Association between haemoglobin A1c and whole‐body heat loss during exercise‐heat stress in physically active men with type 2 diabetes

• Published in: Experimental physiology Vol. 108; no. 3; pp. 338 - 343
• Main Authors: Kirby, Nathalie V., Meade, Robert D., Poirier, Martin P., Sigal, Ronald J., Boulay, Pierre, Kenny, Glen P.
• Format: Journal Article
• Language: English
• Published: Oxford John Wiley & Sons, Inc 01-03-2023; John Wiley and Sons Inc
• Subjects: Body temperature; Calorimetry; chronic disease; Diabetes; Diabetes mellitus (non-insulin dependent); Exercise; extreme heat; glycaemic control; haemoglobin A1c; Heart rate; Heat; Heat loss; Heat stress; Hemoglobin; physical activity; Physical training; Relative humidity; Short Communication; Short Communications; Temperature effects
• ISSN: 0958-0670; 1469-445X
• DOI: 10.1113/EP090915

New Findings
What is the central question of this study?
Is the impairment in heat dissipation during exercise observed in men with type 2 diabetes related to glycaemic control (indexed by glycated haemoglobin; haemoglobin A1c)?
What is the main finding and its importance?
No association was found between haemoglobin A1c (range: 5.1–9.1%) and whole‐body heat loss in men with type 2 diabetes during exercise in the heat. However, individuals with elevated haemoglobin A1c exhibited higher body core temperature and heart rate responses. Thus, while haemoglobin A1c is not associated with heat loss per se, it may still have important implications for physiological strain during exercise.
Type 2 diabetes is associated with a reduced capacity to dissipate heat. It is unknown whether this impairment is related to glycaemic control (indexed by glycated haemoglobin; haemoglobin A1c) is unknown. We evaluated the association between haemoglobin A1c and whole‐body heat loss (via direct calorimetry), body core temperature, and heart rate in 26 physically active men with type 2 diabetes (43–73 years; HbA1c 5.1–9.1%) during exercise at increasing rates of metabolic heat production (∼150, 200, 250 W m−2) in the heat (40°C, ∼17% relative humidity). Haemoglobin A1c was not associated with whole‐body heat loss (P = 0.617), nor the increase in core temperature from pre‐exercise (P = 0.347). However, absolute core temperature and heart rate were elevated ∼0.2°C (P = 0.014) and ∼6 beats min−1 (P = 0.049), respectively, with every percentage point increase in haemoglobin A1c. Thus, while haemoglobin A1c does not appear to modify diabetes‐related reductions in capacity for heat dissipation, it may still have important implications for physiological strain during exercise‐heat stress.