A steep ramp test is valid for estimating maximal power and oxygen uptake during a standard ramp test in type 2 diabetes

A short maximal steep ramp test (SRT, 25W/10s) has been proposed to guide exercise interventions in type 2 diabetes, but requires validation. This study aims to (a) determine the relationship between W<inf>max</inf> and V ˙ O 2 p e a k reached during SRT and the standard ramp test (RT); (b) obtain test-retest reliability; and (c) document electrocardiogram (ECG) abnormalities during SRT. Type 2 diabetes patients (35 men, 26 women) performed a cycle ergometer-based RT (women 1.2; men 1.8W/6s) and SRT on separate days. A random subgroup (n=42) repeated the SRT. ECG, heart rate, and V ˙ O 2 were monitored. W<inf>max</inf> during RT: 193±63 (men) and 106±33W (women). W<inf>max</inf> during SRT: 193±63 (men) and 188±55W (women). The relationship between RT and SRT was described by men RT V ˙ O 2 p e a k (mL/min)=152+7.67×W<inf>max</inf> SRT1 (r: 0.859); women RT V ˙ O 2 p e a k (mL/min)=603+4.75×W<inf>max</inf> SRT1 (r: 0.771); intraclass correlation coefficients between first (SRT1) and second SRT W<inf>max</inf> (SRT2) were men 0.951 [95% confidence interval (CI) 0.899-0.977] and women 0.908 (95% CI 0.727-0.971). No adverse events were noted during any of the exercise tests. This validation study indicates that the SRT is a low-risk, accurate, and reliable test to estimate maximal aerobic capacity during the RT to design exercise interventions in type 2 diabetes patients.

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