TY - JOUR
TI - Severe iatrogenic hypoglycaemia requiring medical assistance is associated with concurrent prolongation of the QTc interval
AU - Mylona, M.
AU - Liatis, S.
AU - Anastasiadis, G.
AU - Kapelios, C.
AU - Kokkinos, A.
JO - Diabetes Research and Clinical Practice
PY - 2020
VL - 161
TODO - null
SP - null
PB - Elsevier Ireland Ltd
SN - 0168-8227
TODO - 10.1016/j.diabres.2020.108038
TODO - 2,4 thiazolidinedione derivative;  dipeptidyl peptidase IV inhibitor;  glucagon like peptide 1 receptor agonist;  glucose;  insulin;  metformin;  sulfonylurea, age;  aged;  Article;  atrioventricular block;  cardiologist;  controlled study;  correlation analysis;  disease association;  disease duration;  disease severity;  electrocardiography;  emergency ward;  female;  follow up;  gender;  glucose blood level;  heart left bundle branch block;  heart right bundle branch block;  heart ventricle bigeminy;  heart ventricle extrasystole;  human;  hypoglycemia;  insulin dependent diabetes mellitus;  major clinical study;  male;  medical care;  non insulin dependent diabetes mellitus;  QT interval;  QT prolongation;  sinus bradycardia;  sinus tachycardia;  supraventricular premature beat;  blood;  clinical trial;  complication;  heart arrhythmia;  hospital emergency service;  hypoglycemia;  iatrogenic disease;  insulin dependent diabetes mellitus;  multicenter study;  procedures;  prospective study, Aged;  Arrhythmias, Cardiac;  Diabetes Mellitus, Type 1;  Electrocardiography;  Emergency Service, Hospital;  Female;  Humans;  Hypoglycemia;  Iatrogenic Disease;  Male;  Medical Assistance;  Prospective Studies
TODO - Aims: Hypoglycaemia has been shown to exert arrhythmogenic effects. Herein, we explore the association between severe hypoglycaemia requiring medical assistance and the length of the QT interval in patients with diabetes. Methods: Data from a prospective study, conducted in eight tertiary hospitals, which recorded cases of hypoglycaemia from patients with diabetes seeking treatment at emergency departments (ED) were analyzed. The patients’ electrocardiograms (ECGs), were compared to those of non-hypoglycaemic diabetic individuals, matched for age, gender and duration of diabetes, obtained during their scheduled follow-up visits. The corrected QT intervals (QTc) were calculated blindly by two cardiologists. Results: ECGs from 154 patients presenting with hypoglycaemia were analyzed and compared to 95 matched controls. The mean QTc interval was significantly longer in patients with hypoglycaemia than in controls (441.9 ± 48.2 vs. 401.0 ± 29.6 ms, p < 0.001) A significantly higher proportion of hypoglycaemic patients had an abnormally prolonged QTc (≥440 ms) compared to controls (49.4% vs. 11.6%, p < 0.001). Among patients with hypoglycaemia, there was a statistically significant but rather weak negative correlation between QTc interval and plasma glucose at presentation (r: −0.183, p = 0.02). Conclusions: In diabetic patients, hypoglycemia requiring medical assistance is associated with a significant prolongation of the QTc interval. The degree of this prolongation is associated with hypoglycaemia severity. © 2020 Elsevier B.V.
ER -