Association Between Heart Rate Variability Measures and Blood Glucose Levels: Implications for Noninvasive Glucose Monitoring for Diabetes

Rothberg, Leon J; Lees, Ty; Clifton‐Bligh, Roderick; Lal, Sara

doi:10.1089/dia.2016.0010

Cited by 44 publications

(26 citation statements)

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“…Previous report described delayed HRR and abnormal HRV in DM patients [2,19]. Reduced HRR reflected impaired vagal functional status after exercise [23].…”

Section: Discussionmentioning

confidence: 86%

“…Hypoglycemic therapy is the main approach for the prevention of organ complications in DM patients, and glycosylated hemoglobin (HbA1c) level is a common parameter measured in the clinical practice, which reflects the status of blood glucose levels in recent 3 months [18] and is also an important monitoring parameter of hypoglycemic therapy. Previous studies indicated that HRR or HRV parameters were significantly correlated with blood glucose level in DM patients [4,19]. However, reports on the association between HbA1c level and HRR or HRV parameters in DM patients are scanty.…”

Section: Introductionmentioning

confidence: 98%

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Impact of blood glucose control on sympathetic and vagus nerve functional status in patients with type 2 diabetes mellitus

et al. 2019

Acta Diabetol

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Aims Present study observed the impact of blood glucose control on sympathetic and vagus functional status in type 2 diabetes mellitus (DM) patients through observing the association between glycosylated hemoglobin (HbA1c) level and sympathetic and vagus functional status detected by heart rate recovery (HRR) and heart rate variability (HRV) assessments. Methods Consecutive hospitalized DM patients were divided into well glycemic control group (HbA1c < 7.0%, group WGC, n = 100) and poor glycemic control group (HbA1c ≥ 7.0%, group PGC, n = 100), 100 hospitalized patients without DM served as control group (group C). All subjects underwent blood biochemistry test, treadmill exercise testing and 24-h Holter monitoring. Results HRR and HRV parameters were significantly lower in group WGC and PGC than in group C. Standard deviation of NN intervals (SDNN), standard deviation of all 5-min average NN intervals (SDANN), very low frequency (VLF) values were significantly lower in group PGC than in group WGC. HbA1c level was negatively correlated with HRR1, SDNN, SDANN, VLF, low frequency and high frequency. Logistic regression analysis showed that lower SDNN, SDANN and VLF values were risk factors for high HbA1c levels in DM patients after adjusting for gender, age and beta-blocker use in the model 1, and for gender, age, beta-blocker use, coronary artery disease and hypertension in the model 2. Conclusions Present results indicate that sympathetic and vagal functional status are impaired independent of HbA1c level, while poor glycemic control is related to more significant neurocardiac dysfunction in DM patients.

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“…Previous report described delayed HRR and abnormal HRV in DM patients [2,19]. Reduced HRR reflected impaired vagal functional status after exercise [23].…”

Section: Discussionmentioning

confidence: 86%

Section: Introductionmentioning

confidence: 98%

Impact of blood glucose control on sympathetic and vagus nerve functional status in patients with type 2 diabetes mellitus

et al. 2019

Acta Diabetol

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“…Higher HRV is associated with greater capacity for emotion regulation (Appelhans & Luecken, ; Mather & Thayer, ), metacognitive awareness and mind reading (Lischke, Lemke, Neubert, Hamm, & Lotze, ; Meessen, Sütterlin, Gauggel, & Forkmann, ), empathy and alexithymia (Lischke et al ., ), and with greater performance on several cognitive tasks involving attention, working memory, and inhibitory control (Hansen, Johnsen, & Thayer, , ; Ottaviani et al ., ; Saus et al ., ). Relevantly, higher vagal tone has also been associated with better physical health: better glucose regulation, better HPA axis function, reduced inflammation, reduced risk for cardiovascular disease, and all‐cause mortality (Hillebrand et al ., ; Rothberg, Lees, Clifton‐Bligh, & Lal, ; Thayer & Fischer, ; Thayer, Yamamoto, & Brosschot, ).…”

Section: The Vagus Nerve and The Neurovisceral Integration Modelmentioning

confidence: 99%

The social brain and heart rate variability: Implications for psychotherapy

Petrocchi

Cheli

2019

Psychol Psychother

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Purpose. Humans evolved within the mammalian line as a highly social species. Indeed, sociality has been a major driver of human social intelligence. From birth, social relationships have emotional and self-regulating properties and operate through different body systems. This paper will explore how heart rate variability (HRV), an index of the vagal regulation of the heart and a central element of the physiological underpinnings of sociality, is related to mental health problems, with important implications for psychotherapy.Methods. We conducted a narrative review of the literature on the bi-directional links between prosocial motivations, HRV, and psychophysiological functioning.Results. HRV is associated not only with the ability to downregulate physiological arousal, but also with a variety of psychological and behavioural variables which are usually the target of psychotherapeutic interventions. A modern neurovisceral integration model can be employed to explain the complex intercorrelation between HRV and psychophysiological functioning. In particular, the link between HRV, the experience of inter-and intrapersonal safeness, and the inhibitory function of the prefrontal cortex will be explored in the context of prosocial motives, such as compassion, that alleviate and help prevent mental health difficulties.Conclusions. Our knowledge of the social brain and its physiological underpinnings might influence important elements of a therapeutic intervention, from the initial assessment of patient's difficulties to the evaluation of therapy outcomes. Practitioner pointsSocial relationships have emotional and self-regulating properties. The experience of inter-and intrapersonal safeness is connected to prosocial motives, such as compassion, and the inhibitory function of the prefrontal cortex. Social relationships and compassion influence different body systems, such as the vagus nerve. Many forms of psychopathology represent the activation of evolved, defensive strategies especially in contexts where there are few stimuli indicating safeness and social support. Heart rate variability predicts psychotherapy outcome.

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“…Moreover, there is no consensus on the decreased levels of HRV parameters in T2DM. Furthermore, despite HRV being linked with the severity of T2DM [ 23 ], no studies have comprehensively assessed the role of the most common variables, such as age [ 24 ], gender [ 25 ], blood glucose control [ 26 ], or medications treating for T2DM, on HRV parameters [ 27 , 28 ].…”

Section: Introductionmentioning

confidence: 99%

Heart rate variability in type 2 diabetes mellitus: A systematic review and meta–analysis

et al. 2018

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BackgroundCardiac autonomic neuropathy in type 2 dibetes mellitus (T2DM) patients is frequent and associated with high cardiovascular mortality. Heart rate variability (HRV) is the gold standard to measure cardiac autonomic neuropathy. We aimed to conduct a systematic review and meta–analysis to evaluate the impact of T2DM on HRV parameters.MethodsThe PubMed, Cochrane Library, Embase and Science Direct databases were searched on 1st October 2017 using the keywords “diabetes” AND (“heart rate variability” OR “HRV”). Included articles had to report HRV parameters in T2DM patients and healthy controls measured during 24 hours with a Holter–electrocardiogram. Measurements of HRV retieved were: RR–intervals (or Normal to Normal intervals—NN), standard deviation of RR intervals (SDNN), percetange of adjacent NN intervals differing by more than 50 milliseconds (pNN50), square root of the mean squared difference of successive RR intervals (RMSSD), total power, Low Frequency (LF), High Frequency (HF) and LF/HF ratio, as per Task Force recommendations.ResultsWe included twenty-five case-control studies with 2,932 patients: 1,356 with T2DM and 1,576 healthy controls. T2DM patients had significantly (P<0.01) lower RR–intervals (effect size = –0.61; 95%CI –1.21 to –0.01), lower SDNN (–0.65; –0.83 to –0.47), lower RMSSD (–0.92; –1.37 to –0.47), lower pNN50 (–0.46; –0.84 to –0.09), lower total power (–1.52; –2.13 to –0.91), lower LF (–1.08; –1.46 to –0.69]), and lower HF (–0.79; –1.09 to –0.50). LF/HF did not differ between groups. Levels of blood glucose and HbA1c were associated with several HRV parameters, as well as Time from diagnosis of T2DMConclusionsT2DM was associated with an overall decrease in the HRV of T2DM patients. Both sympathetic and parasympathetic activity were decreased, which can be explained by the deleterious effects of altered glucose metabolism on HRV, leading to cardiac autonomic neuropathy.

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Association Between Heart Rate Variability Measures and Blood Glucose Levels: Implications for Noninvasive Glucose Monitoring for Diabetes

Abstract: This study demonstrates links between specific HRV variables and BGL. In the future the dynamic nature of HRV could provide a unique and real-time method for monitoring BGL, for continuous noninvasive prediction and/or management of DM.

Cited by 44 publications

References 55 publications

Impact of blood glucose control on sympathetic and vagus nerve functional status in patients with type 2 diabetes mellitus

Impact of blood glucose control on sympathetic and vagus nerve functional status in patients with type 2 diabetes mellitus

The social brain and heart rate variability: Implications for psychotherapy

Heart rate variability in type 2 diabetes mellitus: A systematic review and meta–analysis

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