Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Aug 13;17(1):330.
doi: 10.1186/s13098-025-01862-x.

Effect of slow deep breathing on cardiovascular autonomic neuropathy in type 2 diabetes mellitus patients

Miao Xuan  1 , Yuqin Shen  2 , Wenjun Tang  3 , Ping Fang  1 , Guanghui Liu  1 , Guanghe Li  2 , Qifan Sun  2 , Lingling Pan  4
Affiliations

Effect of slow deep breathing on cardiovascular autonomic neuropathy in type 2 diabetes mellitus patients

Miao Xuan et al. Diabetol Metab Syndr. .

Abstract

Objective: This study aimed to investigate the effects of slow deep breathing (SDB) on heart rate variability (HRV) in patients with type 2 diabetes mellitus (T2DM) patients with cardiovascular autonomic neuropathy (CAN).

Methods: Sixty patients with CAN secondary to type T2DM were randomly assigned to SDB (n = 30) and control (n = 30) groups. All patients were treated with mecobalamin (0.5 mg; times daily). Patients in the SDB group underwent slow deep breathing training against a background of soothing music. Before treatment and 3 months after treatment, height, body weight, heart rate (HR), blood pressure (BP), HbA1c, LDL, TG, heart-rate-variability (HRV), and hart rate recovery (HRR) were measured 1 min after the 6-min walk test in the two groups.

Results: BMI, SBP, DBP, HbA1c, LDL, and TG levels were comparable between the two groups and remained unchanged after treatment in two groups (P > 0.05). In the SDB group, the standard deviation of N-N intervals (SDNN), the square root of the mean squared differences of successive RR (RMSSD), low-frequency power (LF), high-frequency power (HF), and LF/HF ratio changed significantly after treatment (P < 0.05), and these measurements remained statistically significant after adjusting for age (P < 0.05), but HR and the root mean square of the difference between adjacent R-R intervals (PNN50) remained unchanged (P > 0.05). In the control group, HR, SDNN, RMSSD, PNN50, LF, HF, and LF/HF ratio remained unchanged after treatment (P > 0.05). The SBP, SDNN, RMSSD, LF, HF, and LF/HF ratios were significantly different between the two groups after treatment.(P < 0.05), and these measurements remained statistically significant after adjusting for age (P < 0.05). In addition, the HRR1 levels were comparable between the two groups (P > 0.05).

Conclusion: With soothing music as the background, sustained slow deep breathing training can improve heart rate variability in patients with type 2 diabetes mellitus and cardiac autonomic neuropathy, independent of age, providing a new approach for the treatment of cardiac autonomic neuropathy in type 2 diabetes.

Clinical trial number: The study was registered in the Chinese Clinical Trial Registry (ChiCTR2200063260).

Keywords: Cardiovascular autonomic neuropathy (CAN); Deep breathing; Heart rate recovery (HRR); Heart-rate-variability (HRV); Slow breathing; Type 2 diabetes.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was approved by the Ethics Committee of Tongji Hospital, Tongji University (2021-LCYJ-009). The study was conducted according to the Declaration of Helsinki, and written informed consent was obtained from each patient. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Similar articles

See all similar articles

References

    1. Pop-Busui R, Boulton AJM, Feldman EL, et al. Diabetic neuropathy: A position statement by the American diabetes association. Diabetes Care. 2017;40(1):136–54. 10.2337/dc16-2042 - PMC - PubMed
    1. Spallone V, Ziegler D, Freeman R, et al. Cardiovascular autonomic neuropathy in diabetes: clinical impact, assessment, diagnosis, and management. Diabetes Metab Res Rev. 2011;27(7):639–53. 10.1002/dmrr.1239 - PubMed
    1. Orlov S, Cherney DZI, Pop-Busui R, et al. Cardiac autonomic neuropathy and early progressive renal decline in patients with nonmacroalbuminuric type 1 diabetes. Clin J Am Soc Nephrol. 2015;10(7):1136–44. 10.2215/CJN.11441114 - PMC - PubMed
    1. Pop-Busui R. Cardiac autonomic neuropathy in diabetes: A clinical perspective. Diabetes Care. 2010;33(2):434–41. 10.2337/dc09-1294 - PMC - PubMed
    1. Picard M, Tauveron I, Magdasy S, et al. Effect of exercise training on heart rate variability in type 2 diabetes mellitus patients: A systematic review and meta-analysis. PLoS ONE. 2021;16(5):e0251863. 10.1371/journal.pone.0251863 - PMC - PubMed

LinkOut - more resources