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June 7, 2026Diabetes

Youth-onset T2D is linked to higher HR and lower SDNN during exercise recovery versus obese controls.

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Why the study?

Youth-onset type 2 diabetes is characterized by early complications including cardiac autonomic neuropathy, and reduced heart rate variability is an early marker of autonomic dysfunction.

Does youth-onset type 2 diabetes reduce heart rate variability and autonomic recovery during submaximal exercise compared to obesity alone?

Population

19 youth-onset type 2 diabetes patients and 6 controls with obesity

Comparison

Youth-onset type 2 diabetes vs controls with obesity

Design

Interim analysis of a prospective study

Follow-up

24-h

Key result

Youth-onset type 2 diabetes was associated with persistently higher heart rate and lower SDNN during exercise recovery compared to controls with obesity (P<0.05).

Authors

IKILA N. KACKERMGMADILYN M. GAYDOSNSNATHAN GRANT SALA

Discussion

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Overview

May signal early autonomic impairment in youth-onset type 2 diabetes; leaves open prognostic value and intervention effects.

Key Points

  • This study aims to assess autonomic function in youth-onset type 2 diabetes versus controls with obesity by comparing heart rate variability.
  • 19 youth-onset type 2 diabetes and 6 obesity controls participated in a prospective study.
  • Participants wore monitors to assess heart rate and HRV during a submaximal exercise test.
  • Comparative analyses were performed using Welch’s t-tests, Fisher’s exact tests, and two-way ANOVA.
  • No significant differences in 24-h heart rate variability were observed (all P>0.05).
  • Youth-onset type 2 diabetes showed elevated heart rate and reduced SDNN during recovery (P<0.05).
  • Significant group-by-time interactions indicated impaired post-exercise autonomic recovery in youth-onset type 2 diabetes.

Study Design

Type

Observational (n=25)

Structured PICO

Does youth-onset type 2 diabetes reduce heart rate variability and autonomic recovery during submaximal exercise compared to obesity alone?

P
Population
25 young adults (mean age 20 years, 52% female) with youth-onset type 2 diabetes or obesity (controls) assessed for heart rate variability.
E
Exposure
Youth-onset type 2 diabetes (Y-T2D)
C
Comparator
Controls with obesity
O
Outcome
Heart rate (HR) and SDNN (measure of overall HRV) over 24-h and for 1-minute intervals before, during, and after an Astrand-Rhyming submaximal exercise testsurrogate

Main Result

p-value: p=<0.05

Youth-onset type 2 diabetes is associated with reduced post-exercise autonomic recovery compared to obesity alone, indicating early cardiac autonomic dysfunction.

Cite This Study

KACKER et al. (2026) conducted an observational in Youth-onset type 2 diabetes (n=25). Youth-onset type 2 diabetes vs. Controls with obesity was evaluated on Heart rate and SDNN over 24-h and during/after submaximal exercise (p=<0.05). Youth-onset type 2 diabetes was associated with persistently higher heart rate and lower SDNN during exercise recovery compared to controls with obesity (P<0.05).

synapsesocial.com/papers/6a250b0e7def13d035e1b0achttps://doi.org/10.2337/db26-2939-lb
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Heart Rate Variability and Cardiac Autonomic Dysfunction: Prevalence, Risk Factors, and Relationship to Arterial Stiffness in the Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) Study2019 · 92 citations
  2. 2Reduced Heart Rate Variability Among Youth With Type 1 Diabetes2012 · 99 citations
  3. 3High Fasting Glycemia Predicts Impairment of Cardiac Autonomic Control in Adults With Type 2 Diabetes: A Case-Control Study2021 · 10 citations
  4. 4Hyperglycemia: A determinant of cardiac autonomic dysfunction in youth with obesity across the spectrum of glycemic regulation2023 · 10 citations
  5. 5Physical Exercise Before Long‐Term Electrocardiogram May Enhance the Assessment of Nocturnal Heart Rate Variability in Young Individuals With Type 1 Diabetes Melltius2025