# Longitudinal assessment of cardio-respiratory fitness among Indian patients with type 2 diabetes mellitus

## TL;DR

This study shows that lifestyle changes can significantly improve cardiorespiratory fitness and heart health in Indian patients with type 2 diabetes.

## Contribution

The study demonstrates that lifestyle interventions can improve VO2 max and heart rate variability in T2DM patients over one year.

## Key findings

- VO2 max increased significantly from 25.4 ± 5.2 to 30.1 ± 4.8 ml/kg/min after one year of lifestyle changes.
- Heart rate variability improved, indicating better autonomic balance and parasympathetic activity.

## Abstract

Type 2 Diabetes Mellitus (T2DM) is associated with many complications, including cardiovascular and autonomic dysfunctions.
Cardiorespiratory fitness as estimated by maximal oxygen uptake (VO2 max) is a very powerful predictor of cardiovascular health.
Therefore, it is of interest to measure the cardiorespiratory parameters in T2DM patients for diagnosing autonomic dysfunction and to
follow the changes over time. Baseline and follow-up cardiorespiratory fitness parameters among patients of Central India suffering from
T2DM and its effectiveness to lifestyle modifications for these parameters are done. This hospital-based longitudinal study was conducted
on 600 patients between the age group of 30 and 65 years diagnosed with T2DM. Patients were recruited from the Sports Physiology
Laboratory, Department of Physiology, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Maharashtra. Baseline measurements of VO2
max, HRV, and other cardiorespiratory variables were taken with a motorized treadmill using Lab Chart. Then, lifestyle counselling was
undertaken for the participants and the same parameters were reassessed one year later. Statistical package SPSS version 23 was used
during data analysis. After one year of interventions, the improvements at the end of one year include those of VO2 max and HRV. The
mean VO2 max improved from 25.4 ± 5.2 to 30.1 ± 4.8 ml/kg/min while the probability was less than 0.001. The main indices
of HRV showed improved autonomic balance along with enhanced parasympathetic activity. Combining lifestyle interventions with regular
monitoring of cardiorespiratory fitness and HRV can, indeed significantly improve cardiovascular health in T2DM patients. This study
calls for the inclusion of fitness assessments in everyday clinical care for diabetes.