Cardiac autonomic modulation in type 1 diabetes during exercise-heat stress

Macartney, Michael J.; Notley, Sean R.; Herry, Christophe L.; Seely, Andrew J. E.; Sigal, Ronald J.; Kenny, Glen P.

doi:10.1007/s00592-020-01505-9

Cited by 6 publications

(2 citation statements)

References 16 publications

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“…The effect of T1D on HRV was also demonstrated during exercise [ 48 ]. The overall HRV entropy during vigorous exercise was shown to be reduced in both healthy and T1D cohorts, although the attenuation in the T1D group was greater [ 49 ]. The impact on parasympathetic function was additionally demonstrated through the reduction of the cardiac vagal tone , which was shown to be associated with the presence of neuropathy [ 50 ].…”

Section: Resultsmentioning

confidence: 99%

“…This function, which is usually assessed by measuring the ESC or GSR, was shown to be lower in persons with T1D compared with healthy control participants [ 62 ]. Other aspects of thermal homeostasis affected in persons with T1D included the sweat profile, body temperature , and ST during exercise [ 49 , 63 , 64 ]. The methods and findings of the aforementioned studies are presented in Table S3 in Multimedia Appendix 4 .…”

Section: Resultsmentioning

confidence: 99%

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The Potential of Current Noninvasive Wearable Technology for the Monitoring of Physiological Signals in the Management of Type 1 Diabetes: Literature Survey

Daskalaki¹,

Parkinson²,

Brew‐Sam³

et al. 2022

J Med Internet Res

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Background Monitoring glucose and other parameters in persons with type 1 diabetes (T1D) can enhance acute glycemic management and the diagnosis of long-term complications of the disease. For most persons living with T1D, the determination of insulin delivery is based on a single measured parameter—glucose. To date, wearable sensors exist that enable the seamless, noninvasive, and low-cost monitoring of multiple physiological parameters. Objective The objective of this literature survey is to explore whether some of the physiological parameters that can be monitored with noninvasive, wearable sensors may be used to enhance T1D management. Methods A list of physiological parameters, which can be monitored by using wearable sensors available in 2020, was compiled by a thorough review of the devices available in the market. A literature survey was performed using search terms related to T1D combined with the identified physiological parameters. The selected publications were restricted to human studies, which had at least their abstracts available. The PubMed and Scopus databases were interrogated. In total, 77 articles were retained and analyzed based on the following two axes: the reported relations between these parameters and T1D, which were found by comparing persons with T1D and healthy control participants, and the potential areas for T1D enhancement via the further analysis of the found relationships in studies working within T1D cohorts. Results On the basis of our search methodology, 626 articles were returned, and after applying our exclusion criteria, 77 (12.3%) articles were retained. Physiological parameters with potential for monitoring by using noninvasive wearable devices in persons with T1D included those related to cardiac autonomic function, cardiorespiratory control balance and fitness, sudomotor function, and skin temperature. Cardiac autonomic function measures, particularly the indices of heart rate and heart rate variability, have been shown to be valuable in diagnosing and monitoring cardiac autonomic neuropathy and, potentially, predicting and detecting hypoglycemia. All identified physiological parameters were shown to be associated with some aspects of diabetes complications, such as retinopathy, neuropathy, and nephropathy, as well as macrovascular disease, with capacity for early risk prediction. However, although they can be monitored by available wearable sensors, most studies have yet to adopt them, as opposed to using more conventional devices. Conclusions Wearable sensors have the potential to augment T1D sensing with additional, informative biomarkers, which can be monitored noninvasively, seamlessly, and continuously. However, significant challenges associated with measurement accuracy, removal of noise and motion artifacts, and smart decision-making exist. Consequently, research should focus on harvesting the information hidden in the complex data generated by wearable sensors and on developing models and smart decision strategies to optimize the incorporation of these novel inputs into T1D interventions.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

The Potential of Current Noninvasive Wearable Technology for the Monitoring of Physiological Signals in the Management of Type 1 Diabetes: Literature Survey

Daskalaki¹,

Parkinson²,

Brew‐Sam³

et al. 2022

J Med Internet Res

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The impact of age, type 2 diabetes and hypertension on heart rate variability during rest and exercise at increasing levels of heat stress

et al. 2022

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Effects of sex and wet-bulb globe temperature on heart rate variability during prolonged moderate-intensity exercise: a secondary analysis

Barros

Macartney

Peoples

et al. 2022

Appl. Physiol. Nutr. Metab.

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Sex-differences in heart rate (HR) and heart rate variability (HRV), a surrogate of cardiac autonomic modulation, are evident during rest and exercise in young healthy individuals. However, it remains unclear whether sex impacts HRV during prolonged exercise at differing levels of environmental heat stress. Therefore, we completed a secondary analysis upon the effects of sex and wet-bulb globe temperature (WBGT) on HR and HRV during prolonged exercise. To achieve this, HR and HRV were assessed in non-endurance-trained and non-heat-acclimatized healthy men (n=19) and women (n=15) aged 18-45 years during 180-min treadmill walking at a moderate metabolic rate (200 W/m2: equivalent to ~35% peak aerobic power) in 16, 24, 28, and 32°C WBGT. In the final 5 min prior to exercise termination, HR was observed to be higher in women relative to men in all but the 32°C WBGT. Although no sex-differences were observed for the HRV metric of root-mean-square of successive differences, high frequency power was higher in women relative to men across WBGT conditions. These findings indicate that, in healthy non-heat-acclimatized individuals, women respond to prolonged exercise-heat stress with a greater increase in HR despite cardiac vagal autonomic modulation remaining equal or increasing compared to men. Novelty points. • Prior to exercise termination, females respond with a greater increase in heart rate under all wet-bulb globe temperatures except the hottest (32°C). • Sex influenced heart rate variability (HRV) metrics during all wet-bulb globe temperatures, but results were mixed. • Further characterisation of HRV sex differences remains an important area of research.

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Cardiac autonomic modulation in type 1 diabetes during exercise-heat stress

Cited by 6 publications

References 16 publications

The Potential of Current Noninvasive Wearable Technology for the Monitoring of Physiological Signals in the Management of Type 1 Diabetes: Literature Survey

The Potential of Current Noninvasive Wearable Technology for the Monitoring of Physiological Signals in the Management of Type 1 Diabetes: Literature Survey

The impact of age, type 2 diabetes and hypertension on heart rate variability during rest and exercise at increasing levels of heat stress

Effects of sex and wet-bulb globe temperature on heart rate variability during prolonged moderate-intensity exercise: a secondary analysis

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