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Cardiac autonomic dysfunction in type 2 diabetes - effect of hyperglycemia and disease duration

Mika P Tarvainen1, Tomi P Laitinen2, Jukka A Lipponen3

  • 1Department of Applied Physics, University of Eastern Finland , Kuopio , Finland ; Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital , Kuopio , Finland.

Frontiers in Endocrinology
|August 26, 2014
PubMed

Insights

Diabetes mellitus (DM) patients show reduced heart rate variability (HRV), indicating impaired cardiac autonomic regulation. Elevated blood glucose and longer diabetes duration significantly decrease HRV, especially within the first 5-10 years.

Area of Science:

  • Cardiology
  • Endocrinology
  • Autonomic Neuroscience

Background:

  • Diabetes mellitus (DM) is linked to cardiac autonomic dysfunction.
  • Reduced heart rate variability (HRV) in DM patients suggests increased cardiac event risk.

Purpose of the Study:

  • To investigate the association between blood glucose levels (BGL), glycated hemoglobin (HbA1c), and diabetes duration with cardiac autonomic regulation.
  • To assess cardiac autonomic regulation using HRV analysis in type 2 DM (T2DM) patients.

Main Methods:

  • Analysis of resting electrocardiogram (ECG) and clinical data from 189 healthy controls and 93 T2DM patients.
  • HRV assessment using time-domain, frequency-domain, and non-linear methods.
  • Correlation analysis of BGL, HbA1c, and diabetes duration with HRV parameters.

Main Results:

  • Significant differences in HRV parameters were observed between healthy controls and T2DM patients.
  • Hyperglycemia (elevated BGL and HbA1c) correlated with increased heart rate and decreased HRV.
  • Diabetes duration showed a strong association with decreased HRV, most pronounced within 5-10 years of diagnosis.

Conclusions:

  • Elevated blood glucose levels negatively impact cardiac autonomic function in T2DM patients.
  • The detrimental effect of hyperglycemia on cardiac autonomic function is more pronounced in long-term T2DM.
  • Autonomic neuropathy, indicated by significant HRV reduction, is most evident within the first 5-10 years of diabetes progression.

Keywords:
HbA1cblood glucosecardiac autonomic neuropathydurationheart rate variabilityhyperglycemia

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