Can a simple test of functional capacity add to the clinical assessment of diabetes?

Diabet Med. 2016 Aug;33(8):1133-9. doi: 10.1111/dme.13032. Epub 2015 Dec 29.

Abstract

Aim: To identify impairment in functional capacity associated with complicated and non-complicated diabetes using the 6-min walk distance test.

Methods: We enrolled 111 adults, aged ≥40 years, with Type 2 diabetes from a hospital facility and 150 healthy control subjects of similar age and sex from a community site in Lima, Peru. All participants completed a 6-min walk test.

Results: The mean age of the 261 participants was 58.3 years, and 43.3% were male. Among those with diabetes, 67 (60%) had non-complicated diabetes and 44 (40%) had complications such as peripheral neuropathy, retinopathy or nephropathy. The mean unadjusted 6-min walk distances were 376 m and 394 m in adults with and without diabetes complications, respectively, vs 469 m in control subjects (P<0.001). In multivariable regression, the subjects with diabetes complications walked 84 m less far (95% CI -104 to -63 m) and those without complications walked 60 m less far (-77 to -42 m) than did control subjects. When using HbA1c level as a covariate in multivariable regression, participants walked 13 m less far (-16.9 to -9.9 m) for each % increase in HbA1c .

Conclusions: The subjects with diabetes had lower functional capacity compared with healthy control subjects with similar characteristics. Differences in 6-min walk distance were even apparent in the subjects without diabetes complications. Potential mechanisms that could explain this finding are early cardiovascular disease or deconditioning.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Case-Control Studies
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / metabolism
  • Diabetes Mellitus, Type 2 / physiopathology*
  • Diabetic Nephropathies / etiology
  • Diabetic Neuropathies / etiology
  • Diabetic Retinopathy / etiology
  • Female
  • Glycated Hemoglobin / metabolism
  • Humans
  • Linear Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Peru
  • Walk Test*

Substances

  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human