Hypoglycemia, Arrythmia and Mortality in Diabetes, an underestimated risk?

Abstract

Introduction and purpose

Hypoglycemia, characterized by a decrease in blood glucose levels below 70mg/dl, is a dangerous condition, especially in individuals with diabetes mellitus. This condition can trigger a variety of symptoms such as changes in mental status, activation of the sympathetic nervous system and, in severe cases, life-threatening arrhythmias. The aim of the study was to provide an overview of literature linking hypoglycemia with cardiac arrhythmias and increased mortality. A search of the PubMed and Google Schoolar databases was carried out using key words: ‘hypoglycemia’, ‘arrhythmia’, ‘Type 1 diabetes’, ‘Type 2 diabetes’ in order to find the latest publications.

Description

The harmful effects of hypoglycemia on the cardiovascular system are well-documented, with recent studies indicating an association between recurrent hypoglycemic episodes and increased mortality, particularly in individuals with type 1 and type 2 diabetes. Hypoglycemia may contribute to cardiac arrhythmias through multiple mechanisms, including dysregulation of ion channels, catecholamine release, and electrolyte imbalances. Notably, the impact of hypoglycemia on heart rhythm appears to differ between daytime and nighttime episodes, with nocturnal hypoglycemia often leading to bradycardia, while daytime hypoglycemia is more commonly associated with tachycardia.

Summary

Despite advancements in understanding the correlation between hypoglycemia and arrythmias the underling mechanisms remain unclear. With the increasing number of diabetes patients treated with insulin, further research is required.