Diabetes & Metabolism Journal

Original Articles

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

Prevalence and Clinical Characteristics of Aspirin Resistance in the Patients with Type 2 Diabetes Mellitus.: Mi Yeon Kang, Young Min Cho, Hyun Kyung Kim, Jee Hyun An, Hwa Young Ahn, Ji Won Yoon, Hoon Sung Choi, Jie Seon Lee, Kyong Soo Park, Seong Yeon Kim, Hong Kyu Lee; Korean Diabetes J. 2008;32(1):53-59. Published online February 1, 2008; DOI: https://doi.org/10.4093/kdj.2008.32.1.53

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Abstract PDF

BACKGROUND
We examined the prevalence and clinical characteristics of aspirin resistance in the Korean patients with type 2 diabetes mellitus. METHODS: We studied 181 Korean patients with type 2 diabetes mellitus who were taking aspirin (100 mg/day for > or = 3 months) and no other antiplatelet agents. The VerifyNow System was used to determine aspirin responsiveness. Aspirin resistance was defined as an aspirin reaction unit (ARU) > or = 550. We measured the cardio-ankle vascular index (CAVI) and ankle-brachial index (ABI) to evaluate arteriosclerosis. The anthropometric parameters, electrocardiogram, blood pressure, fasting plasma glucose, lipid profiles, hemoglobin A1c, highly sensitive C-reactive protein (hsCRP), homocysteine, and microalbuminuria were measured in each patient. RESULTS: The prevalence of aspirin resistance in type 2 diabetic patients was 9.4% (17 of 181). Those who had aspirin resistance were older than those without aspirin resistance (64.6 +/- 10.6 vs. 59.8 +/- 8.1, P = 0.024). Aspirin resistance was not associated with fasting plasma glucose, total cholesterol, triglyceride, LDL-cholesterol, HDL-cholesterol, hemoglobin A1c, hsCRP, homocysteine, microalbuminuria, ABI, CAVI, and body mass index. CONCLUSION: Prevalence of aspirin resistance in the Korean patients with type 2 diabetes mellitus was 9.4%. Although aspirin resistance was associated with old age, we could not find any good clinical parameter to predict it. Therefore, aspirin resistance should be evaluated in diabetic patients taking aspirin for prevention of cardiovascular complications.

Citations

Citations to this article as recorded by

Long Non-Coding RNA H19 Positively Associates With Aspirin Resistance in the Patients of Cerebral Ischemic Stroke
Jue Wang, Bin Cao, Yan Gao, Dong Han, Haiping Zhao, Yuhua Chen, Yumin Luo, Juan Feng, Yanxia Guo
Frontiers in Pharmacology.2020;[Epub] CrossRef
6^th Asian PAD Workshop

Annals of Vascular Diseases.2015; 8(2): 135. CrossRef
Non-HDL cholesterol is an independent risk factor for aspirin resistance in obese patients with type 2 diabetes
Jong Dai Kim, Cheol-Young Park, Kue Jeong Ahn, Jae Hyoung Cho, Kyung Mook Choi, Jun Goo Kang, Jae Hyeon Kim, Ki Young Lee, Byung Wan Lee, Ji Oh Mok, Min Kyong Moon, Joong Yeol Park, Sung Woo Park
Atherosclerosis.2014; 234(1): 146. CrossRef

Case Report

Two Cases of Autoantibody Negative Fulminant Type 1 Diabetes Mellitus.: Hwa Young Cho, Young Min Cho, Myoung Hee Park, Mi Yeon Kang, Ki Hwan Kim, Yun Hyi Ku, Eun Kyung Lee, Do Joon Park, Chan Soo Shin, Kyong Soo Park, Seong Yeon Kim, Bo Youn Cho, Hong Kyu Lee; Korean Diabetes J. 2007;31(4):372-376. Published online July 1, 2007; DOI: https://doi.org/10.4093/jkda.2007.31.4.372

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Abstract PDF: Autoantibody negative fulminant type 1 diabetes mellitus is a novel subtype of type 1 diabetes, which is characterized by a remarkably abrupt onset, metabolic derangement such as diabetic ketoacidosis at diagnosis, low HbA1c level at onset and a negative islet-related autoantibodies. The prevalence of fulminant type 1 diabetes has large difference between Japan and other countries. The precise reason for this regional variation remains to be clarified. One of the possible explanations is genetic background such as genotype of class II HLA molecule. In addition, environment factors including viral infection are suggested as possible pathogenesis of the disease. Only a few cases with fulminant type 1 diabetes have been reported outside Japan, and most of these cases with definite diagnosis have been reported in Korea. We report here on two Korean patients that met the criteria for diagnosis of fulminant type 1 diabetes in accordance with their HLA genotypes.

Original Article

A Case of Newly Diagnosed Type 2 Diabetes Mellitus Presenting with Rhinocerebral Mucormycosis.: Jung Hwa Jung, Jong Ryeal Hahm, Mi Yeon Kang, Sung Won Moon, Tae Sik Jung, Deok Ryong Kim, Soon Il Chung; Korean Diabetes J. 2004;28(3):225-230. Published online June 1, 2004

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Abstract PDF: Rhinocerebral mucormycosis(RM) is a rare opportunistic fungal infection that mainly occurs in immunocompromised or diabetic patients, but rarely in healthy indi-viduals. This fungal infection usually begins at the nose and progresses through the paranasal sinuses, and secondarily invading the orbit and central nervous system. Because of its rapid progression and high mortality, early diagnosis and treatment are crucial to increase the patient survival rate. A combination of ampho-tericin B administration and surgery is a standard repertoire of RM treatment. Herein, a case in which a 69-year-old male patient with type 2 diabetes mellitus, presentings as RM, is reported. This patient had never been diagnosed with diabetes mellitus until the diabetes and RM were identified by us using the oral glucose tolerance test, measurement of the glycated hemoglobin level and a paranasal sinus CT scan. The RM was further confirmed by a biopsy of an oral mucosal ulcerative lesion. This case suggests that RM can present in newly diagnosed type 2 diabetes patients.

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