Clinical Autonomic Research

, Volume 21, Issue 1, pp 29–35 | Cite as

Inspiratory muscle weakness is associated with autonomic cardiovascular dysfunction in patients with type 2 diabetes mellitus

  • Diogo Machado Kaminski
  • Beatriz D’Agord Schaan
  • Antônio Marcos Vargas da Silva
  • Pedro Paulo Soares
  • Rodrigo Della Méa Plentz
  • Pedro Dall’AgoEmail author
Research Article



Diabetic autonomic neuropathy is a complication of diabetes mellitus (DM) that can cause cardiovascular and respiratory abnormalities. The association between respiratory muscle weakness and autonomic cardiovascular neuropathy has not yet been studied. The aims of the present study were to assess respiratory muscle strength, pulmonary function, and heart rate (HR) variability in diabetic patients with and without diabetic autonomic neuropathy.

Materials and methods

Twenty-four patients with type 2 DM were divided into two groups: those without diabetic autonomic neuropathy (C group, n = 12); and those with diabetic autonomic neuropathy (DAN group, n = 12). We evaluated pulmonary function, maximum static inspiratory pressure (PImax), maximum static expiratory pressure (PEmax), and HR variability.


The results of the pulmonary function tests were similar in both the groups. PImax was lower in the DAN group (80 ± 24 vs. 102 ± 24 cmH2O, p = 0.03), but PEmax was similar in both the groups. RR intervals (878 ± 122 vs. 743 ± 88 ms; p < 0.01), standard deviation of RR intervals (28 ± 11 vs. 14 ± 4 ms; p < 0.01) and squared root of the sum of successive differences of squared RR intervals (15 ± 6 vs. 8 ± 5 ms; p < 0.01) were higher in the C group. In the DAN group, resting HR was higher (82 ± 10 vs. 69 ± 9 bpm; p = 0.01) than in the C group. There was a positive correlation between PImax and RR intervals (r = 0.452, p = 0.02) and a negative correlation between PImax and resting HR (r = −0.482, p = 0.01), and PImax and DM duration (r = −0.463, p = 0.02).


Patients with type 2 DM and autonomic neuropathy showed reduced respiratory muscle strength and less HR variability. Respiratory muscle weakness may be associated with autonomic dysfunction in these patients.


Diabetes mellitus type 2 Diabetic neuropathies Respiratory muscle weakness Heart rate variability 


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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Diogo Machado Kaminski
    • 1
  • Beatriz D’Agord Schaan
    • 1
    • 2
  • Antônio Marcos Vargas da Silva
    • 3
  • Pedro Paulo Soares
    • 4
  • Rodrigo Della Méa Plentz
    • 1
    • 5
  • Pedro Dall’Ago
    • 5
    Email author
  1. 1.Graduate Program in Health Sciences/Cardiology, Heart InstituteFundação Universitária de Cardiologia do Rio Grande do Sul (IC/FUC)Porto AlegreBrazil
  2. 2.Division of Endocrinology, Department of Internal Medicine, Hospital de Clínicas de Porto AlegreUniversidade Federal do Rio Grande do Sul (UFRGS)Porto AlegreBrazil
  3. 3.Department of Physical Therapy and RehabilitationUniversidade Federal de Santa MariaSanta MariaBrazil
  4. 4.Universidade Federal Fluminense (UFF)NiteróiBrazil
  5. 5.Department of Physical TherapyUniversidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA)Porto AlegreBrazil

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