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Cited by 207Heart Rate Variability and Autonomic ControlCardiovascular and exercise physiologyPhysical Activity and Health

Exercise training improves baroreflex sensitivity in type 2 diabetes

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Loimaala, Antti, Huikuri, Heikki V., Kööbi, Tiit, Rinne, Marjo, Nenonen, Arja, Vuori, Ilkka·2003·Diabetes
DOI 10.2337/diabetes.52.7.1837
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Abstract

Type 2 diabetes is a strong risk factor for coronary heart disease and sudden cardiac death. It is associated with reduced baroreflex sensitivity (BRS) and heart rate variability (HRV), which are indicators of increased risk for mortality and morbidity in various patient populations. This study was designed to assess the effects of exercise training on BRS, HRV, and hemodynamics in patients with type 2 diabetes. Subjects (50 men, mean age 53.3 ± 5.1 years) with type 2 diabetes were randomized into either a control group, in which they received conventional treatment only, or an exercise group, in which they received conventional treatment together with heart rate−controlled endurance training twice a week and supervised muscle strength training twice a week for 12 months. Measurements taken at baseline and follow-up included Vo2max, standard time and frequency domain measures of HRV during 24-h recording, and BRS by the phenylephrine method. Cardiac index, systemic vascular resistance index, stroke index, and pulse wave velocity were measured by whole-body impedance cardiography. Significant improvements in Vo2max (exercise group: +2.3 ml · kg−1 · min−1; P < 0.005 vs. control group), muscle strength, and glycemic control (exercise group: HbA1c −0.9%; P < 0.001 vs. control group) were observed in the exercise group. BRS increased in the exercise group, from 6.8 to 8.6 ms/mmHg, and decreased in the control group, from 7.5 to 6.4 ms/mmHg (95% CI for the difference between 0.05 and 4.36 ms/mmHg; P < 0.05). No significant changes in the time or frequency domain measures of HRV or in systemic hemodynamics were observed. We concluded that exercise training improves BRS sensitivity in type 2 diabetes subjects in addition to increasing the exercise capacity and muscle strength and improving glucose control. These beneficial effects in reflectory autonomic regulation and glucose control caused by exercise may be associated with improved prognosis of type 2 diabetes patients.

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  • Moderate-intensity aerobic training can improve autonomic function in individuals with and without CV autonomic neuropathy (CAN); however, improvements may only be evident after an acute submaximal exercise.

    “Moderate-intensity aerobic training can improve autonomic function in individuals with and without CV autonomic neuropathy (CAN) ( 112 , 176 , 208 ); however, improvements may only be evident after an acute submaximal exercise ( 78 ).”

    From Exercise and Type 2 Diabetes (2010) · cites this paper as [176]

    The Methods describe aerobic walking or jogging at an intensity corresponding to 65–75% of maximal oxygen consumption, alongside strength training. The Discussion reports improved baroreflex sensitivity in participants with type 2 diabetes, supporting an improvement in one measure of autonomic function. But the Methods state that none had clinical neuropathy, and the paper does not establish improvement in people both with and without CAN. The acute submaximal-exercise qualification is attached to citation 78, not this source. Page numbers were not provided in our copy. (LLM, conf=0.87)

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Authors
Loimaala, A., Huikuri, H. V., Kööbi, T., Rinne, M., Nenonen, A., & Vuori, I.
Affiliations
  • South Karelia Central Hospital (FI)
  • Oulu University Hospital (FI)
  • Tampere University Hospital, Department of Clinical Physiology, Tampere, Finland
  • Urho Kaleva Kekkonen Institute (FI)
  • Tampere University Hospital (FI)
ORCID
Venue
Diabetes
Publisher
American Diabetes Association
Published
2003-07-01
Volume
52
Issue
7
Pages
1837-1842
ISSN
  • 0012-1797 (ISSN-L)
  • 1939-327X
DOI
10.2337/diabetes.52.7.1837
OpenAlex
W2140739356
Cited by
207
References
36
Citations by year
2026: 6 · 2025: 4 · 2024: 7 · 2023: 8 · 2022: 6 · 2021: 8 · 2020: 5 · 2019: 7 · 2018: 6 · 2017: 7 · 2016: 6 · 2015: 9 · 2014: 18 · 2013: 8 · 2012: 15
FWCI
4.39
Type
journal article
Language
en
Open access
Locations
  • Diabetes (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Tays
  • Pirkanmaan Rahasto
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
  • Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
  • Health Sciences › Medicine › Physiology › Physical Activity and Health
Keywords
type 2 diabetes, baroreflex sensitivity, exercise training, heart rate variability, endurance training, resistance training, autonomic regulation, glycemic control, VO2max, hemodynamics, pulse wave velocity, sudden cardiac death risk
MeSH terms
Blood Pressure, Diabetes Mellitus, Type 2, Diet, Diabetic, Heart Rate, Hemodynamics, Glycated Hemoglobin, Humans, Hypoglycemic Agents, Male, Middle Aged, Oxygen Consumption, Physical Fitness, Vascular Resistance, Exercise, Body Mass Index, Baroreflex

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