[Show abstract][Hide abstract] ABSTRACT: Diabetic cardiac neuropathy, which is characterized by reduced heart rate variability (HRV), frequently coexists with peripheral neuropathy. Gabapentin has been used for the treatment of diabetic neuropathy. We aimed to evaluate the possible effect of gabapentin treatment on autonomic function in patients with type 2 diabetes via HRV.
Thirty patients with type 2 diabetes mellitus and peripheral neuropathy and 28 age- and sex-matched healthy controls were consecutively registered. Each patient underwent HRV measurements, and diabetic patients were administered gabapentin. After 3 months of gabapentin therapy, HRV parameters were measured again.
Baseline HRV parameters were blunted in patients with diabetes mellitus according to the controls [standard deviation of all NN intervals (SDNN, ms): 106.3+/-29.9 vs. 148.8+/-36.5, P=.001; power spectrum of the high-frequency band (HF, ms(2)): 133.6+/-98.3 to 231.4+/-197.6, P=.02; power spectrum of the low-frequency band (LF, ms(2)): 341.8+/-247.8 to 511.5+/-409.4, P=.048; LF/HF ratio: 3.3+/-2.4 to 2.6+/-1.5, P=.33]. After 3 months of treatment with gabapentin, some HRV parameters showed some improvement. SDNN (106.2+/-29.8 to 119.4 +/- 25, P=.016) and HF (133.6+/-98.3 to 167.6+/-118.3, P=.021) increased significantly. LF/HF ratio decreased (from 3.3+/-2.4 to 2.3+/-1.9, P=.039) and LF remained unchanged (341.8+/-247.8 to 352.3+/-228.9, P=.88).
Therapeutic doses of gabapentin not only alleviate neuropathic symptoms but also improve cardiac autonomic function in diabetic patients with peripheral neuropathy.
No preview · Article · Mar 2009 · Journal of diabetes and its complications
[Show abstract][Hide abstract] ABSTRACT: Heart rate recovery at 1min (HRR1) is a strong predictor of all-cause mortality. The effects of statins on the autonomic nervous system may account for their beneficial effects in survival. Our aim was to determine if statin therapy improves heart rate recovery in hypercholesterolemic patients with type 2 diabetes mellitus. Thirty type 2 diabetic patients without known coronary artery disease and low density lipoprotein cholesterol>100mg/dl and 30 age and sex matched non-diabetic controls were included in a prospective study. Patients with diabetes were treated with simvastatin 40mg/day for 1 year. No lipid-lowering therapy was administered to the control group. Exercise testing with 2min cool-down period was performed at baseline, 6, 12 weeks and at 1 year. The diabetics had significantly lower HRR1 compared with non-diabetics at baseline (19.2+/-5.4bpm versus 24.2+/-4bpm, p<0.0001). Simvastatin therapy significantly improved HRR1 after 12 weeks compared to baseline (19.2+/-5.4bpm versus 24+/-5bpm, p<0.0001) and this improvement remained significant at 1 year (26+/-4.4bpm, p<0.0001 compared to baseline). HRR1 did not change in the control group (p=0.39 by ANOVA). This study demonstrates that treatment with simvastatin might improve the attenuated heart rate recovery of diabetic subjects. In patients with diabetes, the mortality benefit provided by statins might involve their effects on the autonomic nervous system.
No preview · Article · Jan 2007 · Pharmacological Research