Lead II electrocardiograph-derived entropy index for autonomic function assessment in type 2 diabetes mellitus

The aim of this study was to introduce and evaluate the baroreflex entropy index (BEI), a novel tool derived from standard lead II electrocardiograph (EKG) for autonomic function (AF) assessment in type 2 diabetes mellitus (T2DM). Researchers with distinct roles (analysis and data preparation) analyzed anonymized EKG data from healthy controls and two patient groups with T2DM (well controlled and poorly controlled). BEI was compared between groups, and correlations with glycemic markers (HbA1c, fasting glucose) were investigated. Logistic regression was used to assess the association between BEI and T2DM risk. BEI showed good repeatability and differentiation between groups. Notably, it required only single-lead EKG. BEI was inversely correlated with glycemic markers, suggesting improved baroreflex regulation with better glycemic control. BEI also outperformed small-scale multiscale entropy in group discrimination. Logistic regression identified BEI as a protective factor for T2DM. BEI represents a promising tool for monitoring AF, assessing glycemic control, and potentially stratifying T2DM risk. Further validation in larger longitudinal studies and an exploration of the applicability of BEI to other diseases are warranted.