The impact of glycemic control on heart rate variability in patients with type 2 Diabetes Mellitus and the potential for prediction
Abstract
The objective was to ascertain whether glycemic control impacts heart rate variability in patients with type 2 diabetes and determine whether alterations in heart rate variability can be anticipated through continuous glucose monitoring data analysis. A total of 53 adult patients with type 2 diabetes (T2DM) and a glycosylated level (HbA1c) of ≤10% were examined. The study was based on the synchronous recording of heart rate variability and continuous glucose monitoring (CGM) before and six months after the modification of glucose-lowering therapy. Correlation, logistic regression, and receiver operating characteristic (ROC) analyses were employed. Following a six-month period, patients exhibited a notable reduction in HbA1c, time above range, time below range, glycemic variability, and a decline in the frequency of hypoglycemic episodes. The presence of hypoglycemia before the modification of glucose-lowering therapy was identified as a prognostic factor for predicting HRV improvement. The study’s findings suggest enhanced glycemic control is associated with increased absolute all-time and frequency domain characteristics of HRV. A mathematical model for HRV prediction based on CGM parameters for T2DM was developed, exhibiting a sensitivity of 60.0% and a specificity of 83.33%.