- Complications
- Baseline-Corrected QT (QTc) Interval Is Associated with Prolongation of QTc during Severe Hypoglycemia in Patients with Type 2 Diabetes Mellitus
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Seon-Ah Cha, Jae-Seung Yun, Tae-Seok Lim, Yoon-Goo Kang, Kang-Min Lee, Ki-Ho Song, Ki-Dong Yoo, Yong-Moon Park, Seung-Hyun Ko, Yu-Bae Ahn
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Diabetes Metab J. 2016;40(6):463-472. Published online October 5, 2016
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DOI: https://doi.org/10.4093/dmj.2016.40.6.463
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- Background
We investigated an association between baseline heart rate-corrected QT (QTc) interval before severe hypoglycemia (SH) and prolongation of QTc interval during SH in patients with type 2 diabetes mellitus (T2DM). MethodsBetween January 2004 and June 2014, 208 patients with T2DM, who visited the emergency department because of SH and underwent standard 12-lead electrocardiography within the 6-month period before SH were consecutively enrolled. The QTc interval was analyzed during the incidence of SH, and 6 months before and after SH. QTc intervals of 450 ms or longer in men and 460 ms or longer in women were considered abnormally prolonged. ResultsThe mean age and diabetes duration were 68.1±12.1 and 14.1±10.1 years, respectively. The mean QTc intervals at baseline and SH episodes were 433±33 and 460±33 ms, respectively (P<0.001). One hundred and fourteen patients (54.8%) had a prolonged QTc interval during SH. There was a significant decrease in the prolonged QTc interval within 6 months after SH (QTc interval prolongation during SH vs. after recovery, 54.8% vs. 33.8%, P<0.001). The prolonged QTc interval was significantly associated with baseline QTc interval prolongation (odds ratio, 2.92; 95% confidence interval, 1.22 to 6.96; P=0.016) after adjusting for multiple confounders. ConclusionA prolonged QTc interval at baseline was significantly associated with prolongation of the QTc interval during SH in patients with T2DM, suggesting the necessity of QTc interval monitoring and attention to those with a prolonged QTc interval to prevent SH.
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Citations
Citations to this article as recorded by  - The association of the triglyceride-glucose index with the risk of atrial fibrillation: Analysis of the UK Biobank
Shanshan Shi, Yanjun Song, Zechen Liu, Jining He, Zhihao Zheng, Chenxi Song, Lei Jia, Guofeng Gao, Qiuting Dong, Rui Fu, Min Yang, Wenjia Zhang, Kefei Dou
Nutrition, Metabolism and Cardiovascular Diseases.2025; 35(4): 103826. CrossRef - 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 - U-shaped association between the triglyceride–glucose index and atrial fibrillation incidence in a general population without known cardiovascular disease
Xiao Liu, Ayiguli Abudukeremu, Yuan Jiang, Zhengyu Cao, Maoxiong Wu, Jianyong Ma, Runlu Sun, Wanbing He, Zhiteng Chen, Yangxin Chen, Peng Yu, Wengen Zhu, Yuling Zhang, Jingfeng Wang
Cardiovascular Diabetology.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 as a risk factor for cardiovascular outcomes in patients with type 2 diabetes: is it preventable?
Seung-Hyun Ko
Cardiovascular Prevention and Pharmacotherapy.2022; 4(3): 106. CrossRef - Heart rate-corrected QT interval prolongation is associated with decreased heart rate variability in patients with type 2 diabetes
Seon-Ah Cha
Medicine.2022; 101(45): e31511. CrossRef - Severe hypoglycemia as a preventable risk factor for cardiovascular disease in patients with type 2 diabetes mellitus
Soo-Yeon Choi, Seung-Hyun Ko
The Korean Journal of Internal Medicine.2021; 36(2): 263. CrossRef - Review of the cardiovascular safety of dipeptidyl peptidase-4 inhibitors and the clinical relevance of the CAROLINA trial
Marile Santamarina, Curt J. Carlson
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Seung-Hyun Ko, Yong-Moon Park, Jae-Seung Yun, Seon-Ah Cha, Eue-Keun Choi, Kyungdo Han, Eugene Han, Yong-ho Lee, Yu-Bae Ahn
Journal of Diabetes and its Complications.2018; 32(2): 157. CrossRef - Incidence of prolonged QTc and severe hypoglycemia in type 1 diabetes: the EURODIAB Prospective Complications Study
Cristina Amione, Sara Giunti, Paolo Fornengo, Sabita S. Soedamah-Muthu, Nish Chaturvedi, J. H. Fuller, Federica Barutta, Gabriella Gruden, Graziella Bruno
Acta Diabetologica.2017; 54(9): 871. CrossRef
- Complications
- Severe Hypoglycemia and Cardiovascular or All-Cause Mortality in Patients with Type 2 Diabetes
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Seon-Ah Cha, Jae-Seung Yun, Tae-Seok Lim, Seawon Hwang, Eun-Jung Yim, Ki-Ho Song, Ki-Dong Yoo, Yong-Moon Park, Yu-Bae Ahn, Seung-Hyun Ko
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Diabetes Metab J. 2016;40(3):202-210. Published online April 5, 2016
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DOI: https://doi.org/10.4093/dmj.2016.40.3.202
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- Background
We investigated the association between severe hypoglycemia (SH) and the risk of cardiovascular (CV) or all-cause mortality in patients with type 2 diabetes. MethodsThe study included 1,260 patients aged 25 to 75 years with type 2 diabetes from the Vincent Type 2 Diabetes Resgistry (VDR), who consecutively enrolled (n=1,260) from January 2000 to December 2010 and were followed up until May 2015 with a median follow-up time of 10.4 years. Primary outcomes were death from any cause or CV death. We investigated the association between the CV or all-cause mortality and various covariates using Cox proportional hazards regression analysis. ResultsAmong the 906 participants (71.9%) who completed follow-up, 85 patients (9.4%) had at least one episode of SH, and 86 patients (9.5%) died (9.1 per 1,000 patient-years). Patients who had died were older, had a longer duration of diabetes and hypertension, received more insulin, and had more diabetic microvascular complications at baseline, as compared with surviving patients. The experience of SH was significantly associated with an increased risk of all-cause mortality (hazard ratio [HR], 2.64; 95% confidence interval [CI], 1.39 to 5.02; P=0.003) and CV mortality (HR, 6.34; 95% CI, 2.02 to 19.87; P=0.002) after adjusting for sex, age, diabetic duration, hypertension, mean glycosylated hemoglobin levels, diabetic nephropathy, lipid profiles, and insulin use. ConclusionWe found a strong association between SH and increased risk of all-cause and CV mortality in patients with type 2 diabetes.
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- Complications
- Cardiovascular Disease Predicts Severe Hypoglycemia in Patients with Type 2 Diabetes
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Jae-Seung Yun, Seung-Hyun Ko, Sun-Hye Ko, Ki-Ho Song, Ki-Dong Yoo, Kun-Ho Yoon, Yong-Moon Park, Yu-Bae Ahn
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Diabetes Metab J. 2015;39(6):498-506. Published online July 8, 2015
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DOI: https://doi.org/10.4093/dmj.2015.39.6.498
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- Background
To investigate whether a history of prior cardiovascular disease (CVD) is associated with severe hypoglycemia (SH) in patients with type 2 diabetes. MethodsWe conducted a prospective cohort study from January 2001 to December 2012 with a median follow-up time of 9.5 years (5,814 person-years). Patients aged 25 to 75 years with type 2 diabetes and without chronic kidney disease were enrolled (n=894), and 624 patients completed follow-up. SH was defined as hypoglycemic episodes requiring hospitalization or medical care in an emergency department. We used the Cox proportional hazards regression analysis to test associations between SH episodes and potential explanatory variables. ResultsAmong the 624 participants who completed follow-up, 60 patients (9.6%) had previous CVD. Compared to patients without CVD, patients with previous CVD were older, had a longer duration of diabetes and hypertension, received more insulin, and had more diabetic microvascular complications at baseline. During follow-up, 62 patients (9.9%) experienced at least one SH episode (incidence of 1.33 per 100 patient-years). The development of SH was associated with a history of CVD (hazard ratio, 1.99; 95% confidence interval, 1.07 to 3.72; P=0.031) after adjusting for sex, age, diabetic duration, hypertension, hemoglobin A1c levels, diabetic complications, cardiovascular autonomic neuropathy, and insulin use. ConclusionA history of CVD was an independent risk factor for the development of SH in patients with type 2 diabetes mellitus. For patients with CVD, modulation of glycemic targets and diabetic education for the prevention of hypoglycemia should be implemented.
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Edward W. Gregg, Naomi Holman, Marisa Sophiea, Shivani Misra, Jonathan Pearson-Stuttard, Jonathan Valabhji, Kamlesh Khunti
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Ninoschka C. D’Souza, Julian A. Aiken, Emily G. Hoffman, Sara C. Atherley, Sabrina Champsi, Nadia Aleali, Dorsa Shakeri, Maya El-Zahed, Nicky Akbarian, Mehran Nejad-Mansouri, Parinaz Z. Bavani, Richard L. Liggins, Owen Chan, Michael C. Riddell
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Jenny Dimakos, Ying Cui, Robert W. Platt, Christel Renoux, Kristian B. Filion, Antonios Douros
Diabetes Care.2023; 46(2): 377. CrossRef - Evaluating the effect of Roxadustat on ventricular repolarization in patients undergoing peritoneal dialysis
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Seon-Ah Cha, Jae-Seung Yun, Tae-Seok Lim, Kyoungil Min, Ki-Ho Song, Ki-Dong Yoo, Yong-Moon Park, Yu-Bae Ahn, Seung-Hyun Ko, James M Wright
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Katharina Mattishent, Yoon Kong Loke
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- Erratum: Author's Name Correction. Diabetic Retinopathy and Endothelial Dysfunction in Patients with Type 2 Diabetes Mellitus
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Jae-Seung Yun, Seung-Hyun Ko, Ji-Hoon Kim, Keon-Woong Moon, Yong-Moon Park, Ki-Dong Yoo, Yu-Bae Ahn
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Diabetes Metab J. 2013;37(6):488-488. Published online December 12, 2013
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DOI: https://doi.org/10.4093/dmj.2013.37.6.488
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Mary H. C. Florido, Nicholas P. Ziats
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Nikolaos Gouliopoulos, Gerasimos Siasos, Evangelos Oikonomou, Spyros Sapounas, Alexandros Rouvas, Apostolos C. Ziogas, Marilita M Moschos, Dimitris Tousoulis
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- Diabetic Retinopathy and Endothelial Dysfunction in Patients with Type 2 Diabetes Mellitus
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Diabetes Metab J. 2013;37(4):262-269. Published online August 14, 2013
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- Background
We investigated the relationship between endothelial dysfunction and diabetic retinopathy (DR) in patients with type 2 diabetes. MethodsWe used a cross-sectional design to examine 167 patients with type 2 diabetes mellitus. All patients underwent biochemical and ophthalmological examination. We assessed endothelial dysfunction by a flow-mediated vasodilation method of the brachial artery. Changes in vasodilation (flow-mediated vasodilatation, %FMD) were expressed as percent change over baseline values. ResultsThe mean±standard deviation of patient age was 54.1±8.6 years. The %FMD was significantly lower in patients with DR than without DR. The prevalence of retinopathy decreased across increasing tertiles of %FMD. After adjusting for patients' age, sex, diabetes duration, use of insulin, use of antihypertensive, antiplatelet, and lipid lowering medications, systolic blood pressure, fasting plasma glucose, 2-hour plasma glucose, glycated hemoglobin, and urinary albumin excretion, participants with a reduced %FMD were more likely to have DR (odds ratio, 11.819; 95% confidence interval, 2.201 to 63.461; P=0.004, comparing the lowest and highest tertiles of %FMD). ConclusionEndothelial dysfunction was associated with DR, which was most apparent when the endothelial dysfunction was severe. Our study provides insights into the possible mechanism of the influence of endothelial dysfunction on the development of DR.
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