According to new research published in Diabetes Care, hypertension, hypokalemia and QT prolongation occur frequently in people with diabetes who experience severe hypoglycaemia, which may explain the link between hypoglycaemia, fatal arrhythmia and mortality.
Researchers retrospectively analysed medical record data from 59,602 people who attended the accident and emergency department of the National Centre for Global Health and Medicine in Tokyo between January 2006 and March 2012. Of these, 356 people were treated for severe hypoglycaemia. ECG readings revealed that half of people with type 1 diabetes and over half of people with type 2 diabetes displayed QT prolongation, which could be predictive of cardiac arrest.
The results also indicate that people with type 1 diabetes had a reduced risk of severe hypertension compared to those with type 2 diabetes, but were equally likely to develop hypokalemia and QT prolongation. Just under a quarter of people with type 1 or type 2 diabetes presented to the emergency department with hypothermia, which is associated with cardiac arrhythmia and adverse outcomes.
Interestingly, people with type 2 diabetes (22.1%) were more likely to have a previous history of cardiovascular disease (CVD) compared to those with type 1 diabetes (6.8%). No new cases of CVD were diagnosed in people with type 1 diabetes whereas 1.5% of individuals with type 2 diabetes were newly diagnosed with CVD such as coronary heart disease or stroke.
Senior author, Dr Mitsuhiko Noda, National Centre for Global Health and Medicine, Tokyo, Japan, said: “We tried to search [for] the link between hypoglycaemia and cardiovascular disease. We also tried to detect the difference in pathophysiologic effects of hypoglycaemia between type 1 and type 2 diabetic patients.”
He added: “Our finding[s] uncovered that severe hypoglycaemia could indeed lead to lethal arrhythmias, cardiovascular events, and subsequent death.”
