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An Acceptable Exercise Test to Study Microalbuminuria in Type 1 Diabetes

A modified test for studying the response of urinary albumin excretion (UAV) to exercise in diabetic patients is described. It is designed to produce a standardized increase in pulse rate (by 90–110 %) rather than a standardized workload. Thirty‐three normotensive Type 1 diabetic patients with normal pre‐exercise UAV (<10 μg min−1) on the day of the test were compared with 25 non‐diabetic subjects matched for age and sex. The patients developed a significantly greater increase in the median UAV (p < 0.05) and systolic blood pressure (p < 0.01) during exercise, despite the use of lower workloads (p < 0.05). During exercise, the albumin excretion in the patients was not related to their heart rate, blood pressure, workload or fall in blood glucose; nor was it related to duration of diabetes, glycosylated haemoglobin or insulin dose. An exercise UAV > 15 μg min−1 was found in 10 of the 33 patients; it was significantly correlated (p < 0.01) with the frequency of previous overnight microalbuminuria (> 10 μg min−1), and was associated with a greater progression of microalbuminuria (p < 0.05) over a mean period of 24 months. Retinol‐binding protein excretion rate was also measured as an indicator of proximal tubular function and did not increase in either group.