title: Application of Heart Rate Variability in Diagnosis and Prognosis of Individuals with Diabetes Mellitus: Systematic Review.
abstract: BACKGROUND
  The use of heart rate variability as a tool capable of discriminating individuals with diabetes mellitus is still little explored, as its use has been limited to comparing those with and without the disease. Thus, the purpose of this study was to verify the use of heart rate variability as a tool for diagnostic and prognostic evaluation in person with diabetes and to identify whether there are cutoff points generated from the use of this tool in these individuals.
  
  
  METHODS
  A search was conducted in the electronic databases MEDLINE, Cochrane Library, Web of Science, EMBASE, and LILACS starting from the oldest records until January 2015, by means of descriptors related to the target condition, evaluated tool, and evaluation method. All the studies were evaluated for methodological quality using the QUADAS-2 instrument.
  
  
  RESULTS
  Eight studies were selected. In general, the studies showed that the heart rate variability is useful to discriminate cardiac autonomic neuropathy in person with diabetes, and the sample entropy, SD1/SD2 indices, SDANN, HF, and slope of TFC have better discriminatory power to detect autonomic dysfunction, with sensitivity and specificity values ranging from 72% to 100% and 71% to 97%, respectively.
  
  
  CONCLUSIONS
  Although there are methodological differences in indices used, in general, this tool demonstrated good sensitivity and specificity and can be used as an additional and/or complementary tool to the conventional autonomic tests, in order to obtain safer and more effective diagnostic, collaborating for better risk stratification conditions of these patients.
authors.affiliation: Physical Therapy, Faculty of Science and Technology, Paulista State University, Presidente Prudente, São Paulo, Brazil.
authors.forename: Anne Kastelianne
authors.initials: AK
authors.lastname: França da Silva
authors.affiliation: Health Sciences, Faculty of Medicine in ABC, Santo André, São Paulo, Brazil.
authors.forename: Marianne
authors.initials: M
authors.lastname: Penachini da Costa de Rezende Barbosa
authors.affiliation: Department of Physical Therapy, Faculty of Science and Technology, Paulista State University, Presidente Prudente, São Paulo, Brazil.
authors.forename: Franciele
authors.initials: F
authors.lastname: Marques Vanderlei
authors.affiliation: Department of Physical Education, Faculty of Science and Technology, Paulista State University, Presidente Prudente, São Paulo, Brazil.
authors.forename: Diego Giuliano
authors.initials: DG
authors.lastname: Destro Christofaro
authors.affiliation: Department of Physical Therapy, Faculty of Science and Technology, Paulista State University, Presidente Prudente, São Paulo, Brazil.
authors.forename: Luiz Carlos
authors.initials: LC
authors.lastname: Marques Vanderlei
mesh_terms: D001341:Autonomic Nervous System / Q000503:physiopathology; D003920:Diabetes Mellitus / Q000175:diagnosis* / Q000503:physiopathology*; D000070276:Heart Rate Determination; D006801:Humans; D011379:Prognosis; D012680:Sensitivity and Specificity
keywords: autonomic nervous system; diabetes mellitus; electrocardiography; heart rate; sensitivity and specificity