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Hypoglycaemia leads to an increased QT interval in normal men

Eckert, Bodil and Agardh, Carl-David LU (1998) In Clinical Physiology 18(6). p.570-575
Abstract
Hypoglycaemia is presumed to be the cause of death in about 3% of insulin-treated diabetic patients. Some of these patients suffer from hypoglycaemic brain damage, but the majority have no evident brain damage and are supposed to have died from other causes such as a cardiac arrhythmia. The putative mechanism is a hypoglycaemia-induced prolongation of the QT interval which increases the risk of malignant ventricular tachycardia. The aim of the present study was to examine the electrocardiogram during and after hypoglycaemia in healthy men. To that end, hypoglycaemia was induced by an intravenous infusion of insulin (2.5 mU kg-1 min-1) in 10 healthy men to reach a venous blood glucose level of 2.1 +/- 0.3 mmol l-1 for 65 +/- 9 min. Before... (More)
Hypoglycaemia is presumed to be the cause of death in about 3% of insulin-treated diabetic patients. Some of these patients suffer from hypoglycaemic brain damage, but the majority have no evident brain damage and are supposed to have died from other causes such as a cardiac arrhythmia. The putative mechanism is a hypoglycaemia-induced prolongation of the QT interval which increases the risk of malignant ventricular tachycardia. The aim of the present study was to examine the electrocardiogram during and after hypoglycaemia in healthy men. To that end, hypoglycaemia was induced by an intravenous infusion of insulin (2.5 mU kg-1 min-1) in 10 healthy men to reach a venous blood glucose level of 2.1 +/- 0.3 mmol l-1 for 65 +/- 9 min. Before hypoglycaemia, after 20 and 50 min of hypoglycaemia and 20 and 45 min after normalization of the blood glucose, the QT interval was measured by a ruler and corrected for the heart rate. Results are given as mean +/- SD and comparisons were made with an ANOVA, except for symptom scores and plasma adrenaline where non-parametric tests were used. When this indicated significance, further analysis was performed with a two-tailed t-test. During hypoglycaemia the corrected QT interval increased from 380 +/- 20 ms1/2 to 440 +/- 30 ms1/2 (P < 0.001), and the amplitude of the T wave decreased (P = 0.002). The serum potassium level decreased from 4.3 +/- 0.3 mmol l-1 to 3.5 +/- 0.2 mmol l-1 (P < 0.001) and the plasma adrenaline concentration increased from 0.20 +/- 0.04 nmol l-1 to 2.46 +/- 2.58 nmol l-1 (P < 0.01). The results of this study confirm that a prolongation of the QT interval occurs during hypoglycaemia, but the significance of this finding still has to be proven. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
cardiac arrhythmia, diabetes mellitus, hypoglycaemia, QT interval, sudden death
in
Clinical Physiology
volume
18
issue
6
pages
570 - 575
publisher
Wiley-Blackwell
external identifiers
  • pmid:9818163
  • scopus:0031793981
ISSN
1365-2281
DOI
10.1046/j.1365-2281.1998.00138.x
language
English
LU publication?
yes
id
fde2a8fb-05bc-43d2-9956-5015a39bf186 (old id 1112637)
date added to LUP
2008-07-10 10:52:51
date last changed
2017-06-04 03:33:28
@article{fde2a8fb-05bc-43d2-9956-5015a39bf186,
  abstract     = {Hypoglycaemia is presumed to be the cause of death in about 3% of insulin-treated diabetic patients. Some of these patients suffer from hypoglycaemic brain damage, but the majority have no evident brain damage and are supposed to have died from other causes such as a cardiac arrhythmia. The putative mechanism is a hypoglycaemia-induced prolongation of the QT interval which increases the risk of malignant ventricular tachycardia. The aim of the present study was to examine the electrocardiogram during and after hypoglycaemia in healthy men. To that end, hypoglycaemia was induced by an intravenous infusion of insulin (2.5 mU kg-1 min-1) in 10 healthy men to reach a venous blood glucose level of 2.1 +/- 0.3 mmol l-1 for 65 +/- 9 min. Before hypoglycaemia, after 20 and 50 min of hypoglycaemia and 20 and 45 min after normalization of the blood glucose, the QT interval was measured by a ruler and corrected for the heart rate. Results are given as mean +/- SD and comparisons were made with an ANOVA, except for symptom scores and plasma adrenaline where non-parametric tests were used. When this indicated significance, further analysis was performed with a two-tailed t-test. During hypoglycaemia the corrected QT interval increased from 380 +/- 20 ms1/2 to 440 +/- 30 ms1/2 (P &lt; 0.001), and the amplitude of the T wave decreased (P = 0.002). The serum potassium level decreased from 4.3 +/- 0.3 mmol l-1 to 3.5 +/- 0.2 mmol l-1 (P &lt; 0.001) and the plasma adrenaline concentration increased from 0.20 +/- 0.04 nmol l-1 to 2.46 +/- 2.58 nmol l-1 (P &lt; 0.01). The results of this study confirm that a prolongation of the QT interval occurs during hypoglycaemia, but the significance of this finding still has to be proven.},
  author       = {Eckert, Bodil and Agardh, Carl-David},
  issn         = {1365-2281},
  keyword      = {cardiac arrhythmia,diabetes mellitus,hypoglycaemia,QT interval,sudden death},
  language     = {eng},
  number       = {6},
  pages        = {570--575},
  publisher    = {Wiley-Blackwell},
  series       = {Clinical Physiology},
  title        = {Hypoglycaemia leads to an increased QT interval in normal men},
  url          = {http://dx.doi.org/10.1046/j.1365-2281.1998.00138.x},
  volume       = {18},
  year         = {1998},
}