Bernjak, A. orcid.org/0000-0001-5954-8079, Novodvorsky, P., Chow, E. et al. (9 more authors) (2021) Cardiac arrhythmias and electrophysiologic responses during spontaneous hyperglycaemia in adults with type 1 diabetes mellitus. Diabetes & Metabolism, 47 (5). 101237. ISSN 1262-3636
Abstract
Aim
We examined the effect of spontaneous hyperglycaemia in adults with type 1 diabetes mellitus (T1DM) and without history of cardiovascular disease on heart rate variability (HRV), cardiac repolarisation and incidence of cardiac arrhythmias.
Methods
Thirty-seven individuals with T1DM (age 17-50 years, 19 males, mean duration of diabetes 19.3 SD(9.6) years) underwent 96 hours of simultaneous ambulatory 12-lead Holter ECG and blinded continuous interstitial glucose (IG) monitoring (CGM). HRV, QT interval and cardiac repolarisation were assessed during hyperglycaemia (IG ≥ 15 mmol/l) and compared with matched euglycaemia (IG 5-10 mmol/l) on a different day, separately during the day and night. Rates of arrhythmias were assessed by calculating incidence rate differences.
Results
Simultaneous ECG and CGM data were recorded for 2395 hours, During daytime hyperglycaemia vs euglycaemia the mean QTc interval duration was 404 SD(21)ms vs 407 SD(20)ms, P = 0.263. T-peak to T-end interval duration corrected for heart rate (TpTendc) shortened (74.8 SD(16.1)ms vs 79.0 SD(14.8)ms, P = 0.033) and T-wave symmetry increased (1.62 SD(0.33) vs 1.50 SD(0.39), P = 0.02). During night-time hyperglycaemia vs euglycaemia, the mean QTc interval duration was 401 SD(26)ms vs 404 SD(27)ms, P = 0.13 and TpTend shortened (62.4 SD(12.0)ms vs 67.1 SD(11.8)ms, P = 0.003). The number of cardiac arrhythmias was low and confined to bradycardia and isolated ectopic beats. A considerable inter-subject and diurnal variability was observed.
Conclusions
Hyperglycaemia in individuals with T1DM without known cardiovascular disease was not associated with clinically important cardiac arrhythmias.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2021 Elsevier Masson SAS. This is an author produced version of a paper subsequently published in Diabetes & Metabolism. Uploaded in accordance with the publisher's self-archiving policy. Article available under the terms of the CC-BY-NC-ND licence (https://creativecommons.org/licenses/by-nc-nd/4.0/). |
Keywords: | Cardiac arrhythmias; Cardiac electrophysiology; Heart rate variability (HRV); Hyperglycaemia; QTc interval; Type 1 diabetes mellitus (T1DM) |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Health and Related Research (Sheffield) > ScHARR - Sheffield Centre for Health and Related Research |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 05 Mar 2021 14:11 |
Last Modified: | 26 Feb 2022 01:38 |
Status: | Published |
Publisher: | Elsevier BV |
Refereed: | Yes |
Identification Number: | 10.1016/j.diabet.2021.101237 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:171843 |
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