Autonomic Dysfunction in Patients with Type 2 Diabetes Mellitus: A Study Using Heart Rate Variability

Abstract

Background: Autonomic dysfunction, particularly cardiac autonomic neuropathy
(CAN), is a common and often overlooked complication of Type 2 Diabetes Mellitus
(T2DM). Early identification is essential, as it is associated with increased
cardiovascular morbidity and mortality. Heart rate variability (HRV) serves as a
sensitive, non-invasive tool for evaluating autonomic nervous system function [1].
Objective: To assess the prevalence and pattern of autonomic dysfunction among
patients with T2DM using HRV analysis and to evaluate its correlation with disease
duration and glycemic control.
Methods: A cross-sectional observational study was conducted on 80 adult patients
with T2DM attending the general outpatient department (OPD) at Jalpaiguri
Government Medical College from March 1, 2024, to February 28, 2025. HRV
parameters were recorded using standard 5-minute ECG-based monitoring. Time and
frequency domain indices were analyzed. Statistical analysis was performed using
SPSS version 25.0.
Results: Out of 80 patients, 47 (58.8%) exhibited signs of autonomic dysfunction.
Patients with a diabetes duration >5 years and poor glycemic control (HbA1c ≥8.0%)
demonstrated significantly lower HRV indices, particularly SDNN and RMSSD, with
an elevated LF/HF ratio, indicating sympathetic dominance and parasympathetic
withdrawal [2,3].
Conclusion: A substantial proportion of patients with T2DM exhibit subclinical
autonomic dysfunction. HRV analysis should be incorporated into routine diabetes
management to facilitate early identification and timely intervention.