Abstract
Aim: Studies investigating the effects of type II diabetes mellitus on exercise capacity, peripheral muscle strength, and physical activity level in patients with heart failure are limited. This study aimed to compare maximal exercise capacity, peripheral muscle strength, and physical activity level in patients with heart failure with and without diabetes mellitus.
Methods: Thirty-four patients with heart failure-16 diabetic and 18 nondiabetic (New York Heart Association Class II and III, left ventricular ejection fraction below 40%)-were included. Pulmonary function was evaluated using spirometry, peripheral muscle strength using a handheld dynamometer, maximal exercise capacity using Modified Incremental Shuttle Walk Test (MISWT), energy expenditure in daily activities, and physical activity level using the International Physical Activity Questionnaire.
Results: The MISWT distance was significantly shorter in diabetic patients with heart failure than in nondiabetic ones (P < .05). Hand grip, biceps brachii, and quadriceps femoris muscle strength were significantly lower in diabetic patients than in nondiabetic ones (P < .05). Thirteen percent of the patients with heart failure with diabetes were minimally active, 88% were inactive. In the nondiabetic group, 11% were minimally active and 88.89% patients were inactive. There was no significant difference in energy expenditure in daily activities between diabetic and nondiabetic patients (P > .05).
Conclusions: Presence of diabetes mellitus further decreases maximal exercise capacity, and peripheral muscle strength in patients with heart failure. Energy expenditure in daily activities is severely impaired in both in diabetic and nondiabetic patients with heart failure. Physical inactivity is present in heart failure independent of the diabetes. Diabetes mellitus should be taken in consideration while evaluating maximal exercise capacity and peripheral muscle strength in patients with heart failure.