human Nutrition, McGill University, Montreal, Québec, Canada.
Objective: Managing blood glucose levels is challenging for elite athletes with type 1 diabetes (T1D) as competition can cause unpredictable fluctuations. While fear of hypoglycemia during physical activity is well documented, research on hyperglycemia-related anxiety (HRA) is limited. HRA refers to the heightened fear that hyperglycemia-related symptoms will impair functioning.
View Article and Find Full Text PDFPLoS One
January 2025
Population Health Research Institute, St George's, University of London, London, United Kingdom.
Aims: Type 2 diabetes (T2D) is more common in certain ethnic groups. This systematic review compares mortality risk between people with T2D from different ethnic groups and includes recent larger studies.
Methods: We searched nine databases using PRISMA guidelines (PROSPERO CRD42022372542).
Eur J Heart Fail
January 2025
Department of Medicine, University of Chicago Medicine, Chicago, IL, USA.
Aims: This post hoc analysis aimed to assess the efficacy and safety of the non-steroidal mineralocorticoid receptor antagonist finerenone by baseline diuretic use in FIDELITY, a pre-specified pooled analysis of the phase III trials FIDELIO-DKD and FIGARO-DKD.
Methods And Results: Eligible patients with type 2 diabetes (T2D) and chronic kidney disease (CKD; urine albumin-to-creatinine ratio [UACR] ≥30-<300 mg/g and estimated glomerular filtration rate [eGFR] ≥25-≤90 ml/min/1.73 m, or UACR ≥300-≤5000 mg/g and eGFR ≥25 ml/min/1.
J Manag Care Spec Pharm
January 2025
Joslin Diabetes Center, Sequel Med Tech, Boston, MA.
Background: Type 2 diabetes (T2D) causes increased health care resource utilization (HCRU) and costs in the United States. People with T2D are more likely to have atherosclerotic cardiovascular disease (ASCVD), which is associated with significant morbidity and mortality. Medical associations recommend cardioprotective antidiabetic medications, including sodium-glucose cotransporter-2 inhibitors (SGLT2is) and glucagon-like peptide 1 receptor agonists (GLP-1 RAs), to reduce the risk of cardiovascular events in patients with T2D with established, or a high risk of, ASCVD, but not all eligible patients receive these medications.
View Article and Find Full Text PDFJ Manag Care Spec Pharm
January 2025
Abbott Diabetes Care, Mississauga, Ontario, Canada.
Background: Both glucagon-like peptide 1 receptor agonists (GLP-1 RAs) and continuous glucose monitoring (CGM) have been shown to improve glycated hemoglobin A1c (A1c) levels among patients with type 2 diabetes mellitus (T2DM). Recently, a US real-world study found statistically significant improvements in A1c levels among patients using GLP-1 RA and a CGM device, compared with a matched cohort receiving only GLP-1 RA.
Objectives: To assess the cost-effectiveness from a US payer perspective of initiating CGM (FreeStyle Libre Systems) in people living with T2DM using a GLP-1 RA therapy, compared with GLP-1 RA alone.
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