R-R Interval Study

The R-R interval study is a simple, affordable test of the vagus nerve, and it should be part of your intial diabetes physical examination.  It is performed like an ordinary EKG, but with only 3 leads.

The vagus nerve is the main control of the “automatic pilot” nervous functions, including heart rate and digestion.  It can be injured by chronic high blood sugar, causing reduced stomach activity (gastroparesis), rapid heart rate and erection problems.  Fortunately it can recover from normalizing your blood sugar.

The R-R Study tests the variation in your heart rate between inhaling and exhaling.  It is a good indicator of blood sugar complications, especially gastroparesis, and more importantly, it shows improvement after aggressive blood sugar control.   I usually perform it once on all new patients and later after 12-18 months.

6 Responses to R-R Interval Study

  1. stu says:

    Dr. Mages,

    Hello, I’ve recently been diagnosed with Gastroparesis after a gastric emptying scan, which showed only 32% of the oatmeal emptied after 90 minutes instead of normal 50%. I can’t eat much for last 5 months, and have lost 25 lbs. and am down to 110lbs. at 5′ 10″. I didn’t think that I was diabetic, and recently had a 75g glucose tolerance test that showed bs = 154 at 1hr. and 145 at 2hr. I’ve been a high carb eater my whole life, always thin. I’m now on low carb diet and I can fairly easily keep my blood sugar always below 130 after meals; in the morning it has always been 73-93.

    I would so much appreciate your thoughts on 2 question (sorry I’m in CO or else would make an appt.)
    1) I’m intrigued by the R-R Interval study – would this help determine the cause of my GP (doctors say my blood sugar wasn’t the cause, but i’m not convinced), and/or whether a low carb diet would potentially help improve it? What type of dr./facility can I go here in Denver to get this done?
    2) Any thoughts you have on the chances of controlling my sugar say to <130 at all times would help improve my GP, and if so, how long would it take – weeks, months, years, more?
    3) if you can recommend dr. similar to yourself in the Denver area that would be great. Right now I'm really thin and look and feel not so good – my GI dr. says to try Domperidone next.

    thanks in advance for your time,


  2. Carrie says:

    Can the R-R Interval Study be helpful for someone with gastroparesis but who does not have diabetes? I was recently diagnosed with Gastroparesis, but do not have diabetes, but have had nighttime acid reflux for years. If the study would be helpful, do you know of anyone in the Pittsburgh area who could perform it?

    Thanks in advance for any information you can provide.

  3. Joseph De Mangeont says:

    I live in canton Ohio and am having a hard tiome finding a physician who knows anything about and or will perform a RR interval test on me (including my Endo doctor). Is there some other type of doctor or lab type that you could recommend that I contact that would be likely to be able and willing to give me an RR test.

    I Read Dr Berstiene’s book and since have found I need to get my sugars down (over 2oo at times). I am taking insulin (Levimar) 100 U per day. That gets my fasting blood sugar down to about 110. Obviously I am insulin resistant.

    Now that fasting BS is down to 110 I am starting an excercise program. Have also started a very low carb diet per Dr Berstien” book (Dr. Berstiene’s Diabetic Solution).

    Also had low testosterone (under 200) but now am applying presription testosterone cream. there fore I should now be able to build some muscle which should help with the insulin resistence. I have just started all this and I want to measure my progress that’s why I want the RR interval test as a baseline as well as to determine if I have any gastrparesis. I am 67, male and 30lbs over weight, most of which is viseral fat (belly fat).

    Any ideas where I should look to get an RR test done? On the off chance I can find someone to do the test what should the readings be for normal, some damage, severe damage??

    Any help would be appreciated.


    Joe De mangeont

  4. dolly paouga says:

    I have been diagnosed with gastreoparesis by my doctor from an upper GI and a few symptoms. I have bloating, stomach spasms, early satiety, etc. A few questions. One is the R-R Interval Test on Vargus Nerve easy to do? Which type of doctor is most familiar with this test? Is the test covered under Medicaid/Medicare.
    My blood sugars are typically normal except for the overnight. However, my symptoms are really ScARED,

  5. drneilmages says:

    It is probably only rarely used, and I do not know if it’s covered by Medicare. (I doubt it). I would work with your doctor to do everything you can to get your blood sugars normal and that might help over several months. I recommend “Diabetes Solution” by Bernstein. Good luck.
    Dr Mages

  6. Steve says:

    What sort of physician does this test? Cardiologist? Neurologist? I need to have it done and cannot find anything in Chicago when I google it. Please help!

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