We published a systematic review and meta-analysis in Diabetes, Obesity and Metabolism on changes in the heart rate-corrected QT interval (QTc) and the concurrent sympathoadrenal response during hypoglycaemia in people with type 1 or type 2 diabetes. Across 32 studies, QTc was prolonged by 44.0 ms under induced and by 16.4 ms under spontaneous hypoglycaemia, with similar estimates in type 1 and type 2 diabetes. Heart rate, systolic blood pressure, epinephrine and norepinephrine increased, while diastolic blood pressure and serum potassium decreased. Only the change in epinephrine correlated with the change in QTc across studies. Hypoglycaemia avoidance remains a safety consideration in people with pre-existing repolarisation vulnerability or QT-prolonging medication. The work is a collaborative effort involving Annina Burgherr, Esther Su Wee Tan, Anika Jacobi, Thomas Pilgrim, Martina Rothenbühler, Benjamin Victor Ineichen, and Lilian Witthauer.

The full article is available open access in Diabetes, Obesity and Metabolism: