Diabetes Center, First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko Hospital, Athens, Greece.
Diabetes Center, First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko Hospital, Athens, Greece.
Diabetes Res Clin Pract. 2020 Mar;161:108038. doi: 10.1016/j.diabres.2020.108038. Epub 2020 Jan 30.
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.
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.
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).
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.
低血糖已被证明具有致心律失常作用。在此，我们探讨了需要医疗协助的严重低血糖与糖尿病患者 QT 间期长度之间的关系。
对在 8 家三级医院进行的一项前瞻性研究的数据进行了分析，该研究记录了急诊科就诊的糖尿病患者低血糖发作的病例。将患者的心电图（ECG）与在其定期随访期间接受检查的非低血糖糖尿病个体的 ECG 进行比较，这些个体在年龄、性别和糖尿病持续时间上与低血糖患者相匹配。由两位心脏病专家对校正的 QT 间期（QTc）进行盲法计算。
分析了 154 例低血糖患者的 ECG，并与 95 例匹配的对照进行了比较。低血糖患者的平均 QTc 间隔明显长于对照组（441.9±48.2 vs. 401.0±29.6 ms，p<0.001）。低血糖患者中异常延长的 QTc（≥440 ms）比例明显高于对照组（49.4% vs. 11.6%，p<0.001）。在低血糖患者中，QTc 间隔与就诊时血糖呈显著负相关（r：-0.183，p=0.02）。
在糖尿病患者中，需要医疗协助的低血糖与 QTc 间期的显著延长有关。这种延长的程度与低血糖的严重程度有关。
