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