RESUMO
BACKGROUND: Sudden nocturnal death is a syndrome that usually affects patients with diabetes mellitus type 1 (DM1), being described mainly due to ventricular arrhythmias in response to nocturnal hypoglycemia. OBJECTIVES: Evaluate the relation between hypoglycemia and ventricular arrhythmias in patients with DM1 and normal structural heart. METHOD: Prospective, observational study with DM1 patients and normal structural heart on echocardiogram aged 18-60â¯years, of both sexes receiving insulin therapy for at least five years. Intermittent glucose reading device was implanted (iPro2 - Medtronic/USA) and 24hr ambulatory electrocardiographic recording by the Holter system (Cardios Systems - Brazil). Patients were monitored for hypoglycemia without any type of induction (interstitial glucose <70â¯mg/dl) and cardiac arrhythmias within 24â¯h. RESULTS: Thirty-two patients were evaluated, with mean-age of 35â¯years, being 16 men. Eleven patients (34%) did not have hypoglycemia, other 3 (27.3%) also had no arrhythmia, while 8 (72.7%) had arrhythmias interpreted as irrelevant. The other 21 patients (66%) presented some hypoglycemic episodes and 10 (47.6%) did not present arrhythmias, whereas 11 (52.4%) presented arrhythmias considered not clinically significant, as also found in non-diabetic individuals. CONCLUSION: In patients with DM1 without structural heart disease there was no relationship between cardiac arrhythmia and episodes of hypoglycemia.
