Lower parasympathetic activation and Depression linked to poor Glycemic control in diabetics

In patients with Type 2 Diabetes, lower parasympathetic activation and higher depressive symptoms affected the Glycemic control as per a recent study that was published in "Journal of Diabetes and its complications, 2022."  

Dysfunctions of the autonomic nervous system (ANS) and comorbidities associated with depression or anxiety are some of the symptoms exhibited by patients with T2 diabetes having poor glycemic control. By using the Heart rate variability (HRV) converted from ECG as the ANS index, researchers from Taiwan conducted a study to explore the association between depression, anxiety, HRV, and glycemic control in patients with type 2 diabetes mellitus. 

647 patients with type 2 diabetes mellitus participated in the study. The Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) questionnaires were given to the patients to assess depression and anxiety symptoms. ECG raw signals were transformed to HRV indices referring ANS activation after collecting them from a 5-min sitting and resting baseline. From the electronic media records other parameters like Blood glucose and lipid profiles including glycated hemoglobin (HbA1c), high-density lipoprotein (HDL), low-density lipoprotein (LDL), and triglyceride were obtained. 

Results: 

• Of the total, 99 (15 %) participants had depressive symptoms and 59 (9 %) had anxiety symptoms.
• Depression and HbA1c were negatively correlated with parasympathetic activation and Depression and anxiety were positively correlated with sympathetic activation.
• After controlling for demographic data and lipid profiles, depression was a significant positive predictor for HbA1c levels; and HRV indices (lnLF and lnHF) were the significant negative predictors for HbA1c levels.
• Mediation effect analysis showed that depression was a mediator between parasympathetic activation and glycemic control. 

Thus from the study, the researchers concluded that in patients with type 2 diabetes mellitus lower parasympathetic activation and higher depressive symptoms may affect glycemic control. They also suggested further testing on glycemic control using intervention programs that increase parasympathetic activities and reduce depression. 

For the full article, click here: https://doi.org/10.1016/j.jdiacomp.2022.108264