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, 25 W/10 s) has been proposed to guide exercise interventions in type 2 diabetes, but requires validation. This study aims to (a) determine the relationship between W-max and (V) over dotO(2)peak 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 1.8 W/6 s) and SRT on separate days. A random subgroup (n = 42) repeated the SRT. ECG, heart rate, and (V) over dotO(2) were monitored. W-max during RT: 193 +/- 63 (men) and 106 +/- 33 W (women). W-max during SRT: 193 +/- 63 (men) and 188 +/- 55 W (women). The relationship between RT and SRT was described by men RT (V) over dotO(2)peak (mL/min) = 152 + 7.67 x W-max SRT1 (r: 0.859); women RT (V) over dotO(2)peak (mL/min) = 603 + 4.75 x W-max SRT1 (r: 0.771); intraclass correlation coefficients between first (SRT1) and second SRT W-max (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.