Incidence of prolonged QTc and severe hypoglycemia in type 1 diabetes

The EURODIAB Prospective Complications Study

Cristina Amione, Sara Giunti, Paolo Fornengo, S.S. Soedamah-Muthu, Nish Chaturvedi, J. H. Fuller, Federica Barutta, Gabriella Gruden, Graziella Bruno

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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.
Keywords: Hypoglycemia, QTc, Complications, Surveys
Original languageEnglish
Pages (from-to)871-876
JournalActa Diabetologica
Volume54
Issue number9
DOIs
Publication statusPublished - 1 Sep 2017

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Amione, Cristina ; Giunti, Sara ; Fornengo, Paolo ; Soedamah-Muthu, S.S. ; Chaturvedi, Nish ; Fuller, J. H. ; Barutta, Federica ; Gruden, Gabriella ; Bruno, Graziella. / Incidence of prolonged QTc and severe hypoglycemia in type 1 diabetes : The EURODIAB Prospective Complications Study. In: Acta Diabetologica. 2017 ; Vol. 54, No. 9. pp. 871-876.
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title = "Incidence of prolonged QTc and severe hypoglycemia in type 1 diabetes: The EURODIAB Prospective Complications Study",
abstract = "AimsTo 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.MethodsPeople 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.ResultsIn 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.ConclusionsSevere hypoglycemia was not associated with incidence QTc prolongation in type 1 diabetic patients from the EURODIAB PCS.Keywords: Hypoglycemia, QTc, Complications, Surveys",
author = "Cristina Amione and Sara Giunti and Paolo Fornengo and S.S. Soedamah-Muthu and Nish Chaturvedi and Fuller, {J. H.} and Federica Barutta and Gabriella Gruden and Graziella Bruno",
year = "2017",
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Amione, C, Giunti, S, Fornengo, P, Soedamah-Muthu, SS, Chaturvedi, N, Fuller, JH, Barutta, F, Gruden, G & Bruno, G 2017, 'Incidence of prolonged QTc and severe hypoglycemia in type 1 diabetes: The EURODIAB Prospective Complications Study', Acta Diabetologica, vol. 54, no. 9, pp. 871-876. https://doi.org/10.1007/s00592-017-1018-6

Incidence of prolonged QTc and severe hypoglycemia in type 1 diabetes : The EURODIAB Prospective Complications Study. / Amione, Cristina; Giunti, Sara; Fornengo, Paolo; Soedamah-Muthu, S.S.; Chaturvedi, Nish; Fuller, J. H.; Barutta, Federica; Gruden, Gabriella; Bruno, Graziella.

In: Acta Diabetologica, Vol. 54, No. 9, 01.09.2017, p. 871-876.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Incidence of prolonged QTc and severe hypoglycemia in type 1 diabetes

T2 - The EURODIAB Prospective Complications Study

AU - Amione, Cristina

AU - Giunti, Sara

AU - Fornengo, Paolo

AU - Soedamah-Muthu, S.S.

AU - Chaturvedi, Nish

AU - Fuller, J. H.

AU - Barutta, Federica

AU - Gruden, Gabriella

AU - Bruno, Graziella

PY - 2017/9/1

Y1 - 2017/9/1

N2 - AimsTo 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.MethodsPeople 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.ResultsIn 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.ConclusionsSevere hypoglycemia was not associated with incidence QTc prolongation in type 1 diabetic patients from the EURODIAB PCS.Keywords: Hypoglycemia, QTc, Complications, Surveys

AB - AimsTo 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.MethodsPeople 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.ResultsIn 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.ConclusionsSevere hypoglycemia was not associated with incidence QTc prolongation in type 1 diabetic patients from the EURODIAB PCS.Keywords: Hypoglycemia, QTc, Complications, Surveys

U2 - 10.1007/s00592-017-1018-6

DO - 10.1007/s00592-017-1018-6

M3 - Article

VL - 54

SP - 871

EP - 876

JO - Acta Diabetologica

JF - Acta Diabetologica

SN - 0940-5429

IS - 9

ER -