Hypoglycaemia may increase cardiac arrhythmia risk in patients with diabetes

  • Fitzpatrick C & al.
  • Diabetes Obes Metab
  • 8 May 2018

  • from Sarfaroj Khan
  • Clinical Summaries
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Takeaway

  • This meta-analysis suggests that hypoglycaemia triggers alteration in ECG in patients with diabetes which may increase the risk for cardiac arrhythmia leading to subsequent cardiovascular morbidity and mortality.

Why this matters

  • It is uncertain whether hypoglycaemia serves as a marker of vulnerability to cardiovascular events or triggers a direct causal effect.

Study design

  • Systematic review and meta-analysis of 20 studies included 357 participants (T1DM, n=241; type 2 diabetes mellitus [T2DM], n=116) with diabetes from inception to October 10, 2017.
  • Differences in QTc (QT corrected for heart rate) and change in heart rate variability and arrhythmia incidence were assessed.
  • Funding: University of Leicester; National Institute for Health Research.

Key results

  • Mean age of participants was 45 years.
  • 2 studies reported a significant increase in QTc length during hypoglycaemia (P<.05).
  • Pooled data from 15 studies showed that hypoglycaemia was associated with significant QTc prolongation vs euglycaemia (standardised mean difference [SMD], 0.64; P=.001).
  • Pooled SMD for QTc was 0.54 (95% CI, 0.10-0.99; P=.017) for T1DM and 0.55 (P>.05) for T2DM.

Limitations

  • Small sample size in included studies.
  • Risk for bias.