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Cited by 20Heart Rate Variability and Autonomic ControlDiabetes, Cardiovascular Risks, and LipoproteinsDiabetes Management and Research

Effect of glycemic control and disease duration on cardiac autonomic function and oxidative stress in type 2 diabetes mellitus

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Verma, Shalini, Alam, Rizwan, Ahmad, Irshad, Singla, Deepika, Ali, Kamran, Hussain, Mohammed E.·2018·Journal of Diabetes & Metabolic Disorders
DOI 10.1007/s40200-018-0354-6PMC PMC6405381
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Abstract

Purpose Cardiac autonomic neuropathy (CAN) is a commonly overlooked complication of type 2 diabetes mellitus (T2DM), with a complex pathogenesis involving hyperglycemia-induced oxidative stress which results in neuronal ischemia and cellular death. The level of hyperglycemia as well as disease duration might be significant determinants of the prognosis of T2DM, but limited studies have explored their relationship with these diabetic complications. Therefore, the purpose of this study was to examine the effect of glycemic control and disease duration on cardiac autonomic function and oxidative stress in patients with T2DM.Methods 60 T2DM patients along with 63 healthy controls were recruited for the study. Diabetic patients were further classified based on glycemic control (HbA1c levels <8% vs. ≥8%) and disease duration (<5 vs. 5-10 vs. >10 years). All participants were assessed for cardiac autonomic function (HRR: heart rate recovery; HRV: heart rate variability), levels of antioxidant enzymes (CAT: catalase; SOD: superoxide dismutase), serum nitric oxide (NO) and other cardiometabolic risk factors (resting blood pressure, glycemic and lipid profile).Results T2DM patients showed a significant reduction in HRR, HRV, CAT, SOD and an increase in LFnu, LF: HF ratio and NO. These impairments were significantly greater for the group with poor glycemic control (p < 0.05). However, no difference for these parameters was observed with respect to different disease durations.Conclusion Cardiac autonomic regulation and endogenous antioxidant defense were compromised and levels of nitric oxide found to be raised in patients with Type 2 diabetes. These findings were more pronounced in subjects with poor glycemic control.

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  • Both diabetes mellitus and prediabetes are independently associated with lower heart rate variability (HRV).

    “Both DM and prediabetes are independently associated with lower heart rate variability (HRV), which suggests that cardiac autonomic dysfunction may be characteristic of prediabetes2–5.”

    From Sleep and temperature data from wearable devices support noninvasive detection of diabetes mellitus in a large-scale, retrospective analysis (2026) · cites this paper as [5]

    The “Effect of DM” section (page unavailable) reports reduced HRV measures in people with type 2 diabetes compared with non-diabetic controls. The cited paper does not report a separate prediabetes group or establish an independent association between prediabetes and lower HRV. (LLM, conf=0.88)

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  • Prior work chiefly assessed statistical aggregation functions of wearable data streams (primary features), which are nonspecific to the effects of DM within data streams that are constantly fluctuating in natural settings.

    “Third, prior work chiefly assessed statistical aggregation functions of wearable data streams (primary features)5,26–32, which are nonspecific to the effects of DM within data streams that are constantly fluctuating in natural settings.”

    From Sleep and temperature data from wearable devices support noninvasive detection of diabetes mellitus in a large-scale, retrospective analysis (2026) · cites this paper as [5]

    The Cardiac autonomic function section (page unavailable) describes time- and frequency-domain measures calculated from a five-minute ECG recording, supporting the use of summary features. But the recording was made under controlled conditions, not from wearable streams in natural settings. The paper does not assess whether those features are nonspecific to diabetes or establish what prior work chiefly assessed. (LLM, conf=0.84)

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  • Prior work was generated from small cohorts (the largest cohort of 70 individuals), raising questions of the generalizability of their findings.

    “Second, prior work was generated from small cohorts (the largest cohort of 70 individuals), that raise questions of the generalizability of their findings5,22–32.”

    From Sleep and temperature data from wearable devices support noninvasive detection of diabetes mellitus in a large-scale, retrospective analysis (2026) · cites this paper as [5]

    The Limitations and future perspective section says the study’s small sample size limits generalizability. But the Sample size section reports 123 participants—60 patients and 63 controls—so this paper does not support describing 70 individuals as the largest cohort across the cited prior work. (LLM, conf=0.88)

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  • Prior work typically uses less than a day of input.

    “First, where prior work typically uses less than a day of input5,22–32, we assess the impact of longitudinal input windows ranging up to multiple weeks and demonstrate improved sensitivity with longer windows (AUROC increases by 0.15 from 1-night to 21-night models, in balanced and imbalanced cohorts).”

    From Sleep and temperature data from wearable devices support noninvasive detection of diabetes mellitus in a large-scale, retrospective analysis (2026) · cites this paper as [5]

  • Features of heart rate, heart rate variability, movement, and electrodermal activity extracted from wearable data have been applied to detect hypoglycemic events in cohorts ranging from 1 to 36 individuals.

    “Features of HR, HRV, movement, and electrodermal activity (EDA; a measure of perspiration) extracted from wearable data have been applied to detect hypoglycemic events in cohorts ranging from 1 to 36 individuals5,26–28.”

    From Sleep and temperature data from wearable devices support noninvasive detection of diabetes mellitus in a large-scale, retrospective analysis (2026) · cites this paper as [5]

    The Cardiac autonomic function section (page unavailable) describes HR and HRV measurements from ECG during an exercise test, not features extracted from wearable data to detect hypoglycemic events. Searches for wearable hypoglycemia detection and electrodermal activity found no passage addressing that application or cohorts of 1–36 individuals. (LLM, conf=0.75)

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Research works printed but not linked: 1

  1. Dincer Y, Akcay T, Alademir Z, Ilkova H. Effect of oxidative stress on glutathione pathway in RBCs from patients with IDDM. Metabolism. 2002;51:1360-2.

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Related

Authors
Verma, S., Alam, R., Ahmad, I., Singla, D., Ali, K., & Hussain, M. E.
Affiliations
Jamia Millia Islamia (IN)
Corresponding author
Verma, Shalini
ORCID
Venue
Journal of Diabetes & Metabolic Disorders
Publisher
Springer Science and Business Media LLC
Published
2018-09-08
Volume
17
Issue
2
Pages
149-158
ISSN
2251-6581 (ISSN-L)
DOI
10.1007/s40200-018-0354-6
PMC
PMC6405381
OpenAlex
W2889577322
Cited by
20
References
54
Citations by year
2026: 4 · 2025: 1 · 2024: 2 · 2022: 5 · 2021: 3 · 2020: 3 · 2019: 2
FWCI
1.51
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Diabetes & Metabolic Disorders (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Keywords
type 2 diabetes, cardiac autonomic neuropathy, glycemic control, disease duration, oxidative stress, heart rate recovery, heart rate variability, antioxidant enzymes, catalase, superoxide dismutase, nitric oxide, HbA1c

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