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KMID : 1200020160400060463
Diabetes & Metabolism Journal
2016 Volume.40 No. 6 p.463 ~ p.472
Baseline-Corrected QT (QTc) Interval Is Associated with Prolongation of QTc during Severe Hypoglycemia in Patients with Type 2 Diabetes Mellitus
Cha Seon-Ah

Yun Jae-Seung
Lim Tae-Seok
Kang Yoon-Goo
Lee Kang-Min
Song Ki-Ho
Yoo Ki-Dong
Park Yong-Moon
Ko Seung-Hyun
Ahn Yu-Bae
Abstract
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¡¾12.1 and 14.1¡¾10.1 years, respectively. The mean QTc intervals at baseline and SH episodes were 433¡¾33 and 460¡¾33 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.
KEYWORD
Diabetes mellitus, type 2, Severe hypoglycemia, QT interval
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