Diabetes Metab J.  2016 Dec;40(6):463-472. 10.4093/dmj.2016.40.6.463.

Baseline-Corrected QT (QTc) Interval Is Associated with Prolongation of QTc during Severe Hypoglycemia in Patients with Type 2 Diabetes Mellitus

• Cha SA
• Yun JS
• Lim TS
• Kang YG
• Lee KM
• Song KH
• Yoo KD
• Park YM
• Ko SH
• Ahn YB

• KMID: 2362219
• DOI: http://doi.org/10.4093/dmj.2016.40.6.463

Abstract

BACKGROUND
We investigated an association between baseline heart rate-corrected QT (QTc) interval before severe hypoglycemia (SH) and prolongation of QTc interval during SH in patients with type 2 diabetes mellitus (T2DM).
METHODS
Between January 2004 and June 2014, 208 patients with T2DM, who visited the emergency department because of SH and underwent standard 12-lead electrocardiography within the 6-month period before SH were consecutively enrolled. The QTc interval was analyzed during the incidence of SH, and 6 months before and after SH. QTc intervals of 450 ms or longer in men and 460 ms or longer in women were considered abnormally prolonged.
RESULTS
The mean age and diabetes duration were 68.1±12.1 and 14.1±10.1 years, respectively. The mean QTc intervals at baseline and SH episodes were 433±33 and 460±33 ms, respectively (P<0.001). One hundred and fourteen patients (54.8%) had a prolonged QTc interval during SH. There was a significant decrease in the prolonged QTc interval within 6 months after SH (QTc interval prolongation during SH vs. after recovery, 54.8% vs. 33.8%, P<0.001). The prolonged QTc interval was significantly associated with baseline QTc interval prolongation (odds ratio, 2.92; 95% confidence interval, 1.22 to 6.96; P=0.016) after adjusting for multiple confounders.
CONCLUSION
A prolonged QTc interval at baseline was significantly associated with prolongation of the QTc interval during SH in patients with T2DM, suggesting the necessity of QTc interval monitoring and attention to those with a prolonged QTc interval to prevent SH.

Keyword

Diabetes mellitus, type 2; Severe hypoglycemia; QT interval

MeSH Terms

Diabetes Mellitus, Type 2*
Electrocardiography
Emergency Service, Hospital
Female
Heart
Humans
Hypoglycemia*
Incidence
Male

Figure

• 

  Fig. 1 Correlations between clinical variables and heart rate-corrected QT (QTc) interval during severe hypoglycemia (SH) episode. (A) Duration of diabetes (years; r=0.036, P=0.621). (B) Plasma glucose (mg/dL; r=0.108, P=0.120). (C) Glycosylated hemoglobin (HbA1c) level (%; r=−0.098, P=0.251). (D) QTc interval before SH (ms; r=0.333, P<0.001).

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