Key result
Progression along the glycaemic spectrum from first-degree relatives of diabetes to overt diabetes was associated with increasing cardiac autonomic dysfunction compared to normoglycemic controls.
Why the study?
Reports on autonomic function in first-degree relatives of diabetics and prediabetes have been controversial, prompting comparison of cardiac autonomic function across the complete glycaemic spectrum in an Indian population.
Does cardiac autonomic function differ across the glycaemic spectrum from healthy controls to diabetes in an Indian population?
Cross-Sectional
Does cardiac autonomic function differ across the glycaemic spectrum from healthy controls to diabetes in an Indian population?
Cardiac autonomic dysfunction is detectable early in the glycaemic spectrum, even in normoglycemic first-degree relatives of diabetic patients, and worsens with progression to diabetes.
Answers are grounded in this paper and cite their sources.
Extends autonomic assessment across the glycaemic spectrum in Indians; leaves open clinical utility pending prospective validation.
OBJECTIVES: Autonomic imbalance is attributed as key mechanism altering metabolic regulation in diabetes mellitus. In view of controversial reports on autonomic function in FDRD and prediabetes, we aimed to assess and compare the autonomic function across the complete glycaemic spectrum in Indian population. METHODS: Short term heart rate variability and cardiac autonomic reactivity tests - blood pressure and heart rate response to orthostatic tolerance and deep breathing exercise, and diastolic response to isometric handgrip exercise were recorded in normoglycemic apparently healthy individual, normoglycemic first degree relatives of diabetes, prediabetes and diabetes individuals. RESULTS: Resting heart rate is significantly higher in FDRD, prediabetes and diabetes as compared to controls (control < FDRD = prediabetes = diabetes). Total power, LF power (control < FDRD < prediabetes = diabetes) and HF power (control < FDRD < prediabetes < diabetes) decreased along the glycaemic spectrum. Time-domain variables of HRV (SDNN, RMSSD, NN50, pNN50) were reduced as we move along the glycaemic spectrum (control < FDRD < prediabetes = diabetes). Cardiac autonomic function reactivity parameters such as 30:15 ratio and E:I ratio are decreased in prediabetes and diabetes group as compared to control and FDRD group (control = FDRD < prediabetes = diabetes). Diastolic response to isometric hand grip increases along the glycaemic spectrum starting from FDRD (control < FDRD < prediabetes = diabetes). CONCLUSIONS: Autonomic dysfunction is observed even in first degree relatives of diabetes. Autonomic dysfunction increases as we move along the glycaemic spectrum (control < FDRD < prediabetes < diabetes).
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Rajendran et al. (2022) conducted a cross-sectional in Diabetes mellitus and prediabetes. Glycaemic impairment (FDRD, prediabetes, diabetes) vs. Normoglycemic apparently healthy individuals was evaluated on Cardiac autonomic function (short term heart rate variability and cardiac autonomic reactivity tests). Progression along the glycaemic spectrum from first-degree relatives of diabetes to overt diabetes was associated with increasing cardiac autonomic dysfunction compared to normoglycemic controls.
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