Better Cardiorespiratory Fitness Defined as VOmax Increases the Chance of Partial Clinical Remission and Prolongs Remission Duration in People with Newly Diagnosed Type 1 Diabetes.

Introduction: An essential process affecting the course of type 1 diabetes (DM1) is the appearance and duration of clinical remission. One of the most important factors promoting the occurrence of remission is physical activity, due to increased activity of antioxidants, reduces insulin resistance and improves glucose transport. Maximal oxygen capacity (VOmax) is an objective measure of the body's aerobic capacity. To assess VOmax, oxygen uptake should be measured directly during the exercise test. The aim of the study was to evaluate the physical capacity in adults with DM1 and its relationship with the occurrence of partial clinical remission (pCR) during 2 years follow-up.

Methods: The pCR was assessed by the following mathematical formula: A1c (%) + [4 × insulin dose (U/kg/d)]. The result ⩽9 indicates pCR. VOmax was assessed between 6th and 24th month of diabetes duration using an ergospirometer (COSMED K5 System), during an exercise test carried out on a cycloergometer (RAMP incremental exercise test).

Results: The study group consisted of 32 adults with DM1. People with pCR were proved to have higher VOmax level [36.0 (33.0-41.5) vs 30.9 (26.5-34.4) ml/min/kg,  = .009. Univariate and multivariate regression confirmed a significant association between VOmax and presence of pCR [AOR 1.26 (1.05-1.52),  = .015]. Duration of remission was longer among group with higher VOmax results [15 (9-24) vs 9 (0-12) months,  = .043]. The positive relationship was observed between diabetes duration and VOmax (rs = 0.484,  = .005). Multivariate linear regression confirms a significant association between remission duration and VOmax (ml/min/kg) (β = 0.595,  = .002).

Conclusion: The higher VOmax, the better chance of partial clinical remission at 2 years of DM1 and longer duration of remission.