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Diabetes Res Clin Pract. 2019 Oct 24:107878. doi: 10.1016/j.diabres.2019.107878. [Epub ahead of print]

Can hypoglycemic episodes in type 1 diabetics trigger cardiac arrhythmias?

Author information

1
Institute of medical assistance to public servants of the state (Iamspe), Mirandinha Street, 755, Sao Paulo, 03641000, Brazil. Electronic address: klainetti@hotmail.com.
2
Instituto de Assistência Médica ao Servidor Público Estadual, São Paulo, SP, Brasil. Electronic address: pimenta@cardiol.br.
3
Instituto de Assistência Médica ao Servidor Público Estadual, São Paulo, SP, Brasil. Electronic address: mfvendramini71@gmail.com.

Abstract

BACKGROUND:

Sudden nocturnal death is a syndrome that usually affects patients with diabetes mellitus type 1 (DM1), being described mainly due to ventricular arrhythmias in response to nocturnal hypoglycemia.

OBJECTIVES:

Evaluate the relation between hypoglycemia and ventricular arrhythmias in patients with DM1 and normal structural heart.

METHOD:

Prospective, observational study with DM1 patients and normal structural heart on echocardiogram aged 18-60 years, of both sexes receiving insulin therapy for at least five years. Intermittent glucose reading device was implanted (iPro2 - Medtronic / USA) and 24hr ambulatory electrocardiographic recording by the Holter system (Cardios Systems - Brazil). Patients were monitored for hypoglycemia without any type of induction (interstitial glucose <70mg/dl) and cardiac arrhythmias within 24 hours.

RESULTS:

Thirty-two patients were evaluated, with mean-age of 35 years, being 16 men. Eleven patients (34%) did not have hypoglycemia, other 3 (27.3%) also had no arrhythmia, while 8 (72.7%) had arrhythmias interpreted as irrelevant. The other 21 patients (66%) presented some hypoglycemic episodes and 10 (47.6%) did not present arrhythmias, whereas 11 (52.4%) presented arrhythmias considered not clinically significant, as also found in non-diabetic individuals.

CONCLUSION:

In patients with DM1 without structural heart disease there was no relationship between cardiac arrhythmia and episodes of hypoglycemia.

KEYWORDS:

arrhythmias; continuous ECG monitoring; continuous glucose monitoring; hypoglycemia; type 1 diabetes mellitus

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