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Gabapentin therapy shows potential to improve heart rate variability, indicating a favourable impact on cardiovascular autonomic regulation in painful diabetic peripheral neuropathy.
Diabetic peripheral neuropathy is a commonly encountered complication of diabetes that often extends beyond pain to involve autonomic nerve abnormality. Reduced heart rate variability (HRV), a hallmark of cardiac autonomic neuropathy, is increasingly associated with higher cardiovascular risk in affected patients. While gabapentin is widely used to manage neuropathic pain, its effect on cardiovascular autonomic regulation remains insufficiently explored.
This randomized controlled trial was executed to explore whether gabapentin therapy could influence HRV in painful diabetic peripheral neuropathy (PDPN). The study included patients with PDPN diagnosed using standard clinical scales such as the neuropathy symptom scale, neuropathy disability score, and visual analog scale (VAS). Volunteers were randomly allocated to:
HRV was measured through 24-hour Holter monitoring, using the standard deviation of normal-to-normal (SDNN) intervals as the key autonomic indicator. Baseline characteristics, including body mass index (BMI), age, and gender were similar between groups. Outcomes were analyzed after treatment completion to evaluate the effect of gabapentin on cardiac autonomic function.
Data were analyzed for 26 participants, representing 86.7% of the randomized cohort. Patients in the intervention and control groups were well matched at baseline, with no pivotal differences in age, sex, or, BMI ensuring a balanced comparison.
These findings suggest a favorable impact of gabapentin therapy on cardiac autonomic function in PDPN. The investigators concluded that gabapentin therapy may boost HRV in patients with PDPN, hinting at a potential heart-protective benefit beyond pain relief.
IJ Pharmaceutical Research
Effect of Gabapentin on Heart Rate Variability in Patients with Painful Diabetic Peripheral Neuropathy: A Double-blinded Randomized Controlled Trial
Farnaz Ahmadi et al.
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