Key result
Severe hypoglycemia in the early morning was associated with a higher risk of abnormal QT prolongation than at other times in diabetic (OR 2.80) and non-diabetic (OR 4.53) patients.
Why the study?
Does severe hypoglycemia in the early morning increase the risk of abnormal QT prolongation compared to other times in patients with and without diabetes?
Observational (n=287)
Does severe hypoglycemia in the early morning increase the risk of abnormal QT prolongation compared to other times in patients with and without diabetes?
Effect estimate: OR 2.80 (DM), OR 4.53 (non-DM) (95% CI 1.15-6.80 (DM), 1.30-15.74 (non-DM))
p-value: p=0.02 (DM), 0.01 (non-DM)
Severe hypoglycemia occurring in the early morning is associated with a significantly higher risk of abnormal QT prolongation compared to other times, regardless of diabetes status.
May prompt time-specific QT monitoring during hypoglycemia; leaves open causality and need for prospective trials.
BACKGROUND: Several studies have suggested that the occurrence of severe hypoglycemia during sleep may be more dangerous for cardiac arrhythmia than that in the day-time. METHODS: We performed a retrospective study between January 2006 and March 2012 to assess electrocardiograms during severe hypoglycemia in patients with or without diabetes. RESULTS: A total of 59,602 patients who visited the emergency room by ambulance were screened, and 287 patients with severe hypoglycemia were enrolled. The median blood glucose levels in patients with (DM, n = 192) and without diabetes (non-DM, n = 95) were 30 and 45 mg/dL, respectively. During severe hypoglycemia, the incidence of abnormal QT prolongation was significantly higher in the early morning (4-10 a.m.) than at other times (DM group, 74.3% versus 54.1%, P = 0.02; non-DM group, 78.3% versus 50.0%, P = 0.01). Multivariate logistic regression analysis identified the occurrence of severe hypoglycemia in the early morning as a strong factor for abnormal QT prolongation (DM group, odds ratio [OR] 2.80, 95% confidence interval [CI] 1.15-6.80, P = 0.02; non-DM group, OR 4.53, 95% CI 1.30-15.74, P = 0.01). CONCLUSIONS: The incidence of abnormal QT prolongation during severe hypoglycemia was significantly higher in the early morning than at all other times, independent of the cause of severe hypoglycemia.
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Tsujimoto et al. (2015) conducted an observational in Severe hypoglycemia (n=287). Severe hypoglycemia in the early morning (4-10 a.m.) vs. Severe hypoglycemia at other times was evaluated on Abnormal QT prolongation (OR 2.80 (DM), OR 4.53 (non-DM), 95% CI 1.15-6.80 (DM), 1.30-15.74 (non-DM), p=0.02 (DM), 0.01 (non-DM)). Severe hypoglycemia in the early morning was associated with a higher risk of abnormal QT prolongation than at other times in diabetic (OR 2.80) and non-diabetic (OR 4.53) patients.