Gabapentin therapy improves heart rate variability in diabetic patients with peripheral neuropathy
Received 15 July 2008; received in revised form 26 September 2008; accepted 3 December 2008. published online 06 February 2009.
Abstract
Purpose
Diabetic cardiac neuropathy, which is characterized by reduced heart rate variability (HRV), frequently coexists with peripheral neuropathy. Gabapentin has been used for the treatment of diabetic neuropathy. We aimed to evaluate the possible effect of gabapentin treatment on autonomic function in patients with type 2 diabetes via HRV.
Methods
Thirty patients with type 2 diabetes mellitus and peripheral neuropathy and 28 age- and sex-matched healthy controls were consecutively registered. Each patient underwent HRV measurements, and diabetic patients were administered gabapentin. After 3 months of gabapentin therapy, HRV parameters were measured again.
Results
Baseline HRV parameters were blunted in patients with diabetes mellitus according to the controls [standard deviation of all NN intervals (SDNN, ms): 106.3±29.9 vs. 148.8±36.5, P=.001; power spectrum of the high-frequency band (HF, ms2): 133.6±98.3 to 231.4±197.6, P=.02; power spectrum of the low-frequency band (LF, ms2): 341.8±247.8 to 511.5±409.4, P=.048; LF/HF ratio: 3.3±2.4 to 2.6±1.5, P=.33]. After 3 months of treatment with gabapentin, some HRV parameters showed some improvement. SDNN (106.2±29.8 to 119.4 ± 25, P=.016) and HF (133.6±98.3 to 167.6±118.3, P=.021) increased significantly. LF/HF ratio decreased (from 3.3±2.4 to 2.3±1.9, P=.039) and LF remained unchanged (341.8±247.8 to 352.3±228.9, P=.88).
Conclusions
Therapeutic doses of gabapentin not only alleviate neuropathic symptoms but also improve cardiac autonomic function in diabetic patients with peripheral neuropathy.
aCardiology Department, Baskent University Medical School, Ankara, Turkey
bEndocrinology Department, Baskent University Medical School, Ankara, Turkey
Corresponding author. Cardiology Department, Adana Teaching and Medical Research Center, Baskent University, 01250 Yuregir, Adana, Turkey. Tel.: +90 322 3272727x2094; fax: +90 322 3271274.
ABSTRACT