PMID- 23939540
OWN - NLM
STAT- MEDLINE
DCOM- 20150818
LR  - 20220311
IS  - 1935-5548 (Electronic)
IS  - 0149-5992 (Linking)
VI  - 37
IP  - 1
DP  - 2014
TI  - Vital signs, QT prolongation, and newly diagnosed cardiovascular disease during 
      severe hypoglycemia in type 1 and type 2 diabetic patients.
PG  - 217-25
LID - 10.2337/dc13-0701 [doi]
AB  - OBJECTIVE To assess vital signs, QT intervals, and newly diagnosed cardiovascular 
      disease during severe hypoglycemia in diabetic patients. RESEARCH DESIGN AND 
      METHODS From January 2006 to March 2012, we conducted a retrospective cohort 
      study to assess type 1 and type 2 diabetic patients with severe hypoglycemia at a 
      national center in Japan. Severe hypoglycemia was defined as the presence of any 
      hypoglycemic symptoms that could not be resolved by the patients themselves in 
      prehospital settings. RESULTS A total of 59,602 cases that visited the emergency 
      room by ambulance were screened, and 414 cases of severe hypoglycemia were 
      analyzed. The median (interquartile range) blood glucose levels were not 
      significantly different between the type 1 diabetes mellitus (T1DM) (n = 88) and 
      type 2 diabetes mellitus (T2DM) (n = 326) groups (32 [24-42] vs. 31 [24-39] 
      mg/dL, P = 0.59). During severe hypoglycemia, the incidences of severe 
      hypertension (>/=180/120 mmHg), hypokalemia (<3.5 mEq/L), and QT prolongation were 
      19.8 and 38.8% (P = 0.001), 42.4 and 36.3% (P = 0.30), and 50.0 and 59.9% (P = 
      0.29) in the T1DM and T2DM groups, respectively. Newly diagnosed cardiovascular 
      disease during severe hypoglycemia and death were only observed in the T2DM group 
      (1.5 and 1.8%, respectively). Blood glucose levels between the deceased and 
      surviving patients in the T2DM group were significantly different (18 [14-33] vs. 
      31 [24-39] mg/dL, P = 0.02). CONCLUSIONS T1DM and T2DM patients with severe 
      hypoglycemia experienced many critical problems that could lead to cardiovascular 
      disease, fatal arrhythmia, and death.
FAU - Tsujimoto, Tetsuro
AU  - Tsujimoto T
AD  - Corresponding author: Mitsuhiko Noda, mnoda@hosp.ncgm.go.jp.
FAU - Yamamoto-Honda, Ritsuko
AU  - Yamamoto-Honda R
FAU - Kajio, Hiroshi
AU  - Kajio H
FAU - Kishimoto, Miyako
AU  - Kishimoto M
FAU - Noto, Hiroshi
AU  - Noto H
FAU - Hachiya, Remi
AU  - Hachiya R
FAU - Kimura, Akio
AU  - Kimura A
FAU - Kakei, Masafumi
AU  - Kakei M
FAU - Noda, Mitsuhiko
AU  - Noda M
LA  - eng
PT  - Journal Article
DEP - 20130812
PL  - United States
TA  - Diabetes Care
JT  - Diabetes care
JID - 7805975
RN  - 0 (Blood Glucose)
RN  - 0 (Hypoglycemic Agents)
RN  - RWP5GA015D (Potassium)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Arrhythmias, Cardiac/etiology/mortality/physiopathology
MH  - Blood Glucose/*metabolism
MH  - Blood Pressure/*physiology
MH  - Cardiovascular Diseases/etiology/mortality/*physiopathology
MH  - Cohort Studies
MH  - Diabetes Mellitus, Type 1/*blood/complications/drug therapy
MH  - Diabetes Mellitus, Type 2/*blood/complications/drug therapy
MH  - *Electrocardiography
MH  - Female
MH  - Heart Rate/physiology
MH  - Humans
MH  - Hypoglycemia/*blood/chemically induced/complications
MH  - Hypoglycemic Agents/adverse effects/therapeutic use
MH  - Japan
MH  - Male
MH  - Middle Aged
MH  - Potassium/blood
MH  - Retrospective Studies
EDAT- 2013/08/14 06:00
MHDA- 2015/08/19 06:00
CRDT- 2013/08/14 06:00
PHST- 2013/08/14 06:00 [entrez]
PHST- 2013/08/14 06:00 [pubmed]
PHST- 2015/08/19 06:00 [medline]
AID - dc13-0701 [pii]
AID - 10.2337/dc13-0701 [doi]
PST - ppublish
SO  - Diabetes Care. 2014;37(1):217-25. doi: 10.2337/dc13-0701. Epub 2013 Aug 12.