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Hypoglycaemia and Cardiac Arrhythmias in Patients with Type 2 Diabetes Mellitus
Author(s) -
Lindström T.,
Jorfeldt L.,
Tegler L.,
Arnqvist H.J.
Publication year - 1992
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.1992.tb01834.x
Subject(s) - medicine , diabetes mellitus , cardiology , type 2 diabetes mellitus , cardiac arrhythmia , atrial fibrillation , endocrinology
Improved blood glucose control by insulin treatment in patients with Type 2 (non‐insulin dependent) diabetes mellitus increases the risk for hypoglycaemic episodes. Our objective was to investigate if hypoglycaemia causes electrocardiographic changes and cardiac arrhythmias in patients with Type 2 diabetes. Six insulin‐treated patients with Type 2 diabetes and no known cardiac disease took part in the study. Hypoglycaemia was induced by insulin infusion aiming at a plasma glucose ≥ 2.0 mmol I −1 or hypoglycaemic symptoms. All patients experienced hypoglycaemic symptoms. The median lowest arterial plasma glucose was 2.0 mmol I −1 . Arterial plasma adrenaline concentration increased from 0.4 ± 0.1 (mean ± SE) to 6.9 ±0.3 nmol I −1 ( p < 0.001) while serum potassium was lowered from 4.1 ± 0.3 mmol I −1 to 3.5 ± 0.2 mmol I −1 ( p < 0.001). The heart rate increased significantly during hypoglycaemia except in one patient who developed hypoglycaemic symptoms and a severe bradyarrhythmia at a plasma glucose of 4.4 mmol I −1 . One patient developed frequent ventricular ectopic beats during hypoglycaemia while four patients showed no arrhythmia. ST‐depression in ECG leads V 2 and V 6 was observed during hypoglycaemia in five patients ( p < 0.05) and four patients developed flattening of the T‐wave. In conclusion, the study supports the hypothesis that hypoglycaemia in patients with Type 2 diabetes may be hazardous by causing cardiac arrhythmias.