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Baseline-Corrected QT (QTc) Interval Is Associated with Prolongation of QTc during Severe Hypoglycemia in Patients with Type 2 Diabetes Mellitus
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
Diabetes Metab J. 2016;40(6):463-472.   Published online October 5, 2016
DOI: https://doi.org/10.4093/dmj.2016.40.6.463
  • 3,877 View
  • 47 Download
  • 10 Web of Science
  • 10 Crossref
AbstractAbstract PDFPubReader   
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).

Methods

Between 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.

Results

The 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.

Conclusion

A 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.

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
  • 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
    BMC Cardiovascular Disorders.2019;[Epub]     CrossRef
  • Antioxidant effects of epigallocatechin-3-gallate on the aTC1-6 pancreatic alpha cell line
    Ting Cao, Xiong Zhang, Dan Yang, Yue-Qian Wang, Zheng-Dong Qiao, Jian-Ming Huang, Peng Zhang
    Biochemical and Biophysical Research Communications.2018; 495(1): 693.     CrossRef
  • Severe hypoglycemia is a risk factor for atrial fibrillation in type 2 diabetes mellitus: Nationwide population-based cohort study
    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
Intensive Individualized Reinforcement Education Is Important for the Prevention of Hypoglycemia in Patients with Type 2 Diabetes
Yun-Mi Yong, Kyung-Mi Shin, Kang-Min Lee, Jae-Young Cho, Sun-Hye Ko, Min-Hyang Yoon, Tae-Won Kim, Jong-Hyun Jeong, Yong-Moon Park, Seung-Hyun Ko, Yu-Bae Ahn
Diabetes Metab J. 2015;39(2):154-163.   Published online March 10, 2015
DOI: https://doi.org/10.4093/dmj.2015.39.2.154
  • 4,253 View
  • 40 Download
  • 17 Web of Science
  • 20 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   
Background

We investigated whether an intensive individualized reinforcement education program could influence the prevention of hypoglycemic events in patients with type 2 diabetes.

Methods

From March 2013 to September 2013, patients aged 35 to 75 years with type 2 diabetes who had not previously participated in diabetes education, and treated with insulin or a sulfonylurea-containing regimen were included in the study. After structured group education, the patients assigned to the intensive individualized education group (IT) were requested to visit for reinforcement. All subjects in the IT were encouraged to self-manage dose adjustments. Participants in both groups (control group [CG, group education only; n=22] and IT [n=24]) attended follow-up visits at 2, 8, 12, and 24 weeks. At each visit, all patients were asked whether they had experienced hypoglycemia.

Results

The total study population consisted of 20 men (43.5%; mean age and diabetic duration of 55.9±11.0 and 5.1±7.3 years, respectively). At 24 weeks, there were no significant differences in hemoglobin A1c values between the CG and IT. The total number of hypoglycemic events per patient was 5.26±6.5 in the CG and 2.58±2.3 times in the IT (P=0.004). Adherence to lifestyle modification including frequency of exercise, self-monitoring of blood glucose, or dietary habit was not significantly different between the groups. However, adherence to hypoglycemia management, especially the dose adjustment of medication, was significantly higher in the IT compared with the CG.

Conclusion

Compared with the structured group education, additional IT resulted in additional benefits in terms of avoidance of hypoglycemia and treating hypoglycemia in patients with type 2 diabetes.

Citations

Citations to this article as recorded by  
  • Effectiveness of the SUGAR intervention on hypoglycaemia in elderly patients with type 2 diabetes: A pragmatic randomised controlled trial
    Huda Y. Almomani, Carlos Rodriguez Pascual, Paul Grassby, Keivan Ahmadi
    Research in Social and Administrative Pharmacy.2023; 19(2): 322.     CrossRef
  • A Cross-Sectional study on risk factors for severe hypoglycemia among Insulin-Treated elderly type 2 diabetes Mellitus (T2DM) patients in Singapore
    Michelle Shi Min Ko, Wai Kit Lee, Li Chang Ang, Su-Yen Goh, Yong Mong Bee, Ming Ming Teh
    Diabetes Research and Clinical Practice.2022; 185: 109236.     CrossRef
  • Management Status of Patients with Type 2 Diabetes Mellitus at General Hospitals in Korea: A 5-Year Follow-Up Study
    Jin Hee Jung, Jung Hwa Lee, Hyang Mi Jang, Young Na, Hee Sun Choi, Yeon Hee Lee, Yang Gyo Kang, Na Rae Kim, Jeong Rim Lee, Bok Rye Song, Kang Hee Sim
    The Journal of Korean Diabetes.2022; 23(1): 64.     CrossRef
  • Anti-hyperglycemic Medication Compliance: A Quality Assurance Project
    Rayan Mamoon, Md Y Mamoon, Debbie Hermanstyne, Issac Sachmechi
    Cureus.2022;[Epub]     CrossRef
  • Randomised controlled trial of pharmacist-led patient counselling in controlling hypoglycaemic attacks in older adults with type 2 diabetes mellitus (ROSE-ADAM): A study protocol of the SUGAR intervention
    Huda Y. Almomani, Carlos Rodriguez Pascual, Sayer I. Al-Azzam, Keivan Ahmadi
    Research in Social and Administrative Pharmacy.2021; 17(5): 885.     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
  • Type 2 diabetes patients’ views on prevention of hypoglycaemia – a mixed methods study investigating self-management issues and self-identified causes of hypoglycaemia
    Stijn Crutzen, Tessa van den Born-Bondt, Petra Denig, Katja Taxis
    BMC Family Practice.2021;[Epub]     CrossRef
  • Cross‐sectional analysis of emergency hypoglycaemia and outcome predictors among people with diabetes in an urban population
    Chukwuma Uduku, Valentina Pendolino, Ian Godsland, Nick Oliver, Monika Reddy, Rachael T. Fothergill
    Diabetic Medicine.2021;[Epub]     CrossRef
  • Short-term efficacy of high intensity group and individual education in patients with type 2 diabetes: a randomized single-center trial
    R. Reale, A. Tumminia, L. Romeo, N. La Spina, R. Baratta, G. Padova, L. Tomaselli, L. Frittitta
    Journal of Endocrinological Investigation.2019; 42(4): 403.     CrossRef
  • The role of structured education in the management of hypoglycaemia
    Ahmed Iqbal, Simon R. Heller
    Diabetologia.2018; 61(4): 751.     CrossRef
  • Association of diabetes therapy-related quality of life and physical activity levels in patients with type 2 diabetes receiving medication therapy: the Diabetes Distress and Care Registry at Tenri (DDCRT 17)
    Yasuaki Hayashino, Satoru Tsujii, Hitoshi Ishii
    Acta Diabetologica.2018; 55(2): 165.     CrossRef
  • Insulin Therapy for Adult Patients with Type 2 Diabetes Mellitus: A Position Statement of the Korean Diabetes Association, 2017
    Byung-Wan Lee, Jin Hwa Kim, Seung-Hyun Ko, Kyu-Yeon Hur, Nan-Hee Kim, Sang Youl Rhee, Hyun Jin Kim, Min Kyong Moon, Seok-O Park, Kyung Mook Choi
    Diabetes & Metabolism Journal.2017; 41(5): 367.     CrossRef
  • Antihyperglycemic Agent Therapy for Adult Patients with Type 2 Diabetes Mellitus 2017: A Position Statement of the Korean Diabetes Association
    Seung-Hyun Ko, Kyu-Yeon Hur, Sang Youl Rhee, Nan-Hee Kim, Min Kyong Moon, Seok-O Park, Byung-Wan Lee, Hyun Jin Kim, Kyung Mook Choi, Jin Hwa Kim
    Diabetes & Metabolism Journal.2017; 41(5): 337.     CrossRef
  • Insulin therapy for adult patients with type 2 diabetes mellitus: a position statement of the Korean Diabetes Association, 2017
    Byung-Wan Lee, Jin Hwa Kim, Seung-Hyun Ko, Kyu Yeon Hur, Nan-Hee Kim, Sang Youl Rhee, Hyun Jin Kim, Min Kyong Moon, Seok-O Park, Kyung Mook Choi
    The Korean Journal of Internal Medicine.2017; 32(6): 967.     CrossRef
  • Physician-Directed Diabetes Education without a Medication Change and Associated Patient Outcomes
    Hun-Sung Kim, Hyunah Kim, Hae-Kyung Yang, Eun Young Lee, Yoo Jin Jeong, Tong Min Kim, So Jung Yang, Seo Yeon Baik, Seung-Hwan Lee, Jae Hyoung Cho, In Young Choi, Hyeon Woo Yim, Bong-Yun Cha
    Diabetes & Metabolism Journal.2017; 41(3): 187.     CrossRef
  • Antihyperglycemic agent therapy for adult patients with type 2 diabetes mellitus 2017: a position statement of the Korean Diabetes Association
    Seung-Hyun Ko, Kyu-Yeon Hur, Sang Youl Rhee, Nan-Hee Kim, Min Kyong Moon, Seok-O Park, Byung-Wan Lee, Hyun Jin Kim, Kyung Mook Choi, Jin Hwa Kim
    The Korean Journal of Internal Medicine.2017; 32(6): 947.     CrossRef
  • Hypoglycemia and Health Costs
    Yong-ho Lee, Gyuri Kim, Eun Seok Kang
    The Journal of Korean Diabetes.2016; 17(1): 11.     CrossRef
  • Association between estimated blood glucose levels and glycated hemoglobin levels
    Seon-Ah Cha, Seung-Hyun Ko
    The Korean Journal of Internal Medicine.2016; 31(3): 457.     CrossRef
  • Characteristics of Hypoglycemia Pateints Visiting the Emergency Department of a University Hospital
    Sang-Hyeon Choi, Deok-Ki Youn, Moon-Gi Choi, Ohk-Hyun Ryu
    The Journal of Korean Diabetes.2016; 17(3): 202.     CrossRef
  • Experiences of Diabetes Education among Educators of Diabetes : a content analysis approach
    Soo Jin Kang, Soo Jung Chang
    Journal of Korean Public Health Nursing.2016; 30(2): 221.     CrossRef

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