Vol 9, No 4 (2020)
Research paper
Published online: 2020-08-11

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The acute effect of a moderate intensity ergocycle exercise on the coagulation parameters in type 2 diabetes mellitus patients: a feasibility study

Novita Intan Arovah1, Bernadetta Wara Kushartanti1
Clin Diabetol 2020;9(4):219-225.

Abstract

Background. Type 2 diabetes mellitus (T2DM) patients experience higher atherothrombotic risks that could lead to cardiovascular diseases, due to increases in coagulation activities. The role of exercise in altering coagulation activities among T2DM patients is still inconclusive. This feasibility study aimed to evaluate the immediate effect of a moderate intensity ergocycle exercise, primary on the coagulation parameters and secondary on the systemic inflammation and blood glucose, in otherwise healthy T2DM patients.

Methods. Ten T2DM patients (64 ± 7 year, 40% female) performed a 30-minute moderate-intensity ergocycle exercise at 50–60% of heart rate reserved. Coagulation parameters (activated partial thromboplastin time [aPTT], prothrombin time [PT] and platelet count), erythrocyte sedimentation rate, and blood glucose were assessed before the exercise (T0), immediately after the exercise (T1), and 30 minutes post exercise (T2). One-way repeated measured ANOVA was used to assess the outcomes over time.

Results. All participants completed and adhered to the exercise protocol. There were increases in aPTT and PT but decreases in platelet count at T1 and T2 compared to at T0 (P < 0.05), indicating reduction in the coagulation activities. Those values, however, were still within normal ranges. The erythrocyte sedimentation rates were unaffected, while blood glucose decreased from 202 ± 35 mg/dL at T0 to 173 ± 33 mg/dL and 158 ± 30 mg/dL at T1 and T2 (P < 0.01).

Conclusion. The 30-minute moderate-intensity ergocycle decreases coagulation activities and blood glucose but does not affect erythrocyte sedimentation rates in T2DM patients. Future studies should focus on the chronic adaptation of the coagulation parameters after ergocycle training among a T2DM patients with coagulation impairments.

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References

  1. Pretorius E. Mechanisms of hypercoagulation and aberrant clot lyses in type 2 diabetes. Mechanisms of Vascular Defects in Diabetes Mellitus. 2017: 377–393.
  2. Lemkes BA, Hermanides J, Devries JH, et al. Hyperglycemia: a prothrombotic factor? J Thromb Haemost. 2010; 8(8): 1663–1669.
  3. Ghosh K. Diabetes as a Prothrombotic State. Mechanisms of Vascular Defects in Diabetes Mellitus. 2017: 361–376.
  4. Carr M. Diabetes mellitus: a hypercoagulable state. Journal of Diabetes and its Complications. 2001; 15(1): 44–54.
  5. Loeffen R, Spronk HMH, Ten Cate H. The impact of blood coagulability on atherosclerosis and cardiovascular disease. J Thromb Haemost. 2012; 10(7): 1207–1216.
  6. Dhule S, Gawali S. Platelet aggregation and clotting time in type 2 diabetic males. National Journal of Physiology, Pharmacy and Pharmacology. 2014; 4(2): 121.
  7. Mani H. Interpretation of coagulation test results under direct oral anticoagulants. Int J Lab Hematol. 2014; 36(3): 261–268.
  8. Green D. Interpreting coagulation assays. Blood Coagul Fibrinolysis. 2010; 21 Suppl 1: S3–S6.
  9. Zhao Y, Zhang J, Zhang J, et al. Diabetes mellitus is associated with shortened activated partial thromboplastin time and increased fibrinogen values. PLoS One. 2011; 6(1): e16470.
  10. Agarwal C, Pujani M, Gahlawat H, et al. Platelet parameters: Can they serve as biomarkers of glycemic control or development of complications in evaluation of type 2 diabetes mellitus? Iraqi Journal of Hematology. 2018; 7(2): 72.
  11. Hilberg T, Eichler E, Gläser D, et al. Blood coagulation and fibrinolysis before and after exhaustive exercise in patients with IDDM. Thromb Haemost. 2003; 90(6): 1065–1073.
  12. Cwikiel J, Seljeflot I, Berge E, et al. Pro-coagulant activity during exercise testing in patients with coronary artery disease. Thromb J. 2017; 15: 3.
  13. Ribeiro J, Almeida-Dias A, Ascensão A, et al. Hemostatic response to acute physical exercise in healthy adolescents. J Sci Med Sport. 2007; 10(3): 164–169.
  14. Hilberg T, Gläser D, Reckhart C, et al. Blood coagulation and fibrinolysis after long-duration treadmill exercise controlled by individual anaerobic threshold. Eur J Appl Physiol. 2003; 90(5-6): 639–642.
  15. Demetz G, Ott I. The Interface between Inflammation and Coagulation in Cardiovascular Disease. Int J Inflam. 2012; 2012: 860301.
  16. Sato Y, Nagasaki M, Kubota M, et al. Clinical aspects of physical exercise for diabetes/metabolic syndrome. Diabetes Res Clin Pract. 2007; 77 Suppl 1: S87–S91.
  17. Colberg SR, Swain DP, Vinik AI. Use of heart rate reserve and rating of perceived exertion to prescribe exercise intensity in diabetic autonomic neuropathy. Diabetes Care. 2003; 26(4): 986–990.
  18. Hanke A, Staib A, Görlinger K, et al. Whole blood coagulation and platelet activation in the athlete: a comparison of marathon, triathlon and long distance cycling. Eur J Med Res. 2010; 15(2): 59.
  19. Arovah N, Kushartanti B. Moderate-Vigorous Physical Activity and Clinical Parameters in Adults with Type 2 Diabetes Mellitus: A Report from the Walking with Diabetes Study. Romanian Journal of Diabetes Nutrition and Metabolic Diseases. 2019; 26(2): 107–117.
  20. Alende-Castro V, Alonso-Sampedro M, Vazquez-Temprano N, et al. Factors influencing erythrocyte sedimentation rate in adults: New evidence for an old test. Medicine (Baltimore). 2019; 98(34): e16816.
  21. Wang X, Bao W, Liu J, et al. Inflammatory markers and risk of type 2 diabetes: a systematic review and meta-analysis. Diabetes Care. 2013; 36(1): 166–175.
  22. Colberg SR, Sigal RJ, Yardley JE, et al. Physical activity/exercise and diabetes: a position statement of the American Diabetes Association. Diabetes Care. 2016; 39(11): 2065–2079.
  23. Snowling NJ, Hopkins WG. Effects of different modes of exercise training on glucose control and risk factors for complications in type 2 diabetic patients: a meta-analysis. Diabetes Care. 2006; 29(11): 2518–2527.
  24. Richter EA, Hargreaves M. Exercise, GLUT4, and skeletal muscle glucose uptake. Physiol Rev. 2013; 93(3): 993–1017.
  25. American Diabetes Association. 2. Classification and Diagnosis of Diabetes. Diabetes Care. 2017; 40(Suppl 1): S11–S24.