Evidence mapPaperPMID 39905568Full record

SynthesisSystematic reviews2025

Effect of exercise training on cardiac autonomic function in type 2 diabetes mellitus: a systematic review and meta-analysis.

Sohini Raje, G Arun Maiya, Padmakumar R, Mukund A Prabhu, Krishnananda Nayak, Shivashankara Kn, B A Shastry, Megha Nataraj

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Systematic reviews, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Sohini RajeCentre for Podiatry & Diabetic Foot Care and Research, Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India.
G Arun MaiyaCentre for Podiatry & Diabetic Foot Care and Research, Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India. arun.maiya@manipal.edu.
Padmakumar RDepartment of Cardiology, Kasturba Medical College-Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India.
Mukund A PrabhuDepartment of Cardiology, Kasturba Medical College-Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India.
Krishnananda NayakDepartment of Cardiovascular Technology, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India.
Shivashankara KnDepartment of Medicine, Kasturba Medical College-Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India.
B A ShastryDepartment of Medicine, Kasturba Medical College-Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India.
Megha NatarajDepartment of Cardiovascular & Respiratory Physiotherapy, MGM College of Physiotherapy, Navi Mumbai, Maharashtra, 400705, India.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCardiac autonomic neuropathy (CAN) is an underdiagnosed complication of type 2 diabetes mellitus (T2DM) and is associated with cardiovascular morbidity and mortality. Cardiac autonomic reflex tests (CARTs) are the gold standard; they are non-invasive and clinically feasible for screening CAN. The objective of the present meta-analysis was to examine exercise's effect on cardiac autonomic function using CARTs in T2DM.

methodsThe Preferred Reporting Items for Systematic Review and Meta-Analysis Checklist (PRISMA) was used. Electronic databases were systematically used to retrieve relevant studies after title and abstract screening. Studies utilizing exercise training with cardiac autonomic function (CARTs) outcomes in individuals with type 2 diabetes mellitus were included. The meta-analysis was conducted using RevMan 5.4.1, using the random effects model, and appropriate tests for heterogeneity. The Cohrane ROB-2 tool was used for randomized controlled trials (RCTs) and the ROBINS-I tool for non-RCT for risk of bias assessment were used.

resultsThree studies were included (two for meta-analysis), considering the outcome of the E:I ratio, 30:15 ratio, and Valsalva ratio. The studies did not show any influence on the E:I and 30:15 ratio in the pooled analysis with a low risk of ineffectiveness for the exercise intervention. Exercise training significantly affected the Valsalva ratio. A different type of exercise intervention was utilized in all three studies. There was a low to moderate certainty for the evidence.

conclusionThe results indicate that further robust and high-quality randomized controlled trials utilizing cardiac autonomic reflex tests (which have clinical and physiological relevance) in type 2 diabetes mellitus are required for drawing conclusions. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42023445561.

Indexed as

Autonomic Nervous SystemDiabetes Mellitus, Type 2Diabetic NeuropathiesExerciseExercise TherapyHeartHumansCardiac autonomic functionCardiac autonomic neuropathyExerciseLifestyle managementMeta-analysisType 2 diabetes

Identifiers

PMID39905568
PMCPMC11792330

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.