ArticleDiabetes2003
Mechanisms of abnormal cardiac repolarization during insulin-induced hypoglycemia.
Article in Diabetes, 2003. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 114 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
FLAT-SUGAR: FLuctuATion Reduction With inSULin and Glp-1 Added togetheR
Predicting Hypoglycaemia and Arrhythmias in the Vulnerable Patient With Diabetes and Chronic Kidney Disease - Validation Study
Who cites it
114 citing papers in PubMed, 4 syntheses or guidelines pooled it, 263 citations in OpenAlex.
- Association of hypoglycaemia with the risks of arrhythmia and mortality in individuals with diabetes - a systematic review and meta-analysis.Frontiers in endocrinology · 2023Pooled it
- Pooled it
- Major adverse cardiovascular events with basal insulin peglispro versus comparator insulins in patients with type 1 or type 2 diabetes: a meta-analysis.Cardiovascular diabetology · 2016Pooled it
- Cardiac implications of hypoglycaemia in patients with diabetes - a systematic review.Cardiovascular diabetology · 2013Pooled it
- The impact of plasma glucose decline rate on cardiac repolarisation in individuals with type 1 diabetes.Diabetes, obesity & metabolism · 2025Trial
- Effect of Hypoglycemia on QT Interval in Individuals With and Without Type 2 Diabetes: A Randomized Crossover Trial.The Journal of clinical endocrinology and metabolism · 2025Trial
- ACTH Infusion Impairs Baroreflex Sensitivity-Implications for Cardiovascular Hypoglycemia-Associated Autonomic Failure.The Journal of clinical endocrinology and metabolism · 2020Trial
- DEVOTE 3: temporal relationships between severe hypoglycaemia, cardiovascular outcomes and mortality.Diabetologia · 2018Trial
- Dynamics of blood electrolytes in repeated hyper- and/or hypoglycaemic events in patients with type 1 diabetes.Diabetologia · 2011Trial
- Effects of metoprolol on QT interval and QT dispersion in Type 1 diabetic patients with abnormal albuminuria.Diabetologia · 2004Trial
- Gender differences in hypoglycaemia in type 1 and insulin-treated type 2 diabetes: the Hypo-METRICS study.Diabetologia · 2026Observational
- Perioperative Glycemic Control and Outcomes in Cardiac Surgery: A Retrospective Cohort Study.Medical science monitor : international medical journal of experimental and clinical research · 2026Article
- Low Blood Glucose and Its Relation to Electrolyte Derangements and Metabolic Acidosis in Critically Ill Children in Malawi.The American journal of tropical medicine and hygiene · 2026Article
- Hypoglycaemia and Cardiac Arrhythmias in Type 1 Diabetes Mellitus: A Mechanistic Review.Journal of personalized medicine · 2026Review
- Electrocardiograpic responses during spontaneous hypoglycaemia in people with type 1 diabetes and impaired awareness of hypoglycaemia.Diabetic medicine : a journal of the British Diabetic Association · 2025Article
- Cardiac arrhythmia and hypoglycaemia among individuals with and without diabetes receiving haemodialysis (the CADDY study): a Danish multicentre cohort study.Diabetologia · 2025Observational
- Changes of the cardiac electrical cycle in type 1 diabetes during hypoglycaemia - a prospective observational study.Frontiers in endocrinology · 2025Observational
- The relationship between blood glucose and clinical outcomes after extracorporeal circulation: a retrospective cohort study.Frontiers in cardiovascular medicine · 2025Article
- Relationship Between Sensor-Detected Hypoglycemia and Patient-Reported Hypoglycemia in People With Type 1 and Insulin-Treated Type 2 Diabetes: The Hypo-METRICS Study.Diabetes care · 2024Article
- Norepinephrine mediates heart block during severe hypoglycemia in male rats.Physiological reports · 2024Article
54 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Prolonged cardiac repolarization causes fatal cardiac arrhythmias. There is evidence that these contribute to sudden death associated with nocturnal hypoglycemia in young people with diabetes. We measured cardiac repolarization (QT interval [QTc] and QT dispersion [QTd]) during experimental hypoglycemia with and without beta-blockade and potassium infusion to establish possible mechanisms. Two groups of 10 nondiabetic men (study 1 and study 2) each underwent four hyperinsulinemic clamps: two euglycemic (5 mmol/l) and two hypoglycemic (5 mmol/l and 2.5 mmol/l for 60 min each). Study 1 was performed with and without potassium infusion to maintain normal concentrations and study 2 with and without beta-blockade (atenolol, 100 mg/day for 7 days). QTd was unchanged during euglycemia but increased during hypoglycemia (55 ms, P < 0.0001 vs. baseline), which was prevented by potassium (6 ms, P = 0.78). QTc increased significantly during hypoglycemia alone (67 ms, P < 0.0001) and during potassium replacement (46 ms, P = 0.02). In study 2, the increase in QTd during hypoglycemia (68 ms, P < 0.0001) was prevented by beta-blockade (3 ms, P = 0.88). The increase in QTc during hypoglycemia (55 ms, P < 0.0001) was prevented by beta-blockade (1 ms, P = 0.98). Our data indicate that hypoglycemia causes an acquired long QT syndrome. Sympathoadrenal stimulation is the main cause, through mechanisms that involve but are not limited to catecholamine-mediated hypokalemia. These abnormalities are prevented by selective beta-blockade.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.