Risk of Cardiac Arrhythmias During Hypoglycemia in Patients With Type 2 Diabetes and Cardiovascular Risk

Authors: Elaine Chow, Alan Bernjak, Scott Williams, Robert A. Fawdry, Steve Hibbert, Jenny Freeman, Paul J. Sheridan, Simon R. Heller.

Summary:

This study evaluated arrhythmia risk in type 2 diabetes patients with cardiovascular risk by comparing arrhythmia frequency, heart rate variability, and cardiac repolarization markers during hypoglycemia, hyperglycemia, and euglycemia at matched times of day.

Key Findings:

Hypoglycemia is associated with increased susceptibility to cardiac arrhythmias in patients with type 2 diabetes with cardiovascular risk.

Changes in cardiac autonomic tone and abnormal repolarization are potential contributory mechanisms.

- QTc intervals prolonged during hypoglycemia, especially during the day, and some episodes had QTc >500 ms.

- Higher incidence of Bradycardia (8x), PACs (4x), and PVCs(3x) during nocturnal hypoglycemia – due to increased vagal counteraction after sympathetic neural activation.

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