Autonomic cardiac regulation during spontaneous nocturnal hypoglycemia in children with type 1 diabetes.
Pediatr Diabetes
; 22(7): 1023-1030, 2021 11.
Article
em En
| MEDLINE
| ID: mdl-34494709
ABSTRACT
BACKGROUND:
Hypoglycemia is the most common complication in insulin treated diabetes. Though mostly mild, it can be fatal in rare cases It is hypothesized that hypoglycemia related QTc prolongation contributes to cardiac arrhythmia.OBJECTIVE:
To evaluate influence of nocturnal hypoglycemia on QTc and heart rate variability (HRV) in children with T1D.METHODS:
Children and adolescents with T1D for at least 6 months participated in an observational study using continuous glucose monitoring (CGM) and Holter electrocardiogram for five consecutive nights. Mean QTc was calculated for episodes of nocturnal hypoglycemia (<3.7 mmol/L) and compared to periods of the same duration preceding hypoglycemia. HRV (RMSSD, low and high frequency power LF and HF) was analyzed for different 15 min intervals before hypoglycemia, onset of hypoglycemia, before/after nadir, end of hypoglycemia and after hypoglycemia.RESULTS:
Mean QTc during hypoglycemia was significantly longer compared to euglycemia (412 ± 15 vs. 405 ± 18 ms, p = 0.005). HRV changed significantly RMSSD (from 88 ± 57 to 73 ± 43 ms) and HF (from 54 ± 17 to 47 ± 17nu) decreased from before hypoglycemia to after nadir, while heart rate (from 69 ± 9 to 72 ± 12 bpm) and LF (from 44 ± 17 to 52 ± 21 nu) increased (p = 0.04).CONCLUSION:
A QTc lengthening effect of nocturnal hypoglycemia in children with T1D was documented. HRV changes occurred even before detection of nocturnal hypoglycemia by CGM, which may be useful for hypoglycemia prediction.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Sistema Nervoso Autônomo
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Diabetes Mellitus Tipo 1
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Coração
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Frequência Cardíaca
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Hipoglicemia
Tipo de estudo:
Observational_studies
Limite:
Adolescent
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Child
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Female
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Humans
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Male
Idioma:
En
Revista:
Pediatr Diabetes
Assunto da revista:
ENDOCRINOLOGIA
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Suíça