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Acta Diabetologica

Published in:

01-03-2017 | Original Article

Changes in cardiac repolarisation during spontaneous nocturnal hypoglycaemia in subjects with type 1 diabetes: a preliminary report

Authors: Minna L. Koivikko, Tuomas Kenttä, Pasi I. Salmela, Heikki V. Huikuri, Juha S. Perkiömäki

Published in: Acta Diabetologica | Issue 3/2017

Abstract

Aims

Experimental studies have revealed that hypoglycaemia can result in morphological changes in electrocardiographic repolarisation in subjects with type 1 diabetes. However, the influence of spontaneous nocturnal hypoglycaemia on repolarisation morphology in a ‘real life’ situation is not clear.

Methods

Adults with type 1 diabetes (n = 11) underwent continuous glucose monitoring with a subcutaneous sensor and digital 12-lead ECG recording for three nights. T-wave morphology was analysed with custom-made software during both hypoglycaemia (glucose <3.5 mmol/l at least 20 min) from ten consecutive heart beats in the middle of the deepest hypoglycaemia and from a control nonhypoglycaemic period (glucose ≥5.0 mmol/l) from the same recording.

Results

In the comparison of 10 hypoglycaemia-control pairs, heart rate (65 ± 12 beats/min during normoglycaemia versus 85 ± 19 beats/min during hypoglycaemia, p = 0.028) increased and the QT_c interval (439 ± 5 vs. 373 ± 5 ms, respectively, p = 0.025) decreased significantly during hypoglycaemia. The spatial QRS-T angle (TCRT) was reduced, and the roughness of the T-wave loop (T-E) increased significantly (p = 0.037 for both) in the patients during hypoglycaemia.

Conclusions

In adults with type 1 diabetes, spontaneous nocturnal hypoglycaemia results in morphological changes and increased heterogeneity of global cardiac repolarisation. These changes may contribute to the risk of ‘dead in bed’ syndrome encountered in young individuals with type 1 diabetes.

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Title: Changes in cardiac repolarisation during spontaneous nocturnal hypoglycaemia in subjects with type 1 diabetes: a preliminary report
Authors: Minna L. Koivikko
Tuomas Kenttä
Pasi I. Salmela
Heikki V. Huikuri
Juha S. Perkiömäki
Publication date: 01-03-2017
Publisher: Springer Milan
Published in: Acta Diabetologica / Issue 3/2017
Print ISSN: 0940-5429
Electronic ISSN: 1432-5233
DOI: https://doi.org/10.1007/s00592-016-0941-2

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