These common drugs linked to sudden cardiac arrest in people with type 2 diabetes

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In a revelation presented at the Annual Meeting of the European Association for the Study of Diabetes (EASD) held in Hamburg, Germany, researchers have spotlighted several characteristics associated with an elevated risk of sudden cardiac arrest (SCA) in individuals with type 2 diabetes (T2D).

These factors incorporate commonly prescribed antibiotic and antipsychotic drugs, prokinetics, and low fasting blood sugar.

SCA: A Pervasive and Lethal Condition

SCA stands out as a principal cause of death, accounting for up to 50% of cardiac deaths and 20% of overall mortality in high-income nations.

The condition, characterized by the abrupt cessation of the heart’s blood-pumping activity, poses a particularly pronounced risk for individuals with T2D, who exhibit a two-fold increased risk of experiencing SCA.

Peter Harms and his team from Amsterdam UMC undertook a case-control study involving 3,919 individuals with T2D to ascertain which clinical characteristics, evident in GP records, were associated with SCA.

This population comprised 689 cases and 3,230 controls, with each case (an individual who suffered an SCA) being matched by age, sex, and GP practice with up to five non-SCA controls.

Clinical measurements and medical history for the five years leading up to each case’s SCA were extracted from GP records.

Risk Characteristics: A Detailed Breakdown

Several characteristics were identified as being associated with a heightened risk of SCA, inclusive of:

  • History of arrhythmias (68% risk increase)
  • Unknown smoking behavior (40% risk increase)
  • Insulin use (138% risk increase)
  • Usage of QTc-prolonging prokinetic medication (66% risk increase)

In T2D patients with a history of cardiovascular disease (CVD), factors such as moderate, severe, and unknown albuminuria, along with heart failure, were associated with SCA.

Conversely, in those without a CVD history, characteristics including low fasting glucose, severely high systolic blood pressure, low HDL cholesterol, high LDL cholesterol, and the usage of QTc-prolonging antipsychotic and antibiotic medications were correlated with SCA.

A Vital Knowledge Gap for General Practitioners

Mr. Harms pointed out that while GPs might already be cognizant of the fact that conventional cardiovascular risk factors, such as high blood pressure, augment the risk of SCA in T2D patients, the association with low fasting glucose and certain medications might be less commonly recognized.

He emphasized, “Our results underline the need for GPs to be aware of the hazards of too strict glycemic control and the prescription of commonly used antibiotics, antipsychotics, and prokinetics.”

Moving Forward: Implications for Clinical Practice

The study illuminates potential risk factors for SCA that may have been underappreciated or overlooked, especially in the context of T2D patients.

The findings underscore the necessity of adopting a judicious approach to glycemic control and prescribe medications, bearing in mind the nuanced risk factors that this patient demographic presents with.

Enhanced awareness and strategically adapted clinical practices amongst GPs could potentially pave the way for better risk management and prevention strategies concerning SCA in T2D patients.

If you care about heart health, please read studies that vitamin K helps cut heart disease risk by a third, and a year of exercise reversed worrisome heart failure.

For more information about heart health, please see recent studies about supplements that could help prevent heart disease, stroke, and results showing this food ingredient may strongly increase heart disease death risk.

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