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Cardiac Autonomic Modulation in Response to Three Types of Exercise in Patients with Type 2 Diabetic Neuropathy

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Abstract

Purpose

Physical exercise is necessary in the handling DM, but it is not distinct which kind of physical exercise can improve cardiac autonomic modulation in T2DM. The purpose of this study was to compare the effects of three different modalities of exercise (aerobic, resistant, and combined) on cardiac autonomic modulation as measured by HRV in patients with type 2 diabetic neuropathy.

Methods

The participants were 45 men (age: 55.24 ± 8.11 years, weight: 89.5 ± 13.4 kg, height: 171.85 ± 6.98 cm, duration of diabetes: 12.51 ± 6.46 years) with type 2 diabetic neuropathy who were clinically free from signs and symptoms of cardiovascular disease. Participants were randomly assigned to one of four groups: aerobic-training (n = 11), dynamic resistant-training (n = 11), Combined-training (n = 11), or a non-exercise control group (n = 12). The exercise groups performed aerobic and resistant exercise for 25–45 min per day, 3–5 times per week for 12 weeks. Anthropometrics, biochemical markers (FBS, HbA1c, Lipid Profile, and Insulin), and heart rate variability in the exercise laboratory and under ambulatory conditions by 3-channel ECG digital Holter recorder were examined.

Results

All time and frequency-domain HRV parameters (except LF power) were significantly improved in the exercise groups, compared with the control group (p < 0.05). SDNN, rMSSD, and HF power were boosted, LF power was not different, and the LF/HF ratio decreased after versus before exercise training, independent of exercise modality. HbA1c in aerobic and resistant-training groups, and insulin and LDL in the resistant-training group were decreased after exercise training (p < 0.05).

Conclusions

Exercise training, independent of modality, in patients with type 2 diabetic neuropathy who were clinically free of the cardiovascular disease cause to significant progress in cardiovascular autonomic function assessed by HRV via enhancing cardio-vagal and reducing cardio-sympathetic tone.

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Acknowledgements

We are grateful to the University of Mohaghegh Ardabili and the University of Tabriz, for their laboratory equipment, exercise facilities, and technical support. We thank the patients and trainers for their participation in this study.

Funding

The funds for this study were provided three quarters by Dr. Elaheh Piralaiyand a quarter by University of Mohaghegh Ardabili. These funds were used to purchase the necessary supplies.

Author information

Author notes

  1. Elaheh Piralaiy and Mostafa Khani contributed equally to this paper

Authors and Affiliations

  1. Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, University of Tabriz, 29 Bahman Blvd, 5166616471, Tabriz, Iran

    Elaheh Piralaiy, Saeed Dabbagh Nikookheslat & Mostafa Khani

  2. Department of Physical Education and Sport Sciences, Faculty of Education and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran

    Marefat Siahkuhian

  3. Department of Kinesiology, University of Connecticut, Mansfield, CT, USA

    Linda S. Pescatello

  4. Department of Physical Education and Sport Sciences, Ahar Branch, Islamic Azad University, Ahar, Iran

    Mahboub Sheikhalizadeh

Authors
  1. Elaheh Piralaiy
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Contributions

EP, MS, SDN, and LSP were involved in study design. EP, MS, MK, and SDN were involved in data collection. MS and SDN were responsible for cleaning and running statistical analysis. EP, MS, SDN, LSP, MS and MK were responsible for interpretation of results. EP was responsible for writing the first draft. All authors contributed equally to editing draft versions and accept full responsibility for the content of the manuscript.

Corresponding authors

Correspondence to Elaheh Piralaiy or Mostafa Khani.

Ethics declarations

Ethics approval

This study was approved by the research ethics committee (REC) of Tabriz University of Medical Sciences (TUOMS) (IR.TBZMED.REC.1395.754).

Consent to participate

Written informed consent was obtained from all the participants after necessary explanations at the beginning of the study.

Consent for publication

All the participants gave their consent for the publication of identifiable details, which can include photograph(s) and/or videos and/or case history and/or details within the text (“Material”) to be published in the Journal of diabetes and metabolic disorders and the present article.

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There are no competing conflicts of interest to declare.

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Piralaiy, E., Siahkuhian, M., Nikookheslat, S.D. et al. Cardiac Autonomic Modulation in Response to Three Types of Exercise in Patients with Type 2 Diabetic Neuropathy. J Diabetes Metab Disord 20, 1469–1478 (2021). https://doi.org/10.1007/s40200-021-00889-x

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