Relationship between changes in heart rate variability indices and blood glucose control in Type 2 Diabetes Mellitus

Diabetes mellitus (DM) is one of the mostcommon health problems in the community.DM is associated with pathologicchanges in the cardiovascular system due to alterations inthe autonomic nervous system (ANS). Dysfunction of thecardiovascular ANS can lead to fatal arrhythmias and suddendeath. The aim of this study was to investigate the relationshipbetween changes in heart rate variability (HRV)indices and blood glucose control status in patients withtype 2 DM. Patients with type 2 DM who presented toour university Diabetes Clinic were eligible to be included.Fasting blood glucose (FBG), 2-hour postprandial bloodglucose test (2PPG), and hemoglobin A1C (HbA1C) weremeasured. According to the HbA1C the patients werecategorized as euglycemia (HbA1C <7%) and poorly controlledDM (HbA1C >7%). HRV indices were determinedby 24-hour Holter monitoring. There were 41 patientswith euglycemia and 39 patients whose blood glucosewas poorly controlled. pNN, SDANN, and SDNN indiceswere significantly higher in the euglycemia group thanin the group with poorly controlled glucose. There wassignificant and inverse correlation between pNN, SDANN,and SDNN with serum levels of HBA1C. However, no significantcorrelation was observed between FBS and 2PPGwith HRV indices. HRV indices were significantly lowerin diabetic patients with poorly controlled blood glucosewhen compared to diabetics with good control of bloodglucose. These findings reflect dysfunction of the ANS inpatents with poorly controlled blood glucose

Relationship between changes in heart rate variability indices and blood glucose control in Type 2 Diabetes Mellitus

Diabetes mellitus (DM) is one of the mostcommon health problems in the community.DM is associated with pathologicchanges in the cardiovascular system due to alterations inthe autonomic nervous system (ANS). Dysfunction of thecardiovascular ANS can lead to fatal arrhythmias and suddendeath. The aim of this study was to investigate the relationshipbetween changes in heart rate variability (HRV)indices and blood glucose control status in patients withtype 2 DM. Patients with type 2 DM who presented toour university Diabetes Clinic were eligible to be included.Fasting blood glucose (FBG), 2-hour postprandial bloodglucose test (2PPG), and hemoglobin A1C (HbA1C) weremeasured. According to the HbA1C the patients werecategorized as euglycemia (HbA1C <7%) and poorly controlledDM (HbA1C >7%). HRV indices were determinedby 24-hour Holter monitoring. There were 41 patientswith euglycemia and 39 patients whose blood glucosewas poorly controlled. pNN, SDANN, and SDNN indiceswere significantly higher in the euglycemia group thanin the group with poorly controlled glucose. There wassignificant and inverse correlation between pNN, SDANN,and SDNN with serum levels of HBA1C. However, no significantcorrelation was observed between FBS and 2PPGwith HRV indices. HRV indices were significantly lowerin diabetic patients with poorly controlled blood glucosewhen compared to diabetics with good control of bloodglucose. These findings reflect dysfunction of the ANS inpatents with poorly controlled blood glucose

Comparison clinical and metabolic effects of metformin and pioglitazone in polycystic ovary syndrome

Introduction: Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in women. PCOS comprises a broad spectrum of anomalies, including hyperandrogenism, chronic anovulation, obesity, and infertility. Insulin resistance and its compensatory hyperinsulinemia play a key role in the pathogenicity of PCOS. This study compares the effects of 2 types of insulin sensitizer drugs, metformin and pioglitazone, on clinical, metabolic, and endocrine characteristics of women with PCOS. Methods: In this randomized clinical trial, 56 women with PCOS (ages 20–49 years) were treated orally with either metformin (500 mg 3 times daily) or pioglitazone (30 mg daily) for 3 months. Clinical (body weight, blood pressure [BP], and body mass index) and laboratory indices (fasting blood sugar [FBS], serum triglyceride [TG], cholesterol, low-density lipoprotein, high-density lipoprotein, insulin, testosterone, and dehydroepiandrosterone [DHEA]) were measured before and after therapy. Data were analyzed by Chi-square and McNemar's tests. Results: Significant decreases were seen after treatment with metformin in extent of hair loss (P = 0.008), wrist circle (P = 0.011), weight (P = 0.047), diastolic BP (P = 0.023), and DHEA (P = 0.035). A significant decrease in TG was seen with pioglitazone treatment (P = 0.047). In both groups, significant decreases in acne, menstrual disturbance, FBS, and serum insulin were seen. Conclusion: There is a significant amelioration of endocrine and metabolic indices with pioglitazone in PCOS patients. Although we were not able to recommend one treatment regime over the other, pioglitazone offers a useful, alternate treatment in women with PCOS who are not able to tolerate metformin