4. Discussion
Hyperglycemia, diabetes, T2DM, CAN
HYPERGLYCEMIA, DIABETES
The present study demonstrates that seven days of JD improved the short-term time domain and Poincaré measures of HRV. The effects of JD on HRV measures carried over for at least seven days after discontinuation of JD and are not gender or age dependent (ESM_File_ We compared our data in T2DM for SDNN and RMSSD to the published normative data by Nunan et al. [Exercise is one such intervention which improves autonomic function. In T2DM, Bhati et al. [Most recently, Picard et al. [Passive simulated jogging (JD) is a method of passive motion of the lower extremities simulating jogging using a motorized pedal device which moves the forefoot in an alternating motion. The upward movement of the pedal is followed by a downward movement of the forefoot tapping against a semirigid bumper to simulate the tapping of feet against the ground; the latter introduces pulsations to the body similar to jogging [This study was not designed to address the mechanism by which JD modifies HRV; however, several potential mechanisms could account for the observed changes in this T2DM population based on our previous data. Hyperglycemia and large glucose fluctuations are believed to be one of the most important factors in the development of CAN [Nitric oxide (NO) may play a role in the improved HRV observed in this study. Specifically, neuronal nitric oxide synthase (nNOS), which has sympathoinhibitory effects under physiological conditions by acting on different sites of the nervous system, including the paraventricular nucleus, the nucleus of the solitary tract, rostral ventral medulla, the carotid body and nerves in the kidney [Recently, pharmacological therapy for diabetes with sodium glucose cotransporter type-2 inhibitors (SGLT2i), which have a reasonable safety profile, also shows promise in CAN [