Glucose Excursions Linked to Ventricular Tachycardia

BERLIN – A hypoglycemic event and a high rate of glucose excursions were associated with an increased rate of ventricular tachycardia, in a study of 30 patients with type 2 diabetes and a history of cardiovascular disease.

The findings highlight the potentially important role that glycemic excursions and hypoglycemic events play in patient health. "We have underestimated the risk from hypoglycemia as a cause of death," Dr. Markolf Hanefeld said in an interview at the annual meeting of the European Association for the Study of Diabetes.

Each patient underwent 5 consecutive days of simultaneous continuous glucose monitoring and ECG recording. During this period, severe hypoglycemic events – defined as a blood glucose level less than 3.1 mmol/L – occurred in 23 patients, with a total of 35 episodes. The average time of each severe episode was 40 minutes.

Twenty-eight of 30 patients had ventricular extrasystoles (VESs), with an average of more than 3,600 during 5 days of ECG recording. Seventeen patients had couplets, 10 had triplets, and 5 had ventricular tachycardia.

Analysis showed a statistically significant increase in the rate of severe VESs in patients who had a mean amplitude of glycemic excursions of at least 4.02 mmol/L, Dr. Hanefeld and his colleaguesreported. The highest rate by far of VES occurred in patients who had at least one severe hypoglycemic event and a mean amplitude of glycemic excursions of greater than 5.61 mmol/L.

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