Autonomic cardiac regulation during spontaneous nocturnal hypoglycemia in children with type 1 diabetes

Bachmann, Sara and Auderset, Anne and Burckhardt, Marie-Anne and Szinnai, Gabor and Hess, Melanie and Zumsteg, Urs and Denhaerynck, Kris and Donner, Birgit. (2021) Autonomic cardiac regulation during spontaneous nocturnal hypoglycemia in children with type 1 diabetes. Pediatric Diabetes, 22 (7). pp. 1023-1030.

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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.; To evaluate influence of nocturnal hypoglycemia on QTc and heart rate variability (HRV) in children with T1D.; 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.; 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).; 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.
Faculties and Departments:03 Faculty of Medicine > Departement Public Health > Institut für Pflegewissenschaft
UniBasel Contributors:Denhaerynck, Kris and Bachmann, Sara
Item Type:Article, refereed
Article Subtype:Research Article
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:10 Nov 2021 14:58
Deposited On:10 Nov 2021 14:58

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