ArticleDiabetologia2004
Changes in cardiac repolarization during clinical episodes of nocturnal hypoglycaemia in adults with Type 1 diabetes.
Article in Diabetologia, 2004. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 52 papers, 3 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
52 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- 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
- Hypoglycaemia detection and prediction techniques: A systematic review on the latest developments.Diabetes/metabolism research and reviews · 2021Pooled it
- Cardiac implications of hypoglycaemia in patients with diabetes - a systematic review.Cardiovascular diabetology · 2013Pooled it
- Effects of metoprolol on QT interval and QT dispersion in Type 1 diabetic patients with abnormal albuminuria.Diabetologia · 2004Trial
- Impact of pre-arrest glycemic state induced by prolonged fasting on defibrillation requirements: a prospective porcine model of ventricular fibrillation cardiac arrest.Resuscitation plus · 2026Article
- Review
- Predicting risk for nocturnal hypoglycemia after physical activity in children with type 1 diabetes.Frontiers in medicine · 2024Article
- Article
- Hypoglycaemia in type 1 diabetes mellitus: risks and practical prevention strategies.Nature reviews. Endocrinology · 2023Review
- Risk Factors for QT Prolongation in Patients with Chronic Hydroxychloroquine Use.Acta Cardiologica Sinica · 2022Article
- Type 1 Diabetes, Sleep, and Hypoglycemia.Current diabetes reports · 2021Review
- Hypoglycaemia combined with mild hypokalaemia reduces the heart rate and causes abnormal pacemaker activity in a computational model of a human sinoatrial cell.Journal of the Royal Society, Interface · 2021Article
- Autonomic cardiac regulation during spontaneous nocturnal hypoglycemia in children with type 1 diabetes.Pediatric diabetes · 2021Observational
- Article
- Early Morning QT Prolongation During Hypoglycemia: Only a Matter of Glucose?Frontiers in cardiovascular medicine · 2021Article
- Increased risk of cardiovascular mortality by strict glycemic control (pre-procedural HbA1c < 6.5%) in Japanese medically-treated diabetic patients following percutaneous coronary intervention: a 10-year follow-up study.Cardiovascular diabetology · 2020Observational
- Precision Medicine and Artificial Intelligence: A Pilot Study on Deep Learning for Hypoglycemic Events Detection based on ECG.Scientific reports · 2020Article
- Hypoglycaemia and cardiac arrhythmias in diabetes.Therapeutic advances in endocrinology and metabolism · 2020Review
- Basal fatty acid oxidation increases after recurrent low glucose in human primary astrocytes.Diabetologia · 2019Article
- Salbutamol-induced electrophysiological changes show no correlation with electrophysiological changes during hyperinsulinaemic-hypoglycaemic clamp in young people with Type 1 diabetes.Diabetic medicine : a journal of the British Diabetic Association · 2018Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aims/hypothesisExperimental hypoglycaemia leads to abnormal cardiac repolarization manifest by a lengthened QT interval and caused by adrenergic stimulation. However it is less clear whether spontaneous clinical episodes lead to similar changes. We have therefore measured cardiac ventricular repolarization and counterregulatory responses in patients with Type 1 diabetes during hypoglycaemic and euglycaemic nights.
methodsWe studied 22 patients with Type 1 diabetes (mean age 40.4+/-17.2 years, duration of diabetes 17.2+/-9.3 years, HbA1c 8.2+/-1.2% overnight). Measurements were taken hourly of blood glucose, plasma potassium, catecholamines and high resolution electrocardiograms.
resultsHypoglycaemia (blood glucose level <2.5 mmol/l) occurred on 7 of the 22 nights. During overnight hypoglycaemia, QTc interval increased by 27 ms (+/-15) above baseline, compared with 9 ms (+/-19) during nights with no nocturnal hypoglycaemia (p=0.034, 95%CI 2, 35). Adrenaline increased by 0.33 nmol/l (+/-0.21) above baseline during hypoglycaemia, compared with -0.05 nmol/l (+/-0.08) during euglycaemia (p=0.001, 95%CI 0.19, 0.56 nmol/l). There was no significant difference between potassium, and noradrenaline concentrations between the two groups. CONCLUSION/
interpretationQTc interval lengthens significantly during spontaneous nocturnal hypoglycaemia. Increases are generally less than those observed during experimental hypoglycaemia and could reflect attenuated sympathoadrenal responses during clinical episodes. The clinical relevance of these changes is uncertain but is consistent with the hypothesis that clinical hypoglycaemia can cause abnormal cardiac repolarization and an attendant risk of cardiac arrhythmia.
Indexed as
Identifiers
14712347What 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.