Changes in heart rate variability after modification of glucose lowering therapy in type 2 diabetic patients

Main Article Content

N.O. Pertseva
K.I. Moshenets

Abstract

Background. The World Health Organization (WHO) has identified diabetes mellitus (DM) as a non-communicable epidemic of the XXI century. Cardiovascular pathology is a major cause of death for these patients. The purpose was to study the indicators of heart rate variability (HRV) in patients with type 2 DM, depending on the course of the disease, and HRV changes after the management of hyperglycemia. Materials and methods. We examined 53 type 2 DM patients and 10 healthy controls. Laboratory tests include determination of C-peptide, glycated hemoglobin (HbA1c), serum creatinine and urinary albumin concentration (UAC). All subjects underwent continuous glucose monitoring and 24-hour Holter monitoring at the same time. The patients were divided into 2 groups according to the НbА1с level: group 1 (n = 23) with НbА1с ≤ 7.0 % and group 2 (n = 30) with НbА1с > 7.0 %. The groups were divided into subgroups according to the absence (a) or presence (b) of hypoglycemia. The patients were re-examined after 6 months of glucose-lowering therapy modification. Results. HRV parameters did not differ significantly between the groups and subgroups of type 2 DM patients (p > 0.05). Both groups and subgroups, as well as the whole basic group of type 2 DM patient, had a significant decrease in SDNN daily, pNN50% daily, VLF daily, HF daily indicators compared with control subjects (р < 0.05). There were no statistically significant differences in daily TP between the control group and subgroup 1а only (р > 0.05). LF daily level was significantly lower compared to control only to all patients with type 2 DM. Daily LF/HF ratio was significantly higher in all subgroups of both groups than the control one (р < 0.05). Conclusions. Type 2 DM patients had significantly lower HRV, which mainly consists of SDNN, TP, VLF, HF LF/HF ratio. Six months after glucose-lowering therapy modification, we received a significant increase in most HRV indicators, except for LF. Main changes were observed in pNN50% daily (+50 %), pNN50% day (+50 %), RMSSD day (+43.5 %), RMSSD daily (+28.6 %), HF (+133.1 % – daily, +172.2 % — day, +57.5 % — at night) and a decrease in LF/HF ratio (–42.9 % — daily, –46.2 % — day, –32.7 % — at night) (p < 0.05). The results clearly demonstrate the restoration of the cardiac vagosympathetic balance due to compensation of carbohydrate metabolism.

Article Details

How to Cite
Pertseva, N., and K. Moshenets. “Changes in Heart Rate Variability After Modification of Glucose Lowering Therapy in Type 2 Diabetic Patients”. INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine), vol. 16, no. 1, Feb. 2020, pp. 25-31, doi:10.22141/2224-0721.16.1.2020.199124.
Section
Original Researches

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