Diabetes & Metabolism Journal

Original Article

Corrected QT Interval Prolongation during Severe Hypoglycemia without Hypokalemia in Patients with Type 2 Diabetes: Jae Won Beom, Jung Min Kim, Eun Joo Chung, Ju Yeong Kim, Seung Yeong Ko, Sang Don Na, Cheol Hwan Kim, Gun Park, Mi Yeon Kang; Diabetes Metab J. 2013;37(3):190-195. Published online June 14, 2013; DOI: https://doi.org/10.4093/dmj.2013.37.3.190

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Background

To evaluate the effects of severe hypoglycemia without hypokalemia on the electrocardiogram in patients with type 2 diabetes in real-life conditions.

Methods

Electrocardiograms of adult type 2 diabetic patients during the episodes of severe hypoglycemia and the recovered stage were obtained and analysed between October 1, 2011 and May 31, 2012. Patients who maintained the normal serum sodium and potassium levels during the episodes of severe hypoglycemia were only selected as the subjects of this study. Severe hypoglycemia was defined, in this study, as the condition requiring active medical assistance such as administering carbohydrate when serum glucose level was less than 60 mg/dL.

Results

Nine type 2 diabetes patients (seven men, two women) were included in the study. The mean subject age was 73.2±7.7 years. The mean hemoglobin A1c level was 6.07%±1.19%. The median duration of diabetes was 10 years (range, 3.5 to 30 years). Corrected QT (QTc) intervals were significantly increased during the episodes of severe hypoglycemia compared to the recovered stage (447.6±18.2 ms vs. 417.2±30.6 ms; P<0.05). However, the morphology and the amplitude of the T waves were not changed and ST-segment elevation and/or depression were not found during the episodes of severe hypoglycemia.

Conclusion

In this study, QTc interval prolongation during the episodes of severe hypoglycemia was observed without hypokalemia. Therefore, the distinct alterations in cardiac repolarization during the episodes of severe hypoglycemia may not be associated with hypokalemia.

Citations

Citations to this article as recorded by

Prevalence of QT prolongation and its risk factors in patients with type 2 diabetes
Khaled Aburisheh, Mohammad F. AlKheraiji, Saleh I. Alwalan, Arthur C. Isnani, Mohamed Rafiullah, Muhammad Mujammami, Assim A. Alfadda
BMC Endocrine Disorders.2023;[Epub] CrossRef
Celebrities in the heart, strangers in the pancreatic beta cell: Voltage‐gated potassium channels Kv7.1 and Kv11.1 bridge long QT syndrome with hyperinsulinaemia as well as type 2 diabetes
Anniek F. Lubberding, Christian R. Juhl, Emil Z. Skovhøj, Jørgen K. Kanters, Thomas Mandrup‐Poulsen, Signe S. Torekov
Acta Physiologica.2022;[Epub] CrossRef
Severe Hypoglycemia Increases Dementia Risk and Related Mortality: A Nationwide, Population-based Cohort Study
Eugene Han, Kyung-do Han, Byung-Wan Lee, Eun Seok Kang, Bong-Soo Cha, Seung-Hyun Ko, Yong-ho Lee
The Journal of Clinical Endocrinology & Metabolism.2022; 107(5): e1976. CrossRef
CHANGES IN THE QT INTERVAL IN PATIENTS WITH ANKYLOSING SPONDYLITIS
A. Zayaeva, Galina Koshukova, E. Dolya, A. Nikolayeva, D. Ten
Tavricheskiy Mediko-Biologicheskiy Vestnik.2022; 23(4): 20. CrossRef
Cardiac Effects of Sulfonylurea-Related Hypoglycemia
Timothy L. Middleton, Jencia Wong, Lynda Molyneaux, Belinda A. Brooks, Dennis K. Yue, Stephen M. Twigg, Ted Wu
Diabetes Care.2017; 40(5): 663. CrossRef
Major rapid weight loss induces changes in cardiac repolarization
Esben Vedel-Larsen, Eva Winning Iepsen, Julie Lundgren, Claus Graff, Johannes J. Struijk, Torben Hansen, Jens Juul Holst, Sten Madsbad, Signe Torekov, Jørgen K. Kanters
Journal of Electrocardiology.2016; 49(3): 467. CrossRef
Avoiding or coping with severe hypoglycemia in patients with type 2 diabetes
Jae-Seung Yun, Seung-Hyun Ko
The Korean Journal of Internal Medicine.2015; 30(1): 6. CrossRef
Blood electrolyte disturbances during severe hypoglycemia in Korean patients with type 2 diabetes
Mi Yeon Kang
The Korean Journal of Internal Medicine.2015; 30(5): 648. CrossRef
Vildagliptin, a DPP-4 inhibitor for the twice-daily treatment of type 2 diabetes mellitus with or without metformin
Thomas Forst, Peter Bramlage
Expert Opinion on Pharmacotherapy.2014; 15(9): 1299. CrossRef
Does glycemic control reverse dispersion of ventricular repolarization in type 2 diabetes?
Takayuki Miki, Toshiyuki Tobisawa, Tatsuya Sato, Masaya Tanno, Toshiyuki Yano, Hiroshi Akasaka, Atsushi Kuno, Makoto Ogasawara, Hiromichi Murase, Shigeyuki Saitoh, Tetsuji Miura
Cardiovascular Diabetology.2014;[Epub] CrossRef
Hypoglycemia at Admission in Patients With Acute Myocardial Infarction Predicts a Higher 30-Day Mortality in Patients With Poorly Controlled Type 2 Diabetes Than in Well-Controlled Patients
Sang Ah Lee, Suk Ju Cho, Myung Ho Jeong, Young Jo Kim, Chong Jin Kim, Myeong Chan Cho, Hyo-Soo Kim, Youngkeun Ahn, Gwanpyo Koh, Jeong mi Lee, Seok Kyu Oh, Kyeong Ho Yun, Ha Young Kim, Chung Gu Cho, Dae Ho Lee
Diabetes Care.2014; 37(8): 2366. CrossRef

Case Report

Hemichorea Associated with Type II Diabetes Mellitus.: Ju Hee Maeng, Hee Sup Lee, Jin Gun Jang, Bae Gun Park, Kwang Deog Jo, Myoung Sook Shim, Jin Yub Kim; Korean Diabetes J. 2003;27(4):362-366. Published online August 1, 2003

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Abstract PDF: Hemichorea has been reported as a rare complication of nonketotic hyperglycemia. We report a diabetic patient who developed paroxysmal hemichorea. When hyperglycemia is corrected, the movement disorder resolves within a few days. The MR images showed high signal intensity on T1-weighted images and low signal intensity on T2-weighted images in the left basal ganglia contralateral to the involuntary movement. We present a case of hemichorea in a poorly controlled diabetic patient.

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