Incidence of prolonged QTc and severe hypoglycemia in type 1 diabetes: The EURODIAB Prospective Complications Study
Amione,Cristina Giunti,Sara Fornengo,Paolo Soedamah-Muthu,S.S. Chaturvedi,Nish Fuller,J. H. Barutta,Federica Gruden,Gabriella Bruno,Graziella
Amione,Cristina
Giunti,Sara
Fornengo,Paolo
Soedamah-Muthu,S.S.
Chaturvedi,Nish
Fuller,J. H.
Barutta,Federica
Gruden,Gabriella
Bruno,Graziella
Abstract
Aims To assess the independent role of severe hypoglycemia on 7-year cumulative incidence of prolonged QTc in a large cohort of patients with type 1 diabetes. Methods People with type 1 diabetes recruited by the EURODIAB Prospective Complications Study who had normal QTc were examined at baseline and after 7 years with standardized methods (n = 1415; mean age ± SD 32.1 ± 9.6 years; diabetes duration 14.2 ± 8.8 years). Hypoglycemic episodes were assessed by a questionnaire. QTc was calculated according to Bazett’s formula. In logistic regression analysis, we examined the role of severe hypoglycemia (none, 1–2, or 3 and more episodes/year) on the cumulative incidence of prolonged QTc, independently of age, sex, HbA1c, blood pressure, BMI, physical activity, distal symmetrical and autonomic neuropathy. Results In total, 264/1415 (17%) patients had incident prolonged QTc. Compared to those with persistently normal QTc, a greater proportion of incident cases had 3 and more hypoglycemic episodes at baseline (16.3 vs 11.2%, p = 0.03) and after 7 years (15.2 vs 9.6%, p = 0.01). In logistic regression analysis, 3 or more episodes of severe hypoglycemia at baseline did not increase cumulative incidence of prolonged QTc (OR 1.34, 95% CI 0.88–2.03). By contrast, severe hypoglycemia at the follow-up examination was associated with higher incidence of QTc prolongation (OR 1.68, 1.09–2.58), which reverted to not significant after adjustment for diabetic neuropathy. Conclusions Severe hypoglycemia was not associated with incidence QTc prolongation in type 1 diabetic patients from the EURODIAB PCS. Keywords: Hypoglycemia, QTc, Complications, Surveys
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Date
2017-09-01
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Research Projects
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SDG 3 - Good Health and Well-being
Citation
Amione, C, Giunti, S, Fornengo, P, Soedamah-Muthu, S S, Chaturvedi, N, Fuller, J H, Barutta, F, Gruden, G & Bruno, G 2017, 'Incidence of prolonged QTc and severe hypoglycemia in type 1 diabetes : The EURODIAB Prospective Complications Study', Acta Diabetologica, vol. 54, no. 9, pp. 871-876. https://doi.org/10.1007/s00592-017-1018-6