A family history of diabetes is associated with reduced physical fitness in the Prevalence, Prediction and Prevention of Diabetes (PPP)-Botnia study.

AIMS/HYPOTHESIS: We studied the impact of a family history of type 2 diabetes on physical fitness, lifestyle factors and diabetes-related metabolic factors. METHODS: The Prevalence, Prediction and Prevention of Diabetes (PPP)-Botnia study is a population-based study in Western Finland, which includes a random sample of 5,208 individuals aged 18 to 75 years identified through the national Finnish Population Registry. Physical activity, dietary habits and family history of type 2 diabetes were assessed by questionnaires and physical fitness by a validated 2 km walking test. Insulin secretion and action were assessed based upon OGTT measurements of insulin and glucose. RESULTS: A family history of type 2 diabetes was associated with a 2.4-fold risk of diabetes and lower physical fitness (maximal aerobic capacity 29.2 +/- 7.2 vs 32.1 +/- 7.0, p = 0.01) despite having similar reported physical activity to that of individuals with no family history. The same individuals also had reduced insulin secretion adjusted for insulin resistance, i.e. disposition index (p < 0.001) despite having higher BMI (27.4 +/- 4.6 vs 26.0 +/- 4.3 kg/m(2), p < 0.001). CONCLUSIONS/INTERPRETATION: Individuals with a family history of type 2 diabetes are characterised by lower physical fitness, which cannot solely be explained by lower physical activity. They also have an impaired capacity of beta cells to compensate for an increase in insulin resistance imposed by an increase in BMI. These defects should be important targets for interventions aiming at preventing type 2 diabetes in individuals with inherited susceptibility to the disease.

Long-term in vivo experience of an electrochemical sensor using the potential step technique for measurement of mixed venous oxygen pressure.

An implantable amperometric blood oxygen sensor was developed to improve rate adaptation of heart pacemakers. Two different working electrode materials in direct contact with the blood were tested, smooth glassy carbon and gold. Reference electrodes of Ag/AgCl and porous pyrolytic carbon were evaluated. A counter electrode being the titanium housing of the pulse generator was partly coated with carbon. An implantable pacemaker system with chronocoulometric oxygen detection was developed. Heart synchronous potential steps were periodically applied to the 7.5 mm2 working electrode in the atrium. Both single and double potential step techniques were evaluated. The oxygen diffusion limited current was used to calculate the stimulation rate. Bench tests and studies on 31 animals were performed to evaluate long-term stability and biocompatibility. In five dogs, the AV node was destroyed by RF ablation to create a realistic animal model of a pacemaker patient. Sensor stability and response to exercise was followed up to a maximum implantation time of 4 years. Post-mortem examinations of the electrode surfaces and tissue response were performed. The results show that a gold electrode is more stable than glassy carbon. The Ag/AgCl reference was found not to be biocompatible, but activated carbon was stable enough for use as reference for the potentiostat. Double potential steps stabilize the sensor response in comparison to single steps. Blood protein adsorption on the gold surface decreased the oxygen transport but not the reaction efficacy. No adverse tissue reactions were observed.

Oxygen pressure as biosensor for rate adaptive cardiac pacing.

A new carbon based oxygen sensor for rate adaptive cardiac pacing has been developed. It measures oxygen partial pressure In mixed venous blood. The system was implanted in six sheep with a mean follow-up time of 261 days after implant. The sensor reacted in a physiological manner when the animals were at rest as well as during exercise. Long-term sensor stability and sensitivity were satisfactory, and we found excellent correlation with spontaneous heart rate variations and with oxygen saturation measurements. The sensor shows great promise although our experience is still limited and further development on the concept is on-going.