What Makes Exercise Feel More Difficult to Women With and Without Type 2 Diabetes (ExPRESS)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00785005
Recruitment Status : Completed
First Posted : November 5, 2008
Last Update Posted : April 19, 2012
Information provided by (Responsible Party):
University of Colorado, Denver

Brief Summary:

Given that sedentary behavior is associated with T2DM, the purpose of this study is to evaluate whether subjects with T2DM have a significant disincentive to performing exercise (due to greater perceived effort) . This study will prospectively compare the perceived exercise effort between T2DM and non-diabetic women while adjusting for potential confounders including baseline physical activity. This study will also assess whether perception of effort is associated with physiologic parameters related to exercise effort. Finally, we have 3 hypothesis-generating exploratory aims designed to screen for additional psychological and physiologic parameters that may increase perceived effort in those with T2DM.

Hypothesis 1: At the same absolute workload (e.g., 30 watts) and the same relative workloads, it is a greater effort for women with T2DM to exercise than for non-diabetic women.

Specific Aim 1: To determine differences in subjective perceived effort of bicycle exercise at low-to-moderate workloads in sedentary women with Type 2 Diabetes Mellitus (T2DM) vs. non-diabetic sedentary women.

Hypothesis 2: There will be a significant association between RPE and the physiologic measures related to work intensity (e.g., relative work intensity and tau2).

Specific Aim 2: In the same populations as SA1, to determine the strength of association during bicycle exercise between subjective perceived effort and physiologic measures related to work intensity.

Exploratory Aims:

Exploratory Aim 1: In the T2DM group described in SA1, to determine the strength of association during bicycle exercise between subjective effort and additional physiologic measures

Exploratory Aim 2: In the T2DM group described in SA1, to determine the strength of association during bicycle exercise between subjective effort and psychologic measures related to perception of effort.

Condition or disease
Type 2 Diabetes

Study Type : Observational
Actual Enrollment : 99 participants
Observational Model: Cohort
Time Perspective: Prospective
Official Title: Exercise-related Perceived Rate of Exertion at Steady-State Workloads (ExPRESS) in Type 2 Diabetes Mellitus
Study Start Date : May 2008
Actual Primary Completion Date : December 2011
Actual Study Completion Date : December 2011

Resource links provided by the National Library of Medicine

Females with Type 2 Diabetes
Females without Type 2 Diabetes

Biospecimen Retention:   Samples Without DNA

During the first visit, blood will be drawn for measurements of overall health (complete blood count and comprehensive metabolic panel), glucose and insulin levels, lipid levels, plasma FSH concentration, and HbA1C.

On two separate visits, blood samples will be drawn from a warmed IV site to measure muscle metabolites which change with exercise (e.g., glucose, calcium, lactate, H+, K+, and HCO3-) and may be associated with muscle pain or fatigue.

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Ages Eligible for Study:   50 Years to 70 Years   (Adult, Older Adult)
Sexes Eligible for Study:   Female
Accepts Healthy Volunteers:   Yes
Sampling Method:   Probability Sample
Study Population
Twenty-five sedentary post-menopausal women with uncomplicated T2DM (of duration ≤ 10 years) between the ages of 50-70 and twenty-five sedentary non-diabetic post-menopausal women between the ages of 50-70 will be recruited.

Inclusion Criteria:

  • Sedentary women not participating in a regular exercise program (> one bout of exercise per week)
  • If subject has diabetes, must be uncomplicated T2DM and < 25 years since T2DM diagnosis
  • Ages of 50-70 years
  • BMI of 25-35
  • Subjects can only be taking the following oral hypoglycemic drugs: metformin, sulfonylureas or sitagliptin. Use of insulin or other oral hypoglycemic medications is not allowed.
  • Persons with T2DM will be accepted for study only if they have total glycosylated hemoglobin levels (HbA1C) <8% (adequate control) on therapy.
  • Control subjects must have HbA1C < 5.5% and a fasting blood glucose of <100 mg/dl suggesting no significant insulin resistance.
  • All women must be post-menopausal, documented by menstrual history and follicle stimulating hormone (FSH) level.
  • Current smokers will be excluded since smoking can impair CV exercise performance but people who have quit smoking for at least 1 year will be accepted for study.
  • Absence of comorbid conditions will be confirmed by history, physical examination and laboratory testing.

Exclusion Criteria:

  • In general, people will be excluded with any condition which could limit exercise performance.
  • Persons with clinically evident distal symmetrical neuropathy, determined by evaluation of symptoms (numbness, paresthesia) and signs (elicited by vibration, pinprick, light touch, ankle jerks), will be excluded from further study as neuropathy may limit exercise performance.
  • Persons with autonomic dysfunction (>20 mm fall in upright BP without a change in heart rate) will be excluded as well, due to associated limitations of exercise performance.
  • Persons will be excluded if they have evidence of heart disease by history (Prior heart attack or bypass surgery, heart failure, or significant valvular disease) or abnormal resting electrocardiogram (EKG) consistent with prior infarct or latent ischemia (unless cardiovascular stress imaging or catheterization shows they do not have coronary artery disease). We will also exclude subjects with left or right bundle branch block on resting EKG (precludes recognition of ischemic EKG changes with exercise) or abnormal exercise EKG (> 1 mm ST segment depression 80 msec out in the ST segment for 3 consecutive beats).
  • Persons with angina or any other exercise-limiting cardiovascular, pulmonary or musculoskeletal symptoms will be excluded as well.
  • Presence of systolic blood pressure >150 at rest or >250 with exercise or diastolic pressure >95 at rest or >105 with exercise are also grounds for exclusion.
  • Subjects with proteinuria (urine protein >200 mg/dl) or a creatinine > 2 mg/dl, suggestive of renal disease will be excluded.
  • Subjects with total cholesterol >220 mg/dl, low density lipoprotein > 130 mg/dl, or triglycerides > 250 mg/dl will be excluded given the potential insulin resistance and endothelial dysfunction associated with these cholesterol parameters.
  • Subjects taking the following medications will be excluded: insulin, oral hypoglycemic agents other than those stated in inclusion criteria, estrogen-containing hormone replacement therapy including the "estring".
  • Control subjects who have an immediate family member with type 2 diabetes will be excluded.

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To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00785005

United States, Colorado
University of Colorado Denver
Aurora, Colorado, United States, 80045
Sponsors and Collaborators
University of Colorado, Denver
Principal Investigator: Amy Huebschmann, MD University of Colorado, Denver

Publications automatically indexed to this study by Identifier (NCT Number):
Responsible Party: University of Colorado, Denver Identifier: NCT00785005     History of Changes
Other Study ID Numbers: 07-0849
First Posted: November 5, 2008    Key Record Dates
Last Update Posted: April 19, 2012
Last Verified: April 2012

Keywords provided by University of Colorado, Denver:

Additional relevant MeSH terms:
Diabetes Mellitus
Diabetes Mellitus, Type 2
Glucose Metabolism Disorders
Metabolic Diseases
Endocrine System Diseases