Document Detail


Continuous glucose monitoring reveals associations of glucose levels with QT interval length.
MedLine Citation:
PMID:  20210566     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: QTc interval lengthening during hypoglycemia is discussed as a mechanism linked to sudden death in diabetes patients and the so-called "dead in bed syndrome." Previous research reported a high interindividual variability in the glucose-QTc association. The present study aimed at deriving parameters for direction and strength of the glucose-QTc association on the patient level using combined Holter electrocardiogram (ECG) and continuous glucose monitoring. METHODS: Twenty type 1 diabetes patients were studied: mean (SD, range) age, 43.6 (10.8, 22-65) years; gender male (n [%]), 10 (50.0%); mean (SD) hemoglobin A1C, 8.5% (1.0%); and impaired hypoglycemia awareness (n [%]), six (30.0%). Continuous interstitial glucose monitoring and Holter ECG monitoring were performed for 48 h. Hierarchical (mixed) regression modeling was used to account for the structure of the data. RESULTS: Glucose levels during nighttime were negatively associated with QTc interval length if the data structure was accounted for (b [SE] = -0.76 [0.17], P = 0.000). Exploratory regression analysis revealed hypoglycemia awareness as the only predictor of the individual strength of the glucose-QTc association, with the impaired awareness group showing less evidence for an association of low glucose with QTc lengthening. CONCLUSIONS: Mixed regression allows for deriving parameters for the glucose-QTc association on the patient level. Consistent with previous studies, we found a large interindividual variability in the glucose-QTc association. The finding on impaired hypoglycemia awareness patients has to be interpreted with caution but provides some support for the role of sympathetic activation for the QTc-glucose link.
Authors:
T Kubiak; A Wittig; C Koll; B Mraz; J Gustav; U Herrmann; H Weber; W Kerner
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Diabetes technology & therapeutics     Volume:  12     ISSN:  1557-8593     ISO Abbreviation:  Diabetes Technol. Ther.     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-03-09     Completed Date:  2010-06-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100889084     Medline TA:  Diabetes Technol Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  283-6     Citation Subset:  IM    
Affiliation:
Institute of Psychology, University of Greifswald, Franz-Mehring-Strasse 47, Greifswald, Germany. kubiak@uni-greifswald.de
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Blood Glucose*
Diabetes Mellitus, Type 1 / blood*,  physiopathology*
Electrocardiography, Ambulatory
Female
Heart / physiopathology*
Humans
Male
Middle Aged
Regression Analysis
Young Adult
Chemical
Reg. No./Substance:
0/Blood Glucose

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