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Aim: This study aimed to compare the estimated and measured resting metabolic rates of patients with type 1 and type 2 diabetes mellitus in an outpatient clinical setting. Material and methods: Participants were categorized into three groups that included type 1 diabetes, type 2 diabetes, and individuals without diabetes. Bland-Altman analysis was used to identify the equation that most accurately predicted the measured resting metabolic rates. Multiple regression analysis was used to identify the factors affecting resting metabolic rates. Results: Resting metabolic rates was observed to be higher in subjects with type 2 diabetes compared to that of the other groups. There was a proportional bias between predicted and measured resting metabolic rates. Type 1 diabetes, type 2 diabetes, male sex, body weight, waist circumference, and triglyceride level were factors that positively predicted resting metabolic rates, and age was a factor that negatively predicted it. Conclusions: Although there was a bias between estimated and measured RMR, the most accurate results were achieved with the Mifflin-St Jeor equation for women with type 1 diabetes, with the Owen equation for men with type 1 diabetes, with the Harris Benedict equation for women with type 2 diabetes, and with the Ikeda equation for men with type 2 diabetes as well as for women and men in the control group.

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BACKGROUND: Impaired glucose tolerance (IGT) forms an intermediate stage in the natural history of diabetes mellitus. Insulin-resistant states might be associated with dysfunction of the vascular endothelium. OBJECTIVES: To determine the effects of chronic exercise and a low-calorie diet on plasma nitric oxide (NO) and endothelin-1 (ET-1) levels in patients with IGT and to elucidate the relationship between the oxidant stress markers and NO/ET-1 levels of blood before and after exercise. METHODS: Patients with IGT (n = 14) participated in a regular exercise program and exercised for 40 minutes each day, 3 days a week for 12 weeks. Physiological, anthropometric, and biochemical measurements were performed before, during the 6th week, and at the end of the program. RESULTS: There was a significant reduction in body mass index, body fat content, systolic and diastolic blood pressures, as well as NO and ET-1 concentrations after 12 weeks of exercise and diet program. Exercise training significantly elevated subjects' maximum oxygen consumption, whereas the resting metabolic rates of the patients did not change. The formation of thiobarbituric acid reactive substances were significantly reduced, whereas sulfhydryl groups were significantly increased on the 6th week (P < .05) and at the end of program (P < .01). CONCLUSION: Our results demonstrate that exercise, along with low-calorie diet, induced reductions in the plasma of both ET-1 and NO. Beneficial effects were observed on anthropometric measurements and plasma oxidant stress markers, indicating weight loss associated with exercise training and calorie restriction may effectively improve endothelial dysfunction in patients with IGT.

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Diabetic nephropathy is a feared complication of diabetes since it can lead to end-stage renal failure and also it is a risk factor of cardiovascular disease. The important clinical problems caused by diabetic nephropathy are proteinuria and decreased renal function. Exercise is a cornerstone of diabetes management, along with diet and medication. Since acute exercise causes proteinuria and decreases glomerular filtration rate, the effect of exercise on diabetic nephropathy is controversial. The aim of this study was to investigate the effect of regular aerobic exercise on microalbuminuria and glomerular filtration rate in diabetic rats. Moderate diabetes was induced by streptozotocin (45 mg/kg IV) in rats and an aerobic exercise- training program on a treadmill was carried out for 8 weeks. Four groups of rats; control sedentary (CS), control exercise (CE), diabetic sedentary (DS) and diabetic exercise (DE) were included in the study. Blood glucose levels were determined from the plasma samples taken at the end of 4 weeks of stabilization period and 8 weeks of training program. Creatinine clearance (CCr) and microalbuminuria (MA) levels were determined to evaluate renal functions. The analyzed data revealed that regular aerobic exercise: 1) significantly decreased the plasma glucose level of the DE group compared to the DS group (p < 0.05), 2) significantly decreased the microalbuminuria level of the DE group compared to those of DS group (p < 0.01), 3) significantly decreased the creatinine clearance levels of the DE and CE groups compared to those of CS group (p < 0.05). The results of this study suggest that despite of decreasing creatinine clearance, regular submaximal aerobic exercise has a preventive effect on development of microalbuminuria and thus may retard nephropathy in diabetic rats. Key pointsRegular submaximal aerobic exercise can facilitate the control of blood glucose level in diabetic rats.Streptozotocin induced diabetes may cause microalbuminuria and regular submaximal aerobic exercise may have a preventive effect on renal functions.

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OBJECTIVE: Some findings of left ventricular (LV) functions in athletes are controversial. On the other hand, studies concerning the right ventricle (RV) are limited. The aim of the study was to assess the effects of endurance training on LV and RV systolic and diastolic function. METHODS: A total of 60 (54 male, 6 female) athletes (mean age 20.7 +/- 2.5 years) and 60 (51 male, 9 female) healthy subjects (mean age 21.3 +/- 2.6 years) were included in the study. Standard echocardiographic examination and pulsed wave Doppler and tissue Doppler imaging (TDI) were performed. RESULTS: Except LV and RV ejection fraction, all M-mode echocardiographic parameters of the athletes were found to be significantly greater compared to untrained subjects. LV cavity dimension enlarged (> 55 mm) in 23 (38.4%) athletes but none of the controls. Of 54 male and 6 female athletes 33 (61.1%) and 5 (83.3%) had left vantricular hypertrophy. Athletes also had a greater RV free-wall thickness and mass index. None of the control subjects had either LV or RV hypertrophy. The mean LVMI/RVMI ratio was 3.77 +/- 1.59 and 3.40 +/- 1.32 in athletes and controls, respectively (p = 0.5). The mean E/A and Em/Am ratios and Sm velocities of both ventricles were significantly higher in athletes compared to untrained subjects (p < 0.001). CONCLUSION: Our study shows that despite an increase in left and right ventricular mass indexes, the LVMI/RVMI ratio stays stable. Training results in a better systolic and diastolic function.

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OBJECTIVE: To investigate the effects of regular submaximal exercise on quality of life, exercise capacity and pulmonary function in asthmatic children. PATIENTS AND METHODS: Sixty-two children with mild-moderate asthma (mean age 10.4 (SD 2.1) years) were randomly allocated into exercise and control groups. The exercise group underwent a moderately intensive basketball training program for 8 weeks. A home respiratory exercise program was advised to both groups. Pediatric Asthma Quality of Life Questionnaire (PAQLQ) was used for the evaluation of activity limitation, symptoms and emotional functions. Exercise capacity was evaluated through the physical work capacity (PWC 170 test) on a cycle ergometer and 6-minute walk test. Spirometric tests were also performed and medication and symptom scores were recorded. RESULTS: Although PAQLQ scores improved in both groups, the improvement in the exercise group was significantly higher. The exercise group performed better in the PWC 170 and 6-minute walk tests, whereas no improvement was detected in the control group at the end of the trial. Medication scores improved in both groups, but symptom scores improved only in the exercise group. No significant changes were detected in pulmonary function in either group, except for peak expiratory flow values in the exercise group. CONCLUSION: Eight weeks of regular submaximal exercise has beneficial effects on quality of life and exercise capacity in children with asthma. Submaximal basketball training is an effective alternative exercise program for asthmatic children.

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The effects of aerobic exercise training on skeletal muscle endurance capacity were examined in diabetic rats in situ. Moderate diabetes was induced by iv injection of streptozotocin and an exercise training program on a treadmill was carried out for 8 weeks. The animals randomly assigned to one of the four experimental groups: control-sedentary (CS), control-exercise (CE), diabetic-sedentary (DS) or diabetic-exercise (DE). The changes in the muscle endurance capacity were evaluated through the square wave impulses (supramaximal) of 0.2-ms duration at 1 Hz in the in situ gastrocnemius-soleus muscle complex. Muscle was stimulated continuously until tension development reduced to the half of this maximal value. Time interval between the beginning and the end of stimulation period is defined as contraction duration. Following the training period, blood glucose level reduced significantly in the DE group compared to DS group (p < 0.05). The soles muscle citrate synthase activity was increased significantly in both of the trained groups compared to sedentary animals (p < 0.05). Fatigued muscle lactate values were not significantly different from each other. Ultrastractural abnormality of the skeletal muscle in DS group disappeared with training. Presence of increased lipid droplets, mitochondria clusters and glycogen accumulation was observed in the skeletal muscle of DE group. The contraction duration was longer in the DE group than others (p < 0.001). Fatigue resistance of exercised diabetic animals may be explained by increased intramyocellular lipid droplets, high blood glucose level and muscle citrate synthase activity. Key PointsAerobic training of diabetic animals increased the endurance capacity.Presence of abnormal ultrastructural alterations with diabetes disaapered with regular training.Increased intramyocelluler lipid droplets, high blood glucose level with citrate synthase activity may explain this finding.