The Relationship between Hypoglycaemic Episodes and Arrhythmias in Type 2 Diabetes Subjects after Acute Myocardial Infarction with ST-Segment Elevation—A Case Series
BackgroundandAims: Several studies have shown that hypoglycaemia, especially a severe episode is
associated with an increased mortality rate in diabetes mellitus subjects with
previous cardiovascular disease or acute coronary syndrome. One of the presumed
mechanisms is the proarrhythmic effect of hypoglycaemia related to the
prolongation of the action potential, or the catecholamine surge that follows
an episode. The aim of this case series analysis was to investigate the
relationship between hypoglycaemia and glucose variability with arrhythmic events in type 2 diabetes patients who
suffered an acute myocardial infarction. MaterialsandMethods: We selected patients admitted consecutively to the cardiology department of
Clinical Emergency Hospital in Bucharest for
a period of three months with acute myocardial infarction and previously
diagnosed type 2 diabetes. For each patient, a retrospective continuous glucose
monitoring system (CGMS) or glucose sensor (Medtronic® Enlite, USA)
and a dual electrocardiograph and blood pressure monitor for 24 hours were
available. Also, patients had an oscillometric device (Arteriograph® TensioMed Ltd) for 24 hours or non-invasive monitoring of central blood
pressure, pulse wave velocity and augmentation index. The data were analysed
using Medtech®, TensioWin® and Carelink iPro® softwares. We used SPSS® version 20.0 (IBM) for the statistical
analysis. The results are presented as median and interquartile range (IQR). ResultsandDiscussion: Ten type 2 diabetes patients (4 males, 6 females)
with anterior (4/10) and inferior acute myocardial infarction (6/10) were
included. They were treated with insulin (3/10), sulphonylurea (Gliclazide)
plus Metformin
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