Glycaemia and cardiac arrhythmias in people with type 1 diabetes: A prospective observational study

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Aim: To investigate the impact of hypoglycaemia, hyperglycaemia and glycaemic variability on arrhythmia susceptibility in people with type 1 diabetes. Materials and Methods: Thirty adults with type 1 diabetes were included in a 12-month observational exploratory study. Daytime and night-time incident rate ratios (IRRs) of arrhythmias were determined for hypoglycaemia (interstitial glucose [IG] <3.9 mmol/L), hyperglycaemia (IG >10.0 mmol/L) and glycaemic variability (standard deviation and coefficient of variation). Results: Hypoglycaemia was not associated with an increased risk of arrhythmias compared with euglycaemia and hyperglycaemia combined (IG ≥ 3.9 mmol/L). However, during daytime, a trend of increased risk of arrhythmias was observed when comparing time spent in hypoglycaemia with euglycaemia (IRR 1.08 [95% CI: 0.99-1.18] per 5 minutes). Furthermore, during daytime, both the occurrence and time spent in hyperglycaemia were associated with an increased risk of arrhythmias compared with euglycaemia (IRR 2.03 [95% CI: 1.21-3.40] and IRR 1.07 [95% CI: 1.02-1.13] per 5 minutes, respectively). Night-time hypoglycaemia and hyperglycaemia were not associated with the risk of arrhythmias. Increased glycaemic variability was not associated with an increased risk of arrhythmias during daytime, whereas a reduced risk was observed during night-time. Conclusions: Acute hypoglycaemia and hyperglycaemia during daytime may increase the risk of arrhythmias in individuals with type 1 diabetes. However, no such associations were found during night-time, indicating diurnal differences in arrhythmia susceptibility.

TidsskriftDiabetes, Obesity and Metabolism
Udgave nummer8
Sider (fra-til)2300-2309
StatusUdgivet - 2023

Bibliografisk note

Funding Information:
The authors thank all the study participants for their commitment and contribution to the study, co‐workers from our department for their support, and project nurse K. Abelin for assistance throughout the study period. This work was supported by the Steno Collaborative Grant from Novo Nordisk (grant number NNF28300). All the CGM systems used in the present study were sponsored by an unrestricted grant from Senseonics, Inc (Germantown, Maryland, USA).

Publisher Copyright:
© 2023 John Wiley & Sons Ltd.

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