Author(s): PERSIANI, M., LAFFI, A., PIRAS, A., MEONI, A., PETRONI, M.L., BRODOSI, L., NICASTRI, A., RAFFI, M., Institution: UNIVERSITY OF BOLOGNA, Country: ITALY, Abstract-ID: 1773

INTRODUCTION:
Chronic hyperglycemia damages body systems, making glucose and cardiovascular management crucial [1]. 50% of diabetic autonomic dysfunction are asymptomatic, increases morbidity, especially via cardiac autonomic neuropathy [2]. Type 2 diabetes mellitus (T2DM) affects both autonomic branches, and physical activity seems to play a role in its management. The study aimed the effect of an exercise program (EP) on autonomic functions in T2DM patients.
METHODS:
21 T2DM patients with no diabetic neuropathy diagnosis were randomly assigned to two groups. The EP group (13: age 59,54±11,79; HbA1c 59,82±19,57; BMI 29,73±5,28); diabetic medication 53,8%; insulin therapy 23%) followed a 12 month exercise program while Control group (8: age 63,75±4,89; HbA1c 65,67±7,23; BMI 32,90±5,38; diabetic medication 12,5%; insulin therapy 0%) maintained a sedentary habits. Heart rate variability (HRV) and heart frequency (HFrest) were assessed at baseline, 6 and 12 months. HRV parameters measure the time between heartbeats providing insights into the autonomic nervous systems balance. The time domain parameters such as MeanRR (average time interval between consecutive heartbeats (R-R intervals) reflecting overall heart rate), SDNN (standard deviation of R-R intervals, indicating overall HRV and autonomic balance), RMSSD (measures short-term HRV and is sensitive to parasympathetic activity). The frequency-domain parameters include LF/HFratio (represent the sympathetic (LF) and parasympathetic (HF) balance). Repeated measures ANOVA was performed along variables, with the significance level set at p<0.05.
RESULTS:
SDNN showed a significant difference between groups over time (p=0.008), while other parameters did not. Notably, HRV and HRrest exhibited a positive trend, suggesting improved autonomic nervous function as a result of exercise
CONCLUSION:
Exercise program seems to improve cardiovascular autonomic function in adults with TDM2. The SDNN, considered the "gold standard" for a strong prognostic marker for heart disease [3]. In the EP group, SDNN increased compared to the Control group, suggesting that physical exercise has the potential to prevent -or at least delay- the onset of autonomic complications in T2DM.
References
1 Cannata F, Vadalà G, Russo F, Papalia R, Napoli N, Pozzilli P. Beneficial Effects of Physical Activity in Diabetic Patients. J Funct Morphol Kinesiol. 2020 Sep 4;5(3):70. doi: 10.3390/jfmk5030070. PMID: 33467285; PMCID: PMC7739324
2 Vinutha, H. T.; Raghavendra, B. R.; Manjunath, N. K.. Effect of integrated approach of yoga therapy on autonomic functions in patients with type 2 diabetes. Indian Journal of Endocrinology and Metabolism 19(5):p 653-657, Sep–Oct 2015. | DOI: 10.4103/2230-8210.163194
3 Shaffer F, Ginsberg JP. An Overview of Heart Rate Variability Metrics and Norms. Front Public Health. 2017 Sep 28;5:258. doi: 10.3389/fpubh.2017.00258. PMID: 29034226; PMCID: PMC5624990.