The influence of autonomous dysfunction on the restoration of the heart rate and cardiac rhythm variability under loading test conditions in the children and adolescents presenting with type 1 diabetes mellitus

Abstract

The present study included 71 patients with type 2 diabetes mellitus (41 boys and 30 girls) at the age from 9 to 18 (mean 15.2 (13.6; 16.5)) years, duration of the disease 5.0 (2.5; 9) years, and the HbA1c level of 9.1% (7.0; 10.2). All the patients underwent continuous ECG monitoring with the assessment of the cardiac rhythm variability (CRV) characteristics and the QT interval duration over 24 hours. These studies were supplemented by cardiovascular tests and the PWC170 test with the evaluation of CRV and the heart rate (HR) during testing and the rehabilitation period. Autonomous dysfunction was documented in 22 (30.9%) patients. It was shown that the children and adolescents presenting with the cardiovascular form of autonomous neuropathy (KAH+) had lower CRV values during physical exercises than the patients without KAH+ , and their CRV and HR characteristics failed to be fully normalized after the cessation of loading. This fact may be responsible for the high cardiovascular morbidity and mortality rate among the patients with DM1 in the mature age.