Autonomic Neuropathy Profiles and Heart Rate Variability Parameters in Long-Term Type 2 Diabetic Patients

International Journal of Anatomy and Physiology | Vol. 15, No. 9, September 2026 | pp. 149–160

DOI: 10.46882/2026/IJAP/000180

Article Type: Original Research Article

Title: Autonomic Neuropathy Profiles and Heart Rate Variability Parameters in Long-Term Type 2 Diabetic Patients

Names of Authors: Kofi A. Mensah¹, Kwame O. Appiah²

Authors’ Affiliations: ¹Department of Physiology, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana; ²Department of Human Anatomy, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana

Abstract:
Cardiovascular autonomic neuropathy (CAN) is a severe, underdiagnosed complication of diabetes mellitus that increases cardiovascular mortality risk. This study evaluated the alterations in heart rate variability (HRV) parameters as a non-invasive index of autonomic function in long-term type 2 diabetic patients. Eighty participants were enrolled: forty diagnosed with type 2 diabetes for over 10 years and forty age-matched healthy controls. Short-term 5-minute electrocardiogram (ECG) recordings were captured during quiet breathing, deep breathing, and the Valsalva maneuver. Time-domain indices, including the standard deviation of normal-to-normal intervals (SDNN) and root mean square of successive differences (RMSSD), were computed alongside frequency-domain indicators. The diabetic group demonstrated a significant reduction in mean SDNN (22.4 ± 3.1 ms vs 44.8 ± 5.2 ms in controls, p < 0.001) and RMSSD (14.2 ± 2.6 ms vs 32.5 ± 4.1 ms in controls, p < 0.001), indicating marked parasympathetic withdrawal. High-frequency (HF) power spectrum density dropped sharply by 58.4% in diabetic subjects (p < 0.01), whereas the low-frequency to high-frequency ratio (LF/HF ratio) rose from 1.35 ± 0.22 to 2.84 ± 0.41, showing a clear sympathetic shift. Valsalva ratios were significantly lower in diabetic subjects (1.12 ± 0.08 vs 1.45 ± 0.12, p < 0.01). These quantifiable disruptions verify that advanced type 2 diabetes causes severe cardiac autonomic imbalance, emphasizing the utility of routine, early HRV screening in clinical workflows.

Keywords: Cardiovascular Autonomic Neuropathy, Heart Rate Variability, Type 2 Diabetes, Parasympathetic Withdrawal, Electrocardiogram

Manuscript Timeline: Received: June 22, 2026; Revised: August 04, 2026; Accepted: August 20, 2026; Published: September 04, 2026

Citation: Mensah A.K., & Appiah K.O. (2026). Autonomic Neuropathy Profiles and Heart Rate Variability Parameters in Long-Term Type 2 Diabetic Patients. International Journal of Anatomy and Physiology, 15(9), 149–160. DOI: 10.46882/2026/IJAP/000180

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