Hamasaki Hidetaka
Hamasaki Clinic, 2-21-4 Nishida, Kagoshima 890-0046, Japan.
Healthcare (Basel). 2023 Oct 1;11(19):2668. doi: 10.3390/healthcare11192668.
Diabetic neuropathy, including autonomic neuropathy, is a severe complication in patients with poorly controlled diabetes. Specifically, cardiovascular autonomic neuropathy (CAN) plays a significant prognostic role in cardiovascular morbidity and mortality. Exercise, an essential component of diabetes treatment, may have a therapeutic effect on patients with diabetes complicated by CAN. However, it remains unclear whether exercise has a therapeutic or protective effect in diabetes patients with CAN.
The author conducted a systematic search of PubMed/MEDLINE, Embase, and The Cochrane Library, resulting in the identification of eight eligible randomized controlled trials for this review.
Exercise, including aerobic exercise combined with resistance training (RT), high-intensity interval training, and progressive RT, has shown a beneficial effect on cardiac autonomic function (CAF) in patients with type 2 diabetes, as measured by heart rate variability, heart rate recovery, and baroreflex sensitivity. However, most studies had low quality. Moreover, there were no relevant studies examining the effect of exercise on CAF in older patients, patients with poorly controlled diabetes, and patients with type 1 diabetes.
Exercise has the potential to manage patients with CAN by balancing sympathetic and parasympathetic nervous system functions; however, further studies are warranted in the future.
糖尿病神经病变，包括自主神经病变，是糖尿病控制不佳患者的一种严重并发症。具体而言，心血管自主神经病变（CAN）在心血管疾病的发病率和死亡率中起着重要的预后作用。运动作为糖尿病治疗的重要组成部分，可能对合并CAN的糖尿病患者具有治疗作用。然而，运动对患有CAN的糖尿病患者是否具有治疗或保护作用仍不清楚。
作者对PubMed/MEDLINE、Embase和Cochrane图书馆进行了系统检索，最终确定了八项符合条件的随机对照试验用于本综述。
运动，包括有氧运动结合抗阻训练（RT）、高强度间歇训练和渐进性RT，通过心率变异性、心率恢复和压力反射敏感性测量，已显示对2型糖尿病患者的心脏自主神经功能（CAF）有有益影响。然而，大多数研究质量较低。此外，没有相关研究考察运动对老年患者、糖尿病控制不佳患者和1型糖尿病患者CAF的影响。
运动有可能通过平衡交感神经系统和副交感神经系统功能来管理CAN患者；然而，未来仍需要进一步研究。
