Key result
Paired CGM and ECG may identify high-risk T1D patients by detecting early glycemic and cardiac disturbances.
Why the study?
Existing studies on hypoglycaemia and cardiac arrhythmias in T1DM often involve mixed diabetes populations, small cohorts, or limited nocturnal monitoring, leaving gaps in understanding how glucose fluctuations drive arrhythmic events.
This mechanistic review highlights how hypoglycemia in T1DM triggers arrhythmias via autonomic and ionic disturbances, suggesting a role for combined continuous glucose and ECG monitoring.
Supports combined CGM-ECG monitoring in T1DM; hypothesis-generating and requires prospective validation before practice change.
Hypoglycaemia in patients with type 1 diabetes mellitus (T1DM) remains a major clinical burden and, beyond its metabolic complications, can cause serious cardiac arrhythmias. Multiple mechanisms lead to different types of arrhythmias during hypoglycaemia. However, existing studies often involve mixed diabetes populations, small cohorts, or limited monitoring during nocturnal periods, leaving a critical gap in understanding the links between glucose fluctuations and arrhythmic events. This review provides an updated combination of experimental and clinical evidence describing how autonomic dysfunction and ionic imbalances lead to electrophysiological instability and structural remodelling of the myocardium during hypoglycaemia. Continuous glucose monitoring (CGM) combined with electrocardiographic or wearable rhythm tracking may enable early detection of glycemic and cardiac disturbances and help identify high-risk individuals. Future prospective studies using combined CGM–ECG monitoring, particularly during sleep, are essential to clarify the relationship between hypoglycaemia and arrhythmic events.
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Mavromoustakou et al. (2026) studied this question. Continuous glucose monitoring paired with ECG may enable early detection of glycemic and cardiac disturbances in type 1 diabetes, identifying high-risk individuals.
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