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Incidence of prolonged QTc and severe hypoglycemia in type 1 diabetes: the EURODIAB Prospective Complications Study

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Abstract

Aims

To assess the independent role of severe hypoglycemia on 7-year cumulative incidence of prolonged QTc in a large cohort of patients with type 1 diabetes.

Methods

People with type 1 diabetes recruited by the EURODIAB Prospective Complications Study who had normal QTc were examined at baseline and after 7 years with standardized methods (n = 1415; mean age ± SD 32.1 ± 9.6 years; diabetes duration 14.2 ± 8.8 years). Hypoglycemic episodes were assessed by a questionnaire. QTc was calculated according to Bazett’s formula. In logistic regression analysis, we examined the role of severe hypoglycemia (none, 1–2, or 3 and more episodes/year) on the cumulative incidence of prolonged QTc, independently of age, sex, HbA1c, blood pressure, BMI, physical activity, distal symmetrical and autonomic neuropathy.

Results

In total, 264/1415 (17%) patients had incident prolonged QTc. Compared to those with persistently normal QTc, a greater proportion of incident cases had 3 and more hypoglycemic episodes at baseline (16.3 vs 11.2%, p = 0.03) and after 7 years (15.2 vs 9.6%, p = 0.01). In logistic regression analysis, 3 or more episodes of severe hypoglycemia at baseline did not increase cumulative incidence of prolonged QTc (OR 1.34, 95% CI 0.88–2.03). By contrast, severe hypoglycemia at the follow-up examination was associated with higher incidence of QTc prolongation (OR 1.68, 1.09–2.58), which reverted to not significant after adjustment for diabetic neuropathy.

Conclusions

Severe hypoglycemia was not associated with incidence QTc prolongation in type 1 diabetic patients from the EURODIAB PCS.

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Abbreviations

CVD:

Cardiovascular diseases

CHD:

Coronary heart disease

BMI:

Body mass index

OR:

Odds ratio

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Author information

Authors and Affiliations

  1. Department of Medical Sciences, University of Turin, Corso Dogliotti 14, 10126, Turin, Italy

    Cristina Amione, Sara Giunti, Paolo Fornengo, Federica Barutta, Gabriella Gruden & Graziella Bruno

  2. Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands

    Sabita S. Soedamah-Muthu

  3. Department of Epidemiology and Public-Health, University College London, London, UK

    Nish Chaturvedi & J. H. Fuller

Authors
  1. Cristina Amione
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  2. Sara Giunti
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  3. Paolo Fornengo
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  4. Sabita S. Soedamah-Muthu
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  5. Nish Chaturvedi
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  6. J. H. Fuller
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  7. Federica Barutta
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  8. Gabriella Gruden
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  9. Graziella Bruno
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Contributions

CA and GB contributed to the study concept and design, researched and interpreted the data, and drafted the manuscript. SG, PF, DF, SS, JF, NC, FB, GG researched data and reviewed the manuscript. GG and GB oversaw the progress of the project, contributed to the discussion, and reviewed the manuscript. GB is the guarantors of this work and, as such, had full access to all the data analysis and take responsibility for the integrity of the data and the accuracy of the data.

Corresponding author

Correspondence to Graziella Bruno.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethics approval

The study was approved by local ethics committees

Human and animal rights

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institution and national) and ith the Helsinki Declaration of 1975, as revised in 2008.

Informed consent

Informed consent was obtained from all subjects.

Availability of data and materials

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Additional information

Managed by Antonio Secchi.

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Amione, C., Giunti, S., Fornengo, P. et al. Incidence of prolonged QTc and severe hypoglycemia in type 1 diabetes: the EURODIAB Prospective Complications Study. Acta Diabetol 54, 871–876 (2017). https://doi.org/10.1007/s00592-017-1018-6

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  • DOI: https://doi.org/10.1007/s00592-017-1018-6

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