Assessment of Short-Term Heart Rate and Breathing Rate Asymmetry in Diabetic and Non-Diabetic Individuals

This study aimed to investigate short-term heart rate asymmetry (HRA) and breathing rate asymmetry (BRA) in individuals with type 2 diabetes mellitus (T2DM) compared to non-diabetic controls. Thirty-eight participants (20 T2DM, 18 controls) were studied at four stages-supine, orthostatic, paced respiration, and Valsalva maneuver-by continuously recording electrocardiogram and respiratory signals to derive beat-to-beat (RR) and breath-to-breath (BB) intervals time series. Classical asymmetry indices from two-minute segments-Porta, Guzik, Ehlers-and the Slope Index were calculated to quantify HRA and BRA. Notably, the Porta index for HRA (PRR) increased significantly in the T2DM group 54.1 ± 5.7% compared with controls 48.2 ± 2.6% (p < 0.0001) during paced respiration, indicating a higher number of cardiac accelerations. HRA changes dependent on stage were most evident for the diabetic group, suggesting overactive autonomic regulation. In contrast, no variations in BRA among stages were noted in this group, suggesting a potential loss of normal respiratory modulation. We found different patterns of autonomic dysfunction in diabetes, reinforcing the importance of asymmetry-based measures as potential clinical indicators for early identification and management of diabetic autonomic dysfunction.Clinical Relevance- Asymmetric measures of short-term heart rate and breathing rate may help clinicians detect early autonomic dysfunction in type 2 diabetes, potentially guiding timely interventions to reduce cardiovascular risks.