title: Impact of disease control and co-existing risk factors on heart rate variability in Gujarati type 2 diabetics: An observational study.
abstract: BACKGROUND
  Type 2 diabetes mellitus (T2DM) is a proven threat of cardiac dysautonomia with paucity of studies from India. Poor disease control makes it further worse with co-existence of hypertension in majority. Heart rate variability (HRV) is a validated noninvasive tool to assess cardiac autonomic status.
  
  
  OBJECTIVE
  We studied HRV parameters of type 2 diabetics looking for effects of disease control and other co-existing risk factors.
  
  
  METHODS
  Ninety-eight hypertensive and forty normotensive under-treatment, Gujarati type 2 diabetics were evaluated for disease control and risk stratification. Five minutes resting, HRV was measured by Variowin HR, software-based instrument, using standard protocols to record time domain, frequency domain, and Poincare plot HRV parameters. They were compared between subgroups for the difference withP< 0.05 defining statistical significance.
  
  
  RESULTS
  All HRV parameters were reduced in type 2 diabetics, having mean age 56 years, mean duration 6 years with poor glycemic but comparatively better pressure control. HRV parameters were significantly not different in good compared to poor glycemics or in subjects with optimum pressure control than those without it. Results did not differ significantly, by the presence of individual cardiovascular risk factor in diabetics except resting heart rate.
  
  
  CONCLUSIONS
  Our findings of HRV suggest that type 2 diabetics with poor glycemic control do not have a significant difference of cardiac dysautonomia by pressure control, glycemic control, and absence of risk cardiovascular factor. It suggests diabetes as a major cause for cardiac dysautonomia, residual risk despite treatment and need for HRV screening, strict glycemic control, and further studies.
authors.affiliation: Department of Physiology, Government Medical College, Bhavnagar, Gujarat, India.
authors.forename: Jayesh Dalpatbhai
authors.initials: JD
authors.lastname: Solanki
authors.affiliation: Student, PDU Medical College, Rajkot, Gujarat, India.
authors.forename: Sanket D
authors.initials: SD
authors.lastname: Basida
authors.affiliation: Department of Physiology, Government Medical College, Bhavnagar, Gujarat, India.
authors.forename: Hemant B
authors.initials: HB
authors.lastname: Mehta
authors.affiliation: Department of Medicine, Government Medical College, Bhavnagar, Gujarat, India.
authors.forename: Sunil J
authors.initials: SJ
authors.lastname: Panjwani
authors.affiliation: Department of Physiology, Government Medical College, Bhavnagar, Gujarat, India.
authors.forename: Bhakti P
authors.initials: BP
authors.lastname: Gadhavi
authors.affiliation: Student, Government Medical College, Bhavnagar, Gujarat, India.
authors.forename: Pathik
authors.initials: P
authors.lastname: Patel
keywords: Dysautonomia; heart rate variability; hypertension; normotensive; type 2 diabetes