Physical Exercise Improves Heart Rate Variability in Patients with Type 2 Diabetes: A Systematic Review

Abstract

Although HRV is not routinely measured in the management of T2DM, it is an important measure due to its relation with mortality and diabetic neuropathy. Physical exercise has become a therapy for T2DM, because it improves physical fitness and functional capacity, enhances metabolic control and insulin sensitivity, reduces inflammatory markers and neuropathy symptoms and can increase the regenerative capacity of cutaneous axons, slowing or preventing neuropathy progression. However, it is not clear to what extent physical exercise can improve HRV in this population. Participation in the 15 selected studies was similar in men and women (48.01% men and 51.99% women). All the intervention programs included aerobic training, and it was complemented by strength training in four studies. Duration of physical exercise sessions ranged between 30 and 75 min, the frequency being between 2 and 7 days/week. Statistically significant improvements in groups with diabetes, relative to baseline, were observed in nine studies. More than 3 days per week of aerobic training, complemented by strength training, during at least 3 months seems to improve HRV in T2DM. Weekly frequency might be the most important factor to improve HRV. These aspects could help to design better programs based in scientific evidence, incorporating HRV as an important variable associated with diabetic neuropathy and mortality.

The Effects of Passive Simulated Jogging on Short-Term Heart Rate Variability in a Heterogeneous Group of Human Subjects

“…Normal HRV is beneficial in the aging and frail, those with cognitive decline, diabetes, coronary artery disease, and heart failure [ 4 , 7 , 11 , 12 ]. Various interventions modify HRV, with physical activity being the most studied intervention [ 4 ].…”

Effects of 8-Week Whole-Body Vibration Training on the HbA1c, Quality of Life, Physical Fitness, Body Composition and Foot Health Status in People with T2DM: A Double-Blinded Randomized Controlled Trial

“…In this regard, Sanudo, Alfonso-Rosa, Del Pozo-Cruz, Del Pozo-Cruz, Galiano, and Figueroa [29] found a 7.2% body fat mass reduction after 12 weeks of WBV training. In this intervention, authors followed a similar vibration procedure (12)(13)(14)(15)(16) Hz and 30-60 s of duration), however, they combined dynamic and static exercises. In other populations, such as post-menopausal women, these changes have been also observed when WBV was combined with resistance training [43].…”

“…Physical exercise has become a therapy for people with T2DM [9], improving physical fitness [10,11], quality of life [12], and autonomic modulation [13]; as well as enhancing metabolic control [14] and insulin sensitivity; and reducing inflammatory markers [15] and neuropathy symptoms [16]. Interestingly, physical activity could also increase the regenerative capacity of cutaneous axons, slowing or preventing neuropathy progression [17].…”

Cardiovascular autonomic neuropathy in the course of diabetes – the review of actual knowledge.

“…Ponadto mnogość różnych i równoczesnych interwencji u tych chorych czy też różnorodność użytych do oceny wskaźników, utrudnia ujednolicenie wniosków. Aktywność fizyczna jest jednym z elementów terapii T2DM z uwagi na uznane benefity w zakresie ogólnej sprawności organizmu, poprawy insulinowrażliwości, co za tym idzie kontroli metabolicznej oraz redukcji wskaźników stanu zapalnego [33]. Wydaje się, że regularna aktywność fizyczna złożona z ćwiczeń aerobowych jak i siłowych poprawia zmienność akcji serca (HRV) u pacjentów z typem 2 cukrzycy [34].…”