Risk of and risk factors for hypoglycemia and associated arrhythmias in patients with type 2 diabetes and cardiovascular disease: a cohort study under real-world conditions

Acta Diabetologica
Frank PistroschM Hanefeld

Abstract

Severe hypoglycemia is one of the strongest predictors of adverse clinical outcomes in patients with type 2 diabetes. Our study addressed the question whether there is a relationship between hypoglycemic events (HE) and severe cardiac arrhythmias in type 2 diabetic patients with established clinical risk factors under real-world conditions. We included 94 patients with type 2 diabetes and documented cardiovascular disease, in which interstitial glucose values and Holter ECG were recorded for 5 days in parallel. Patients received a stable treatment with insulin and/or sulfonylurea and were instructed to record symptoms of hypoglycemia or arrhythmias. Continuous glucose monitoring revealed 54 HE (interstitial glucose <3.1 mmol/l) in a total of 26 patients. Patients perceived only 39 % of HE during the day and 11 % of HE during the night. Patients with HE had a significantly higher number of severe ventricular arrhythmias [ventricular tachycardia (VT) 32.8 ± 60 vs. 0.9 ± 4.2, p = 0.019], and multivariate regression analysis revealed the duration of severe HE and TSH level as independent predictors of the occurrence of a VT. In conclusion, our study suggests that hypoglycemia might be able to trigger at least under certain circumst...Continue Reading

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Citations

Jan 25, 2016·Reviews in Endocrine & Metabolic Disorders·L MonnierD R Owens
Oct 16, 2015·Current Diabetes Reports·Frank Pistrosch, Markolf Hanefeld
Aug 25, 2015·Acta Diabetologica·Jong Shiuan YehChen-Huan Chen
Apr 24, 2016·Reviews in Endocrine & Metabolic Disorders·Avivit CahnItamar Raz
Jul 22, 2016·Diabetes Care·Markolf HanefeldFrank Pistrosch
Dec 7, 2017·Heart and Vessels·Jennifer Leigh RodgersSiva Kumar Panguluri
Mar 29, 2018·The Journal of Clinical Endocrinology and Metabolism·Esmeralda CapristoGeltrude Mingrone
Aug 3, 2018·Diabetes Technology & Therapeutics·Keiichi TorimotoYoshiya Tanaka
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