CARDIAC autonomic dysfunction was associated with greater diabetic peripheral neuropathy (DPN) severity, with researchers identifying a significant relationship between reduced heart rate variability and impaired peripheral nerve conduction, regardless of diabetic foot ulcer status.
The findings, based on 794 participants, suggested that cardiac autonomic dysfunction and peripheral nerve impairment were closely linked, even among individuals without neuropathic foot ulceration.
Researchers investigated whether the severity of cardiac autonomic dysfunction was associated with DPN severity and whether this relationship differed according to the presence of neuropathic diabetic foot ulceration (DFU).
The study included 794 participants with DPN, comprising 268 with neuropathic DFU and 526 without foot ulceration.
Cardiac autonomic dysfunction was assessed using heart rate variability, while peripheral neuropathy severity was evaluated through nerve conduction studies.
Multivariate logistic regression was used to examine associations between neuropathy severity and cardiac autonomic dysfunction. Subgroup and interaction analyses assessed potential differences according to DFU status.
Researchers observed that declining standard deviation of the normal sinus interval (SDNN), a measure of heart rate variability, was accompanied by reductions in conduction velocities and amplitudes across all tested nerves.
In both participant groups, greater abnormalities in sural or common peroneal nerve conduction parameters were independently associated with lower SDNN values (all p0.05).
This indicated that the relationship between cardiac autonomic dysfunction and DPN severity did not differ significantly according to the presence of neuropathic foot ulceration.
Overall, the findings highlighted the association between autonomic and peripheral nerve dysfunction in individuals with DPN.
The researchers’ observations may support greater clinical awareness of concurrent cardiac autonomic abnormalities when evaluating peripheral neuropathy severity, irrespective of diabetic foot ulcer status.
Reference
Ma C et al. Association of peripheral neuropathy severity and cardiac autonomic dysfunction in individuals with neuropathic diabetic foot versus those with diabetic peripheral neuropathy alone. Diab Res Clin Pract. 2026. https://doi.org/10.1016/j.diabres.2026.113606
Image credit: Adobestock/amazing studio
Image credit: Adobestock/amazing studio
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