Effect of inspiratory muscle training on autonomic symptoms in pateints with type II diabetes

Abstract

Background: Diabetic autonomic neuropathy (DAN) is a serious and common complication of diabetes. Major clinical manifestations of DAN include resting tachycardia, exercise intolerance, orthostatic hypotension, impaired neurovascular functions. Inspiratory muscle training (IMT) demonstrates beneficial outcomes in a number of cardiovascular population, which may potentially extend to patients with type II diabetes mellitus. The aim of this study was to further evaluate the effect of IMT on autonomic symptoms in patients with long standing diabetes mellitus. Method: Thirty patients with long standing diabetes were randomly assigned to an four-week IMT program. We assessed autonomic dysfunction in the patients with survey of autonomic symptom (SAS) scale. Score was recorded by the scale before and after the treatment program. Results: There was significant decrease in the autonomic symptoms in males compared to females. There was significant decrease in the Q1a symptom score in male population (2.235±0.9034mmHg, 1.824±1.015mmHg, p= 0.0299) There was also reduction in Q1b total impact score in males as well (5.353±2.290mmHg, 4.059±1.191mmHg, p= 0.0001). Significant difference was also seen in orthostatic dysfunction (1.588±1.121mmHg, 1.176±0.8828mmHg, p= 0.0144) in male population. Difference was also seen in females in their Q1b total impact score (5.846±1.819mmHg, 4.769±1.739mmHg, p= 0.0093). Conclusion: IMT demonstrates beneficial effects on autonomic symptoms in patients with type II diabetes.