scholarly journals Effect on Time Domain Parameters of HRV after Slow Breathing Exercise in Type 2 Diabetes Mellitus

2017 ◽  
Vol 12 (1) ◽  
pp. 15-20
Author(s):  
Jenefer Yesmin ◽  
Noorzahan Begum ◽  
Sultana Ferdousi

Background: Cardiac autonomic nerve dysfunction has been associated with Type 2 Diabetes Mellitus (T2DM) with reduced Heart Rate Variability (HRV). Regular practice of slow breathing exercise (SBE) improves cardiac autonomic nerve function.Objective: To assess the effects of slow breathing exercise on cardiac autonomic nerve function by analysis of HRV in patients with Type 2 Diabetes Mellitus (T2DM).Methods: This prospective interventional study was carried out in the Department of Physiology, Bangabandhu Sheikh Mujib Medical University in 2015. For this, total 30 male diagnosed T2DM patients from the Out Patient Department of Endocrinology, BSMMU aged 45-55 years with diseases duration of 5-10 years were included in the study group. All the patients underwent slow breathing exercise (SBE -30 mins twice daily) for 3 months along with medical treatment. Mean heart rate (HR), mean R-R interval, standard deviation of the NN intervals (SDNN), Square root of mean squared differences of successive N-N intervals (RMSSD) of HRV parameters were recorded at the beginning of 3 months and also at the end of 3 months of study period. Thirty age, BMI matched healthy subject also included as control. For statistical analysis paired and unpaired sample t-test were done as applicable.Results: In this study, Pre-exercise value of mean HR was significantly higher (p< 0.001) and Pre-exercise values of mean R-R interval, SDNN and RMSSD were significantly lower (p< 0.001) in diabetic patients in comparison to control. After 3 months of performing SBE, post exercise values of all parameters were improved significantly (p< 0.001).Conclusion: The results of this study revealed that SBE has some beneficial effects on cardiac autonomic balance in T2DM patients.Bangladesh Soc Physiol. 2017, June; 12(1): 15-20

2018 ◽  
Vol 13 (1) ◽  
pp. 22-28 ◽  
Author(s):  
Farhana Rahman ◽  
Sultana Ferdousi

Background: Type 2 Diabetes Mellitus (T2DM) may be associated with autonomic dysfunction. Performance of deep relaxation technique (DRT) may cause upturn of this deranged nerve function.Objective: To evaluate the impact of DRT on cardiac autonomic nerve function by analysis of time domain series of Heart Rate Variability (HRV) in T2DM patients.Methods: This prospective study was carried out on 30 female T2DM patients aged 50-55 years with duration of diabetes of 5-10 years enrolled from the Out Patient Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University, Dhaka. They performed DRT (20 minutes twice daily) for 3 months. Thirty apparently healthy female with similar age who did not perform DRT or any other form of exercise, were included as control. To assess the cardiac autonomic nerve function, time domain measures of HRV of all subjects were recorded by a data acquisition device Power Lab (Australia). HRV data of all subjects were collected at baseline (pre) and also after 3 months(Post). For statistical analysis, paired and independent sample t-test were used.Results: The pre-intervention values of resting HR was significantly higher (p<0.001) and mean R-R interval, SDRR, CVRR, SDSD, RMSSD and pRR50% were significantly lower (p<0.001) in all diabetic patients compared to control. After 3 months of DRT, there was significant decrement in resting mean heart rate (p<0.01) and significant increment in mean R-R interval, SDRR, CVRR, SDSD, RMSSD and pRR50% (p<0.001) compared to their pre-intervention values.Conclusion: Cardiac autonomic nerve dysfunction may occur in T2DM and 3 months regular practice of DRT mayy significantly improv cardiac autonomic nerve function with parasympathetic dominance.J Bangladesh Soc Physiol. 2018, June; 13(1): 22-28


2018 ◽  
Vol 12 (2) ◽  
pp. 65-71
Author(s):  
Farhana Rahman ◽  
Sultana Ferdousi

Background: Autonomic nerve dysfunction has been noted in type 2 diabetes mellitus (T2DM). Regular practice of supine rest (SR) may cause improvement of this impaired autonomic nerve function.Objective: To observe the effect of SR on the autonomic nerve activity by analysis of heart rate variability (HRV) in patients with T2DM.Methods: This prospective interventional study was carried out in the Department of Physiology, Bangabandhu Sheikh Mujib Medical University (BSMMU)during 2016 on 30 female diagnosed T2DM patients aged 50-55 years with duration of diabetes of 5-10 years. They performed SR (20 minutes twice daily) for 3 months. The diagnosed patients were selected from the Out Patient Department of Endocrinology, BSMMU, Dhaka. Thirty age matched apparently healthy females who did not perform regular SR, were control. To assess the cardiac autonomic nerve function, HRV parameters of all subjects were recorded by PowerLab. HRV data of all subjects were collected at baseline and also after 3 months follow-up. In addition, urinary level of Vanillyl Mandelic acid (VMA) of all subjects were measured at baseline and at post intervention period for patients. For statistical analysis, paired and independent sample t-tests were done, as applicable.Results: The pre-intervention values of LF normalized unit (LF nu), LF/HF ratio(p<0.01) and urinary VMA were significantly higher(p <0.001) and HF normalized unit (HF nu) was significantly (p<0.01)lower in all diabetic patients compared to control. The post-intervention data showed LF nu, LF/HF ratio and urinary VMA were reduced and HF nu was increased but these changes were not statistically significant (p> 0.05) in diabetic patients.Conclusion: This study concluded that parasympathetic activity decreased, increased sympathetic activity with higher sympathovagal balance indicating autonomic dysfunction in patients with T2DM, which was shown with trend of improvement after regular practice of supine rest of 3 months though statistically not significant.Bangladesh Soc Physiol. 2017, December; 12(2): 65-71


2020 ◽  
Vol 14 (2) ◽  
pp. 63-68
Author(s):  
Jenefer Yesmin ◽  
Noorzahan Begum ◽  
Sultana Ferdousi

Background: Reduced heart rate variability (HRV) with cardiac autonomic nerve dysfunction has been found in Type 2 Diabetes Mellitus (T2DM) patients. Yoga based slow breathing exercise (SBE) improved this autonomic functions in healthy subjects. Objectives: To assess the effect of SBE on cardiac autonomic nerve function(CANF) by power spectral analysis of HRV in patients with T2DM. Methods: This prospective interventional study was carried on 30 male diagnosed T2DM patients aged 45-55 years with disease duration 5-10 years enrolled from Out Patient Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University, Dhaka. They performed SBE for 30 minutes twice daily for 3 months. Thirty apparently healthy age, BMI matched male who did not undergo any type of exercise were included as control. To assess the cardiac autonomic nerve function, power spectral analysis of HRV of all patients were done before and after 3 months of SBE. HRV data were recorded by polyrite D (RMS India). For statistical analysis, independent sample and paired sample t-test were used. Results: The preintervention values of Low frequency (LF) normalized unit(nu) and Low frequency/High frequency( LF/HF) ratio were significantly (p<0.001) higher and the values of LF power, HF power, HF normalized unit (HF nu) were significantly (p<0.001) lower in all diabetic patients compared to control. The postintervention values of LF power, HF power, HF nu increased significantly (p<0.001) and the LF nu, LF/HF ratio decreased significantly (p<0.001)compared to their pre-intervention values in T2DM. There were no significant differences between the post intervention values of LF nu, HF nu and LF/HF ratio in T2DM and the control. Conclusion: Impaired cardiac autonomic nerve function was significantly improved by SBE in T2DM. J Bangladesh Soc Physiol. 2019, December; 14(2): 63-68


2021 ◽  
Vol 16 (1) ◽  
pp. 11-15
Author(s):  
Jenefer Yesmin ◽  
Noorzahan Begum ◽  
Sultana Ferdousi

Background: Slow breathing exercise (SBE) has some useful effects on cardiovascular system. Objectives: To observe the effects of slow breathing exercise on blood pressure in male patients with type 2 diabetes mellitus (DM). Methods: This interventional study was implemented on sixty (60) diagnosed male type 2 diabetes mellitus (T2DM) patients aged 45-55 years with disease history 5-10 years, selected from Out Patients Department (OPD) of Endocrinology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. The subjects were divided into two groups, control group (n=30) included type 2 DM patients without SBE and study group included patients performing SBE for 3 months(n=30) and they were enrolled bypurposive sampling method. The study group was advised to practice SBE for 30 minutes 2 times daily for 3 months. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure(MAP),pulse pressure(PP) and rate pressure product (RPP)were recorded at the start of the study and after 3 months in both group of patients.. Independent sample t test and paired sample t-test were used for statistical analysis and p<0.05 was taken as statistical significance. Results: In this study, the value of mean HR, SBP, DBP, MAP and RPP were significantly (p<0.05) reduced after 3 months of SBE. Again no significant changes observed (p>0.05) after 3 months in the group who did not practice SBE. Conclusion: Cardiovascular functions in T2DM patients was improved after performing slow breathing exercise for 3 months. J Bngladesh Soc Physiol 2021;16(1): 11-15


2015 ◽  
Vol 85 (3-4) ◽  
pp. 145-155 ◽  
Author(s):  
Marjan Ghane Basiri ◽  
Gity Sotoudeh ◽  
Mahmood Djalali ◽  
Mohammad Reza Eshraghian ◽  
Neda Noorshahi ◽  
...  

Abstract. Background: The aim of this study was to identify dietary patterns associated with general and abdominal obesity in type 2 diabetic patients. Methods: We included 728 patients (35 - 65 years) with type 2 diabetes mellitus in this cross-sectional study. The usual dietary intake of individuals over 1 year was collected using a validated semi-quantitative food frequency questionnaire. Weight, height, and waist circumference were measured according to standard protocol. Results: The two major dietary patterns identified by factor analysis were healthy and unhealthy dietary patterns. After adjustment for potential confounders, subjects in the highest quintile of the healthy dietary pattern scores had a lower odds ratio for the general obesity when compared to the lowest quintile (OR = 0.45, 95 % CI = 0.26 - 0.79, P for trend = 0.02), while patients in the highest quintile of the unhealthy dietary pattern scores had greater odds for the general obesity (OR = 3.2, 95 % CI = 1.8 - 5.9, P for trend < 0.001). There were no significant associations between major dietary patterns and abdominal obesity, even after adjusting for confounding factors. Conclusion: This study shows that in patients with type 2 diabetes mellitus, a healthy dietary pattern is inversely associated and an unhealthy dietary pattern is directly associated with general obesity.


Author(s):  
Shah Namrata Vinubhai ◽  
Pardeep Agarwal ◽  
Bushra Fiza ◽  
Ramkishan Jat

Background: Serum ferritin is known as an index for body iron stores also as an inflammatory marker and it is influenced by several disease. We were looking for a correlation between HbA1c and S. Ferritin in type 2 DM. Methodology: The present study a total of 150 participants were enrolled of which 100 were confirmed cases of Type 2 Diabetes Mellitus and rest 50 age and sex matched healthy subjects constituted the control group. All were screened for HbA1c, Fasting blood sugar, Post prandial blood sugar and S.Ferritin. Results: A highly significant variation and positive correlation was observed with respect to S.Ferritin and HbA1c levels. Mean S.Ferritin was high in the subgroup with poor glycemic control. Conclusion: The fasting, post prandial sugar levels, HbA1c and S.Ferritin were significantly higher in the diabetic subjects. This study shows a positive correlation between HbA1c and S. Ferritin levels. So we can conclude that in diabetic patients S. Ferritin may serve as an independent marker of poor glycemic and metabolic control. Keywords: Serum ferritin, Type 2 Diabetes Mellitus, HbA1c.


Nutrients ◽  
2021 ◽  
Vol 13 (1) ◽  
pp. 183
Author(s):  
Anna Izzo ◽  
Elena Massimino ◽  
Gabriele Riccardi ◽  
Giuseppe Della Pepa

Type 2 diabetes mellitus (T2DM) represents a major health burden for the elderly population, affecting approximately 25% of people over the age of 65 years. This percentage is expected to increase dramatically in the next decades in relation to the increased longevity of the population observed in recent years. Beyond microvascular and macrovascular complications, sarcopenia has been described as a new diabetes complication in the elderly population. Increasing attention has been paid by researchers and clinicians to this age-related condition—characterized by loss of skeletal muscle mass together with the loss of muscle power and function—in individuals with T2DM; this is due to the heavy impact that sarcopenia may have on physical and psychosocial health of diabetic patients, thus affecting their quality of life. The aim of this narrative review is to provide an update on: (1) the risk of sarcopenia in individuals with T2DM, and (2) its association with relevant features of patients with T2DM such as age, gender, body mass index, disease duration, glycemic control, presence of microvascular or macrovascular complications, nutritional status, and glucose-lowering drugs. From a clinical point of view, it is necessary to improve the ability of physicians and dietitians to recognize early sarcopenia and its risk factors in patients with T2DM in order to make appropriate therapeutic approaches able to prevent and treat this condition.


2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Yuki Yamauchi ◽  
Hidekazu Tanaka ◽  
Shun Yokota ◽  
Yasuhide Mochizuki ◽  
Yuko Yoshigai ◽  
...  

Abstract Background Left ventricular (LV) longitudinal myocardial dysfunction is considered a marker of preclinical LV dysfunction in patients with type 2 diabetes mellitus (T2DM). High heart rate (HR) is associated with cardiovascular outcomes, but the effect of HR on LV longitudinal myocardial function in T2DM patients is uncertain. Methods We studied 192 T2DM patients with preserved LV ejection fraction (LVEF), and 81 age-, sex-, and LVEF-matched healthy volunteers. HR was measured as the average HR during echocardiography, and high HR was defined as resting HR ≥ 70 beats/minute. LV longitudinal myocardial function was assessed as global longitudinal strain (GLS). The predefined cutoff for subclinical LV dysfunction was set at GLS < 18%. Results GLS in T2DM patients with high HR was significantly lower than that in T2DM patients with low HR (16.3% ± 4.2% vs. 17.8% ± 2.8%; P = 0.03), whereas GLS in normal subjects with high and low HR was similar (20.3 ± 1.7% vs. 20.3 ± 2.0%; P = 0.99). Multivariable logistic regression analysis showed that high HR (odds ratio: 1.04; 95% confidence interval: 1.01–1.07; P = 0.01) was independently associated with GLS < 18% in T2DM patients as well as HbA1c, T2DM duration, LVEF, body mass index, and mitral inflow E and mitral e’ annular velocity ratio. One sequential logistic model evaluating the associations between GLS < 18% and clinical variables in T2DM patients showed an improvement with the addition of LVEF and E/e’ (P < 0.001) and a further improvement with the addition of high HR (P < 0.001). Conclusion Compared with normal subjects, resting HR was associated with LV longitudinal myocardial function in asymptomatic T2DM patients with preserved LVEF. Our findings provide new insights on the management of T2DM patients.


2021 ◽  
Vol 40 (1) ◽  
Author(s):  
Freda Lalrohlui ◽  
Souvik Ghatak ◽  
John Zohmingthanga ◽  
Vanlal Hruaii ◽  
Nachimuthu Senthil Kumar

AbstractOver the last few decades, Mizoram has shown an increase in cases of type 2 diabetes mellitus; however, no in-depth scientific records are available to understand the occurrence of the disease. In this study, 500 patients and 500 healthy controls were recruited to understand the possible influence of their dietary and lifestyle habits in relation with type 2 diabetes mellitus. A multivariate analysis using Cox regression was carried out to find the influence of dietary and lifestyle factors, and an unpaired t test was performed to find the difference in the levels of biochemical tests. Out of 500 diabetic patients, 261 (52.3%) were males and 239 (47.7%) were females, and among the control group, 238 (47.7%) were males and 262 (52.3%) were females. Fermented pork fat, Sa-um (odds ratio (OR) 18.98), was observed to be a potential risk factor along with tuibur (OR 0.1243) for both males and females. Creatinine level was found to be differentially regulated between the male and female diabetic patients. This is the first report of fermented pork fat and tobacco (in a water form) to be the risk factors for diabetes. The unique traditional foods like Sa-um and local lifestyle habits like tuibur of the Mizo population may trigger the risk for the prevalence of the disease, and this may serve as a model to study other populations with similar traditional practices.


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