Assessment of Frailty Status and Its Association with Heart Rate Variability and Body Composition Among Patients with Type 2 Diabetes Mellitus: A Cross-Sectional Study.

Objective: To evaluate frailty status and its association with heart rate variability (HRV), body composition, and metabolic profile in patients with Type 2 Diabetes Mellitus (T2DM). Methods: In this cross-sectional study, 139 T2DM patients (age 50-65 years) were recruited. Frailty status was classified as non-frail, pre-frail, or frail using the Physical Frailty Phenotype (PFP) criteria. Outcome measures included HRV from a 5-minute ECG, body composition via bioelectrical impedance analysis, and a full metabolic profile. Results: The prevalence of pre-frailty or frailty was 95%. Increasing frailty status was significantly associated with autonomic dysfunction, characterized by reduced parasympathetic and increased sympathetic HRV indices (e.g., higher LF:HF ratio, p=0.003). Frail patients had a significantly higher fat percentage (p=0.015) and lower lean percentage (p=0.015) compared to non-frail participants. Poorer glycemic control (HbA1c: p=0.003) and a more adverse lipid profile were also significantly associated with worsening frailty. Conclusion: Frailty is highly prevalent in this T2DM cohort and is associated with significant adverse changes in autonomic function, body composition, and cardiometabolic health, highlighting the need for a multifaceted management approach.