Increase in the Heart Rate Variability with Deep Breathing in Diabetic Patients after 12-Month Exercise Training

Department of Physiology, Kasturba Medical College, Mangalore, India.
The Tohoku Journal of Experimental Medicine (Impact Factor: 1.35). 02/2010; 220(2):107-13. DOI: 10.1620/tjem.220.107
Source: PubMed


Autonomic neuropathy in diabetes leads to impaired regulation of blood pressure and heart rate variability (HRV), which is due to a shift in cardiac autonomic balance towards sympathetic dominance. Lower HRV has been considered a predictor of cardiac mortality and morbidity. Deep breathing test is a simple method to measure HRV and it provides a sensitive measure of cardiac autonomic function. The effect of long-term physical activity on HRV in type-2 diabetes mellitus is inconclusive. We aimed to evaluate the effects of regular physical exercise on HRV with deep breathing in type 2 diabetes (n = 105). Thirty normotensive diabetic patients and 25 hypertensive diabetic patients underwent physical exercise program for 12 months, and the other 50 patients (22 normotensive and 28 hypertensive diabetic patients) were considered the non-exercised group. Electrocardiogram was recorded during deep breathing and HRV was measured. Regular exercise significantly increased HRV in diabetic patients with and without hypertension. The degree of the increase in HRV was greater in hypertensive diabetic patients (p < 0.01) than in normotensive diabetic patients (p < 0.05). After exercise, glycosylated hemoglobin levels were decreased in both groups of diabetic patients. Moreover, the hypertensive diabetic patients showed a decrease (p < 0.05) in blood pressure after regular exercise. Thus, regular exercise training increases HRV, suggesting that there is a shift in the cardiac sympathovagal balance in favor of parasympathetic dominance in diabetic patients. Long-term physical training may be an effective means to reverse the autonomic dysregulation seen in type 2 diabetes.

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    • "These variations in heart rate can be seen by a frequency analysis of the EKG. As diabetes progresses, heart rate variability is reduced such that finally, sympathetic damage and parasympathetic damage have occurred to the extent that there is very little variation in heart rate with normal respiration or even a change in body position [37] [57] [61]. "
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    ABSTRACT: Type 2 diabetes (T2D) and ageing have well documented effects on every organ in the body. In T2D the autonomic nervous system is impaired due to damage to neurons, sensory receptors, synapses and the blood vessels. This paper will concentrate on how autonomic impairment alters normal daily activities. Impairments include the response of the blood vessels to heat, sweating, heat transfer, whole body heating, orthostatic intolerance, balance, and gait. Because diabetes is more prevalent in older individuals, the effects of ageing will be examined. Beginning with endothelial dysfunction, blood vessels have impairment in their ability to vasodilate. With this and synaptic damage, the autonomic nervous system cannot compensate for effectors such as pressure on and heating of the skin. This and reduced ability of the heart to respond to stress, reduces autonomic orthostatic compensation. Diminished sweating causes the skin and core temperature to be high during whole body heating. Impaired orthostatic tolerance, impaired vision and vestibular sensing, causes poor balance and impaired gait. Overall, people with T2D must be made aware and counseled relative to the potential consequence of these impairments.
    Full-text · Article · Apr 2012 · Experimental Diabetes Research
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    • "In addition, exercise has been shown to increase insulin sensitivity. Skeletal muscles are the major site for metabolic fuel consumption in the resting state, and increased muscle activity during vigorous aerobic exercise greatly increases fuel requirements.7 Studies in animal models have indicated a general improvement in the ability of diabetic animals to conduct and sustain chronic physical exercise, especially regarding the metabolism of energy substrates and secreting hormones.8 "
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    ABSTRACT: We investigated the effects of chronic (eight weeks) low-to moderate-intensity swimming training on thermal pain sensitivity in streptozotocin-induced diabetic female rats. Female Wistar rats (n = 51) were divided into the following groups: trained streptozotocin-induced diabetic rats [hyperglycemic trained (HT)], sedentary streptozotocin-induced diabetic rats [hyperglycemic sedentary (HS)], normoglycemic trained rats (NT) and normoglycemic sedentary rats (NS). Diabetes was induced by a single injection of streptozotocin (50 mg/kg, i.p.). One day after the last exercise protocol (60 min/day, five days/week for eight weeks) in the trained groups or after water stress exposure (ten min/twice a week) in the sedentary groups, the rats were subjected to a hot plate test. After eight weeks of swimming training, streptozotocin-induced diabetic rats presented a significantly lower body mass (trained: 219.5 ± 29 g, sedentary: 217.8 ± 23 g) compared with the normoglycemic groups (trained: 271 ± 24 g, sedentary: 275.7 ± 32 g). Interestingly, we did not find differences in blood glucose levels (mg/dl) between the trained and sedentary groups of the hyperglycemic or normoglycemic rats (HT: 360.2 ± 66.6, HS: 391.7 ± 66.7, NT: 83.8 ± 14.0, NS: 77.5 ± 10.1). In the hot plate test, the rats from the HT group presented a significantly lower latency than the other rats (HT: 11.7 ± 7.38 s, HS: 7.02 ± 7.38 s, NT: 21.21 ± 7.64 s, NS: 22.82 ± 7.82 s). Low-to-moderate swimming training for a long duration reduces thermal hyperalgesia during a hot plate test in streptozotocin-induced diabetic female rats.
    Full-text · Article · Sep 2011 · Clinics (São Paulo, Brazil)
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