Musi M. Anwi¹, Azabji-Kenfack M.², C.N Nganou Gnindjio^1,3, Liliane Mfeukeu Kuate^1,3, Crista T. Arrey⁴, Ndipenock D. Ndipachere¹, Abomo N. C. Raissa¹, Eugene Sobngwi^1,4,5, Jean Claude Mbanya^1,4,5.

Authors’ affiliations: 

1. Department of Internal Medicine, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
2. Department of Physiology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
3. Cardiology Service, Yaoundé Central Hospital, Yaoundé, Cameroon
4. National Obesity Center, Yaoundé, Cameroon
5. Service of Endocrine and Metabolic diseases, Yaoundé Central Hospital, Yaoundé, Cameroon.

Corresponding author:  Eugene Sobngwi. E-mail: Cette adresse e-mail est protégée contre les robots spammeurs. Vous devez activer le JavaScript pour la visualiser.

Abstract

Aim: To study the effect of 8-weeks very low calorie diet on the heart rate variability in patients newly diagnosed with type 2 diabetes mellitus.

Methods: We conducted a non-randomized single-arm clinical trial during a period of eight months in patients newly diagnosed with type 2 diabetes mellitus, naïve to anti- diabetic medication, having a body mass index of at least 25kg/m² and HbA1c between 47.5- 80.3 mmol/mol (6.5-9.5%). Intervention consisted of daily consumption of 600+/- 50 kcal meals over a period of 8 weeks. Before and after intervention we measured body fat composition by bioimpedance, office blood pressure, fasting blood sugar, glycatedhaemoglobin, lipid profile, liver function tests, serum creatininaemia and full blood count. We also performed a resting ECG and a 24- hour ECG recording, from where parameters of the heart rate variability (HRV) were obtained: SDNN, SDANN, LF, PNN50%, RMSSD, HF, LF/HF.Data was analyzed using Microsoft Excel 2016 Statistical Package for Social Sciences (SPSS) version 20.0.

Results: We included 18 patients (10 females) aged 53 (45-57) years, newly diagnosed with diabetes and with 51.0mmol/mol baseline HbA1c. The intervention induced the following decrements: 3.4% BMI, 10.7 % fat mass, 46.2% fasting blood glucose, 14.7% HbA1c and 14.3% triglycerides. We also found significant increments in HRV parameters as follows: Sympathetic markers: SDNN27.3%, SDANN 35.3%, LF 458%; Parasympathetic markers: PNN50% 95.1%, RMSSD231%, HF 867%. There was also significant improvement in sympatho-vagal balance, indicated by a 32.6% decrease in LF/HF ratio.

Conclusion: A very low calorie diet is feasible, well tolerated, and accepted, and resulted in tremendous metabolic and cardiovascular improvements after 8 weeks, in a Cameroonian population with newly diagnosed type 2 diabetes mellitus.

Key words: type 2 diabetes, heart rate variability, very low calorie diet