Peripheral fatigue regulation during knee extensor exercise in type 1 diabetes and consequences on the force–duration relationship

Purpose This study aimed to examine if peripheral fatigue is adjusted during knee extensor (KE) exercise in order not to surpass a critical threshold patient with type 1 diabetes (T1D) and the consequences of this mechanism on the force–duration relationship. Methods Eleven T1D individuals randomly performed two different sessions in which they performed 60 maximum voluntary contractions (MVC; 3 s contraction, 2 s relaxation). One trial was performed in the non-fatigued state (CTRL) and another after fatiguing neuromuscular stimulation of the KE (FNMES). Peripheral and central fatigue were quantified by the difference between pre and post exercise in quadriceps voluntary activation (ΔVA) and potentiated twitch (ΔPtw). Critical torque (CT) was determined as the average force of the last 12 contractions, whereas W' was calculated as the area above the CT. Results Although FNMES led to a significant decrease in potentiated twitch (Ptw) before performing the 60-MVCs protocol ( p < 0.05), ΔVA (∼ −7.5%), ΔP tw (∼ −39%), and CT (∼816 N) post-MVCs were similar between the two conditions. The difference in W' between CTRL and FNMES was correlated with the level of pre-fatigue induced in FNMES (r 2 = 0.60). In addition, W' was correlated with ΔP tw (r 2 = 0.62) in the CTRL session. Conclusion Correlative results in the present study indicate that regulating peripheral fatigue mechanisms at a critical threshold limit W'. Additionally, peripheral fatigue during KE exercise is limited to an individual threshold in T1D patients.