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Altered ventricular repolarization during hypoglycaemia in patients with diabetes
Diabetic medicine, 1997-08, Vol.14 (8), p.648-654
Marques, J.L.B.
George, E.
Peacey, S.R.
Harris, N.D.
Macdonald, I.A.
Cochrane, T.
Heller, S.R.
1997
Volltextzugriff (PDF)
Details
Autor(en) / Beteiligte
Marques, J.L.B.
George, E.
Peacey, S.R.
Harris, N.D.
Macdonald, I.A.
Cochrane, T.
Heller, S.R.
Titel
Altered ventricular repolarization during hypoglycaemia in patients with diabetes
Ist Teil von
Diabetic medicine, 1997-08, Vol.14 (8), p.648-654
Ort / Verlag
Chichester, UK: John Wiley & Sons, Ltd
Erscheinungsjahr
1997
Quelle
Wiley-Blackwell Journals
Beschreibungen/Notizen
There is circumstantial evidence implicating hypoglycaemia in the sudden overnight death of young patients with insulin‐dependent (Type 1) diabetes mellitus (IDDM), the mechanism of which is unknown. We have investigated the effects of hypoglycaemia on the electrocardiogram in 15 patients with diabetes (8 with IDDM and 7 with NIDDM) using a high resolution computer‐based system. Patients were randomized to either 2 h of euglycaemia or hypoglycaemia (at around 3 mmol l−1 ) during the afternoon, using hyperinsulinaemic glucose clamps, the two visits separated by a period of at least 4 weeks. Corrected QT interval (QTc), plasma potassium, and adrenaline were measured at baseline and at 0, 60, and 120 min. The degree of QTc lengthening (from baseline) during clamped hypoglycaemia was greater compared to the euglycaemic control period in patients with IDDM (median{range} at 60 min, 156{8 to 258 } vs 6{−3 to 28} ms, p <0.02) and NIDDM (120 min, 128{16 to 166} vs 4{ −3 to 169} ms, p <0.05). The fall in plasma potassium was greater during clamped hypoglycaemia compared to euglycaemia in those with NIDDM ( p <0.03) but not with those with IDDM ( p >0.06). The rise in plasma adrenaline was greater during clamped hypoglycaemia in both groups (IDDM p <0.02, NIDDM p <0.02) and there was a strong relationship between the rise in adrenaline and increase in QTc ( r = 0.73, p <0.0001).These data demonstrate alteration of ventricular repolarization with lengthening of the QT interval during hypoglycaemia and suggest a possible mechanism by which hypoglycaemia could cause ventricular arrhythmias. © 1997 by John Wiley & Sons, Ltd.
Sprache
Englisch
Identifikatoren
ISSN: 0742-3071
eISSN: 1464-5491, 1096-9136
DOI: 10.1002/(SICI)1096-9136(199708)14:8<648::AID-DIA418>3.0.CO;2-1
Titel-ID: cdi_proquest_miscellaneous_79239713
Format
–
Schlagworte
Adult
,
Associated diseases and complications
,
Biological and medical sciences
,
Blood Glucose - metabolism
,
catecholamines
,
Diabetes Mellitus, Type 1 - blood
,
Diabetes Mellitus, Type 1 - complications
,
Diabetes Mellitus, Type 1 - physiopathology
,
Diabetes Mellitus, Type 2 - blood
,
Diabetes Mellitus, Type 2 - complications
,
Diabetes Mellitus, Type 2 - physiopathology
,
Diabetes. Impaired glucose tolerance
,
electrocardiogram
,
Electrocardiography
,
Endocrine pancreas. Apud cells (diseases)
,
Endocrinopathies
,
Epinephrine - blood
,
Female
,
Glucose Clamp Technique
,
Heart Rate
,
Heart Ventricles - physiopathology
,
Humans
,
hypoglycaemia
,
Hypoglycemia - blood
,
Hypoglycemia - complications
,
Hypoglycemia - physiopathology
,
IDDM
,
Insulin - blood
,
Male
,
Medical sciences
,
Middle Aged
,
NIDDM
,
Potassium - blood
,
QT interval
,
sudden death
,
Tachycardia, Ventricular - etiology
,
Tachycardia, Ventricular - physiopathology
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