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Background <p>Iron-deficiency anemia frequently coexists with type 2 diabetes mellitus, increasing cardiovascular risk through autonomic dysfunction. The isometric handgrip test is a simple, non-invasive tool to assess autonomic regulation, but its role in type 2 diabetes mellitus with anemia remains underexplored.</p> Objective <p>The study aims to evaluate cardiovascular responses to the isometric handgrip test in diabetic patients with and without anemia and determine its utility as a risk stratification tool for early detection of cardiovascular disease.</p> Methods <p>The case-control study included 140 female type 2 diabetes patients (40–60&#xa0;years), categorized as follows: Group 1 (controlled T2DM + IDA), Group 2 (uncontrolled T2DM + IDA), and Group 3 (T2DM without anemia). Hematological, anthropometric, and glycemic profiles were recorded. IHT was performed at 33% of maximum handgrip strength for 3&#xa0;min, and changes in heart rate, systolic, and diastolic blood pressure were analyzed and interpreted.</p> Results <p>The maximum HGS was significantly higher among diabetic patients without anemia than among those with anemia (<i>p</i> = 0.00). ΔDBP varied significantly across groups (Group 1: 19 ± 7.3&#xa0;mmHg; Group 2: 9.07 ± 5.4&#xa0;mmHg; Group 3: 12.45 ± 3.4&#xa0;mmHg; <i>p</i> &lt; 0.001). Anemic patients with diabetes under control showed an exaggerated DBP response, while those with uncontrolled diabetes displayed a blunted response. Maximum handgrip strength correlated positively with hemoglobin and ferritin (<i>r</i> = 0.29 and 0.40; <i>p</i> &lt; 0.05). Logistic regression revealed that each unit rise in hemoglobin and ferritin increased the odds of diastolic pressure response by 15% and 30%, respectively (<i>p</i> &lt; 0.01).</p> Conclusions <p>The study concludes that incorporating the isometric handgrip test in chronic disease management highlights a paradigm shift toward early cardiovascular risk detection rather than late structural damage, which could substantially reduce the burden of cardiovascular complications in this vulnerable population.</p>

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Evaluation of cardiovascular responses to isometric handgrip exercise: A risk stratification tool in diabetic patients with iron-deficiency anemia

  • 期刊论文

  • 发表日期：

    2025年10月27日

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  • Ashwini Kishan,
  • Namratha Ashwin Ullal

摘要

Background

Iron-deficiency anemia frequently coexists with type 2 diabetes mellitus, increasing cardiovascular risk through autonomic dysfunction. The isometric handgrip test is a simple, non-invasive tool to assess autonomic regulation, but its role in type 2 diabetes mellitus with anemia remains underexplored.

Objective

The study aims to evaluate cardiovascular responses to the isometric handgrip test in diabetic patients with and without anemia and determine its utility as a risk stratification tool for early detection of cardiovascular disease.

Methods

The case-control study included 140 female type 2 diabetes patients (40–60 years), categorized as follows: Group 1 (controlled T2DM + IDA), Group 2 (uncontrolled T2DM + IDA), and Group 3 (T2DM without anemia). Hematological, anthropometric, and glycemic profiles were recorded. IHT was performed at 33% of maximum handgrip strength for 3 min, and changes in heart rate, systolic, and diastolic blood pressure were analyzed and interpreted.

Results

The maximum HGS was significantly higher among diabetic patients without anemia than among those with anemia (p = 0.00). ΔDBP varied significantly across groups (Group 1: 19 ± 7.3 mmHg; Group 2: 9.07 ± 5.4 mmHg; Group 3: 12.45 ± 3.4 mmHg; p < 0.001). Anemic patients with diabetes under control showed an exaggerated DBP response, while those with uncontrolled diabetes displayed a blunted response. Maximum handgrip strength correlated positively with hemoglobin and ferritin (r = 0.29 and 0.40; p < 0.05). Logistic regression revealed that each unit rise in hemoglobin and ferritin increased the odds of diastolic pressure response by 15% and 30%, respectively (p < 0.01).

Conclusions

The study concludes that incorporating the isometric handgrip test in chronic disease management highlights a paradigm shift toward early cardiovascular risk detection rather than late structural damage, which could substantially reduce the burden of cardiovascular complications in this vulnerable population.