Effect of exercise training on cardiac autonomic function and left ventricular mass index in type 2 diabetes mellitus with cardiac autonomic neuropathy

The study is randomized controlled trial in individuals with type 2 diabetes mellitus with cardiac autonomic neuropathy, between ages 40 to 65 years of any gender. Participants with type 2 diabetes mellitus will be screened for cardiac autonomic neuropathy (CAN) using Cardiac Autonomic Reflex Tests (Ewing’s battery of 5 tests). Participants falling in the inclusion will be informed about the study and written informed consent will be taken. Baseline assessments of cardiac autonomic function (using cardiac autonomic reflex tests) left ventricular mass index (2D Echocardiography), heart rate variability, glycemic parameters, functional capacity (6-minute walk test) and quality of life (WHO QOL-BREF Questionnaire).  Participants will be randomized into intervention group (Standard care, routine physical activity education, exercise training) and control group (Standard care and routine physical activity education). The intervention will be for the duration of 12 weeks- consisting of aerobic, resistance and flexibility exercises. First 2 weeks of intervention will be supervised followed by a virtually supervised exercise program (using a validated digital application). After 12 weeks, cardiac autonomic function, heart rate variability, functional capacity and quality of life will be assessed in all participants. At 24th week (maintenance phase), all outcomes assessed at baseline will be reassessed in all participants.