Changes in cardiac repolarisation during spontaneous nocturnal hypoglycaemia in subjects with type 1 diabetes: a preliminary report
Aims Experimental studies have revealed that hypoglycaemia can result in morphological changes in electrocardiographic repolarisation in subjects with type 1 diabetes. However, the influence of spontaneous nocturnal hypoglycaemia on repolarisation morphology in a ‘real life’ situation is not clear....
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| Veröffentlicht in: | Acta diabetologica 2017-03, Vol.54 (3), p.251-256 |
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| container_title | Acta diabetologica |
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| creator | Koivikko, Minna L. Kenttä, Tuomas Salmela, Pasi I. Huikuri, Heikki V. Perkiömäki, Juha S. |
| description | Aims
Experimental studies have revealed that hypoglycaemia can result in morphological changes in electrocardiographic repolarisation in subjects with type 1 diabetes. However, the influence of spontaneous nocturnal hypoglycaemia on repolarisation morphology in a ‘real life’ situation is not clear.
Methods
Adults with type 1 diabetes (
n
= 11) underwent continuous glucose monitoring with a subcutaneous sensor and digital 12-lead ECG recording for three nights. T-wave morphology was analysed with custom-made software during both hypoglycaemia (glucose |
| doi_str_mv | 10.1007/s00592-016-0941-2 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1877842056</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1847893031</sourcerecordid><originalsourceid>FETCH-LOGICAL-c405t-d608e08062dbf67c26e3ba6fe89abeeb46fb849af43c86da5a5809c21d96c5b13</originalsourceid><addsrcrecordid>eNqNkc-L1DAUgIMo7uzqH-BFAl68VF9-NvUmg7rCghc9lzR9ncnQpjVJkTnvP247XUUEwVMgfO8LeR8hLxi8YQDl2wSgKl4A0wVUkhX8EdkxKXihuBCPyW65hEJJXl2R65ROAIyXwjwlV7yshFBM7sj9_mjDARP1gTobW28djTiNvY0-2ezHQNs5-nCgaRpDtgHHOdEwujzHYHt6PE_joT87i4O3qyTNzQldTvSHz0eazxNSRhdtgxnTO2rpFLH3gw82ni8vxfyMPOlsn_D5w3lDvn388HV_W9x9-fR5__6ucBJULloNBsGA5m3T6dJxjaKxukNTLXZspO4aIyvbSeGMbq2yykDlOGsr7VTDxA15vXmnOH6fMeV68Mlh32-_qpkpSyM5KP0fqCxNJUCs1ld_oafxspuLUILQqoSFYhvl4phSxK6eoh-WHdQM6jVmvcWsl5j1GrPmy8zLB_PcDNj-nvhVbwH4BqRpTYTxj6f_af0JFPusHw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1874036570</pqid></control><display><type>article</type><title>Changes in cardiac repolarisation during spontaneous nocturnal hypoglycaemia in subjects with type 1 diabetes: a preliminary report</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Koivikko, Minna L. ; Kenttä, Tuomas ; Salmela, Pasi I. ; Huikuri, Heikki V. ; Perkiömäki, Juha S.</creator><creatorcontrib>Koivikko, Minna L. ; Kenttä, Tuomas ; Salmela, Pasi I. ; Huikuri, Heikki V. ; Perkiömäki, Juha S.</creatorcontrib><description>Aims
Experimental studies have revealed that hypoglycaemia can result in morphological changes in electrocardiographic repolarisation in subjects with type 1 diabetes. However, the influence of spontaneous nocturnal hypoglycaemia on repolarisation morphology in a ‘real life’ situation is not clear.
Methods
Adults with type 1 diabetes (
n
= 11) underwent continuous glucose monitoring with a subcutaneous sensor and digital 12-lead ECG recording for three nights. T-wave morphology was analysed with custom-made software during both hypoglycaemia (glucose <3.5 mmol/l at least 20 min) from ten consecutive heart beats in the middle of the deepest hypoglycaemia and from a control nonhypoglycaemic period (glucose ≥5.0 mmol/l) from the same recording.
Results
In the comparison of 10 hypoglycaemia-control pairs, heart rate (65 ± 12 beats/min during normoglycaemia versus 85 ± 19 beats/min during hypoglycaemia,
p
= 0.028) increased and the QT
c
interval (439 ± 5 vs. 373 ± 5 ms, respectively,
p
= 0.025) decreased significantly during hypoglycaemia. The spatial QRS-T angle (TCRT) was reduced, and the roughness of the T-wave loop (T-E) increased significantly (
p
= 0.037 for both) in the patients during hypoglycaemia.
Conclusions
In adults with type 1 diabetes, spontaneous nocturnal hypoglycaemia results in morphological changes and increased heterogeneity of global cardiac repolarisation. These changes may contribute to the risk of ‘dead in bed’ syndrome encountered in young individuals with type 1 diabetes.</description><identifier>ISSN: 0940-5429</identifier><identifier>EISSN: 1432-5233</identifier><identifier>DOI: 10.1007/s00592-016-0941-2</identifier><identifier>PMID: 27933514</identifier><identifier>CODEN: ACDAEZ</identifier><language>eng</language><publisher>Milan: Springer Milan</publisher><subject>Adult ; Arrhythmias, Cardiac - epidemiology ; Arrhythmias, Cardiac - etiology ; Arrhythmias, Cardiac - physiopathology ; Blood Glucose - physiology ; Blood Glucose Self-Monitoring ; Case-Control Studies ; Circadian Rhythm - drug effects ; Circadian Rhythm - physiology ; Diabetes ; Diabetes Mellitus, Type 1 - blood ; Diabetes Mellitus, Type 1 - complications ; Diabetes Mellitus, Type 1 - drug therapy ; Diabetes Mellitus, Type 1 - physiopathology ; Electrocardiography ; Female ; Glucose ; Heart - physiopathology ; Heart Rate - drug effects ; Heart Rate - physiology ; Humans ; Hypoglycemia ; Hypoglycemia - chemically induced ; Hypoglycemia - epidemiology ; Hypoglycemia - physiopathology ; Incidence ; Internal Medicine ; Male ; Medicine ; Medicine & Public Health ; Metabolic Diseases ; Morphology ; Original Article ; Pilot Projects ; Young Adult</subject><ispartof>Acta diabetologica, 2017-03, Vol.54 (3), p.251-256</ispartof><rights>Springer-Verlag Italia 2016</rights><rights>Acta Diabetologica is a copyright of Springer, 2017.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c405t-d608e08062dbf67c26e3ba6fe89abeeb46fb849af43c86da5a5809c21d96c5b13</citedby><cites>FETCH-LOGICAL-c405t-d608e08062dbf67c26e3ba6fe89abeeb46fb849af43c86da5a5809c21d96c5b13</cites><orcidid>0000-0001-7227-966X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00592-016-0941-2$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00592-016-0941-2$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27933514$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Koivikko, Minna L.</creatorcontrib><creatorcontrib>Kenttä, Tuomas</creatorcontrib><creatorcontrib>Salmela, Pasi I.</creatorcontrib><creatorcontrib>Huikuri, Heikki V.</creatorcontrib><creatorcontrib>Perkiömäki, Juha S.</creatorcontrib><title>Changes in cardiac repolarisation during spontaneous nocturnal hypoglycaemia in subjects with type 1 diabetes: a preliminary report</title><title>Acta diabetologica</title><addtitle>Acta Diabetol</addtitle><addtitle>Acta Diabetol</addtitle><description>Aims
Experimental studies have revealed that hypoglycaemia can result in morphological changes in electrocardiographic repolarisation in subjects with type 1 diabetes. However, the influence of spontaneous nocturnal hypoglycaemia on repolarisation morphology in a ‘real life’ situation is not clear.
Methods
Adults with type 1 diabetes (
n
= 11) underwent continuous glucose monitoring with a subcutaneous sensor and digital 12-lead ECG recording for three nights. T-wave morphology was analysed with custom-made software during both hypoglycaemia (glucose <3.5 mmol/l at least 20 min) from ten consecutive heart beats in the middle of the deepest hypoglycaemia and from a control nonhypoglycaemic period (glucose ≥5.0 mmol/l) from the same recording.
Results
In the comparison of 10 hypoglycaemia-control pairs, heart rate (65 ± 12 beats/min during normoglycaemia versus 85 ± 19 beats/min during hypoglycaemia,
p
= 0.028) increased and the QT
c
interval (439 ± 5 vs. 373 ± 5 ms, respectively,
p
= 0.025) decreased significantly during hypoglycaemia. The spatial QRS-T angle (TCRT) was reduced, and the roughness of the T-wave loop (T-E) increased significantly (
p
= 0.037 for both) in the patients during hypoglycaemia.
Conclusions
In adults with type 1 diabetes, spontaneous nocturnal hypoglycaemia results in morphological changes and increased heterogeneity of global cardiac repolarisation. These changes may contribute to the risk of ‘dead in bed’ syndrome encountered in young individuals with type 1 diabetes.</description><subject>Adult</subject><subject>Arrhythmias, Cardiac - epidemiology</subject><subject>Arrhythmias, Cardiac - etiology</subject><subject>Arrhythmias, Cardiac - physiopathology</subject><subject>Blood Glucose - physiology</subject><subject>Blood Glucose Self-Monitoring</subject><subject>Case-Control Studies</subject><subject>Circadian Rhythm - drug effects</subject><subject>Circadian Rhythm - physiology</subject><subject>Diabetes</subject><subject>Diabetes Mellitus, Type 1 - blood</subject><subject>Diabetes Mellitus, Type 1 - complications</subject><subject>Diabetes Mellitus, Type 1 - drug therapy</subject><subject>Diabetes Mellitus, Type 1 - physiopathology</subject><subject>Electrocardiography</subject><subject>Female</subject><subject>Glucose</subject><subject>Heart - physiopathology</subject><subject>Heart Rate - drug effects</subject><subject>Heart Rate - physiology</subject><subject>Humans</subject><subject>Hypoglycemia</subject><subject>Hypoglycemia - chemically induced</subject><subject>Hypoglycemia - epidemiology</subject><subject>Hypoglycemia - physiopathology</subject><subject>Incidence</subject><subject>Internal Medicine</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Metabolic Diseases</subject><subject>Morphology</subject><subject>Original Article</subject><subject>Pilot Projects</subject><subject>Young Adult</subject><issn>0940-5429</issn><issn>1432-5233</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqNkc-L1DAUgIMo7uzqH-BFAl68VF9-NvUmg7rCghc9lzR9ncnQpjVJkTnvP247XUUEwVMgfO8LeR8hLxi8YQDl2wSgKl4A0wVUkhX8EdkxKXihuBCPyW65hEJJXl2R65ROAIyXwjwlV7yshFBM7sj9_mjDARP1gTobW28djTiNvY0-2ezHQNs5-nCgaRpDtgHHOdEwujzHYHt6PE_joT87i4O3qyTNzQldTvSHz0eazxNSRhdtgxnTO2rpFLH3gw82ni8vxfyMPOlsn_D5w3lDvn388HV_W9x9-fR5__6ucBJULloNBsGA5m3T6dJxjaKxukNTLXZspO4aIyvbSeGMbq2yykDlOGsr7VTDxA15vXmnOH6fMeV68Mlh32-_qpkpSyM5KP0fqCxNJUCs1ld_oafxspuLUILQqoSFYhvl4phSxK6eoh-WHdQM6jVmvcWsl5j1GrPmy8zLB_PcDNj-nvhVbwH4BqRpTYTxj6f_af0JFPusHw</recordid><startdate>20170301</startdate><enddate>20170301</enddate><creator>Koivikko, Minna L.</creator><creator>Kenttä, Tuomas</creator><creator>Salmela, Pasi I.</creator><creator>Huikuri, Heikki V.</creator><creator>Perkiömäki, Juha S.</creator><general>Springer Milan</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-7227-966X</orcidid></search><sort><creationdate>20170301</creationdate><title>Changes in cardiac repolarisation during spontaneous nocturnal hypoglycaemia in subjects with type 1 diabetes: a preliminary report</title><author>Koivikko, Minna L. ; Kenttä, Tuomas ; Salmela, Pasi I. ; Huikuri, Heikki V. ; Perkiömäki, Juha S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c405t-d608e08062dbf67c26e3ba6fe89abeeb46fb849af43c86da5a5809c21d96c5b13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Arrhythmias, Cardiac - epidemiology</topic><topic>Arrhythmias, Cardiac - etiology</topic><topic>Arrhythmias, Cardiac - physiopathology</topic><topic>Blood Glucose - physiology</topic><topic>Blood Glucose Self-Monitoring</topic><topic>Case-Control Studies</topic><topic>Circadian Rhythm - drug effects</topic><topic>Circadian Rhythm - physiology</topic><topic>Diabetes</topic><topic>Diabetes Mellitus, Type 1 - blood</topic><topic>Diabetes Mellitus, Type 1 - complications</topic><topic>Diabetes Mellitus, Type 1 - drug therapy</topic><topic>Diabetes Mellitus, Type 1 - physiopathology</topic><topic>Electrocardiography</topic><topic>Female</topic><topic>Glucose</topic><topic>Heart - physiopathology</topic><topic>Heart Rate - drug effects</topic><topic>Heart Rate - physiology</topic><topic>Humans</topic><topic>Hypoglycemia</topic><topic>Hypoglycemia - chemically induced</topic><topic>Hypoglycemia - epidemiology</topic><topic>Hypoglycemia - physiopathology</topic><topic>Incidence</topic><topic>Internal Medicine</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Metabolic Diseases</topic><topic>Morphology</topic><topic>Original Article</topic><topic>Pilot Projects</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Koivikko, Minna L.</creatorcontrib><creatorcontrib>Kenttä, Tuomas</creatorcontrib><creatorcontrib>Salmela, Pasi I.</creatorcontrib><creatorcontrib>Huikuri, Heikki V.</creatorcontrib><creatorcontrib>Perkiömäki, Juha S.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Acta diabetologica</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Koivikko, Minna L.</au><au>Kenttä, Tuomas</au><au>Salmela, Pasi I.</au><au>Huikuri, Heikki V.</au><au>Perkiömäki, Juha S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Changes in cardiac repolarisation during spontaneous nocturnal hypoglycaemia in subjects with type 1 diabetes: a preliminary report</atitle><jtitle>Acta diabetologica</jtitle><stitle>Acta Diabetol</stitle><addtitle>Acta Diabetol</addtitle><date>2017-03-01</date><risdate>2017</risdate><volume>54</volume><issue>3</issue><spage>251</spage><epage>256</epage><pages>251-256</pages><issn>0940-5429</issn><eissn>1432-5233</eissn><coden>ACDAEZ</coden><abstract>Aims
Experimental studies have revealed that hypoglycaemia can result in morphological changes in electrocardiographic repolarisation in subjects with type 1 diabetes. However, the influence of spontaneous nocturnal hypoglycaemia on repolarisation morphology in a ‘real life’ situation is not clear.
Methods
Adults with type 1 diabetes (
n
= 11) underwent continuous glucose monitoring with a subcutaneous sensor and digital 12-lead ECG recording for three nights. T-wave morphology was analysed with custom-made software during both hypoglycaemia (glucose <3.5 mmol/l at least 20 min) from ten consecutive heart beats in the middle of the deepest hypoglycaemia and from a control nonhypoglycaemic period (glucose ≥5.0 mmol/l) from the same recording.
Results
In the comparison of 10 hypoglycaemia-control pairs, heart rate (65 ± 12 beats/min during normoglycaemia versus 85 ± 19 beats/min during hypoglycaemia,
p
= 0.028) increased and the QT
c
interval (439 ± 5 vs. 373 ± 5 ms, respectively,
p
= 0.025) decreased significantly during hypoglycaemia. The spatial QRS-T angle (TCRT) was reduced, and the roughness of the T-wave loop (T-E) increased significantly (
p
= 0.037 for both) in the patients during hypoglycaemia.
Conclusions
In adults with type 1 diabetes, spontaneous nocturnal hypoglycaemia results in morphological changes and increased heterogeneity of global cardiac repolarisation. These changes may contribute to the risk of ‘dead in bed’ syndrome encountered in young individuals with type 1 diabetes.</abstract><cop>Milan</cop><pub>Springer Milan</pub><pmid>27933514</pmid><doi>10.1007/s00592-016-0941-2</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0001-7227-966X</orcidid></addata></record> |
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| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Adult Arrhythmias, Cardiac - epidemiology Arrhythmias, Cardiac - etiology Arrhythmias, Cardiac - physiopathology Blood Glucose - physiology Blood Glucose Self-Monitoring Case-Control Studies Circadian Rhythm - drug effects Circadian Rhythm - physiology Diabetes Diabetes Mellitus, Type 1 - blood Diabetes Mellitus, Type 1 - complications Diabetes Mellitus, Type 1 - drug therapy Diabetes Mellitus, Type 1 - physiopathology Electrocardiography Female Glucose Heart - physiopathology Heart Rate - drug effects Heart Rate - physiology Humans Hypoglycemia Hypoglycemia - chemically induced Hypoglycemia - epidemiology Hypoglycemia - physiopathology Incidence Internal Medicine Male Medicine Medicine & Public Health Metabolic Diseases Morphology Original Article Pilot Projects Young Adult |
| title | Changes in cardiac repolarisation during spontaneous nocturnal hypoglycaemia in subjects with type 1 diabetes: a preliminary report |
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