Type 2 diabetes (T2D) is known to double the risk of sudden cardiac arrest (SCA), a leading cause of death where the heart abruptly stops pumping blood.
Despite this known risk, predicting SCA, especially in those without a history of cardiovascular disease (CVD), remains challenging.
Recent research presented at the European Association for the Study of Diabetes (EASD) Annual Meeting in Hamburg, Germany, has made significant strides in identifying risk factors for SCA in individuals with T2D.
The study, led by Peter Harms from Amsterdam UMC, Amsterdam, The Netherlands, involved analyzing clinical characteristics from general practitioner (GP) records.
The study was a case-control investigation involving 3,919 individuals with T2D, including 689 SCA cases and 3,230 controls.
The cases, who experienced SCA between 2010-2019 in Noord-Holland, were matched with controls based on age, sex, and GP practice. Clinical measurements and medication use were examined for five years leading up to the SCA event.
Key Findings: Risk Factors for Sudden Cardiac Arrest
Increased Risk Factors (Both with and without CVD):
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- History of arrhythmias (68% increased risk)
- Unknown smoking behavior (40% increase)
- Insulin use (138% increase)
- QTc-prolonging prokinetic medication use (66% increase)
Risk Factors in Patients with CVD:
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- Moderate to severe and unknown albuminuria (54-90% increase)
- Heart failure (85% increase)
Risk Factors in Patients without CVD:
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- Low fasting glucose (<4.5 mmol/mol: 150% increase)
- Severely high systolic blood pressure (>180mmHg: 121% increase)
- Low HDL cholesterol (<1.0 mmol/l: 35% increase)
- High LDL cholesterol (>2.6 mmol/l: 64% increase)
- Use of QTc-prolonging antipsychotic (187% increase) and antibiotic medications (66% increase)
QTc-prolonging medications, such as certain prokinetics, antibiotics, and antipsychotics, can alter the heart’s electrical system, potentially increasing SCA risk.
These include drugs like domperidone, marcolides, fluoroquinolones, and haloperidol.
Conclusions and Implications for General Practitioners
The study underlines the importance of general practitioners being vigilant about the risks associated with low fasting glucose levels and the prescription of QTc-prolonging medications.
While high blood pressure is a known risk factor, the link with low fasting glucose and certain medications is less recognized.
Mr. Harms emphasizes the need for GPs to be aware of the hazards of overly strict glycemic control and commonly prescribed antibiotics, antipsychotics, and prokinetics.
This awareness is crucial in managing the health of individuals with T2D and preventing sudden cardiac arrest.
Conclusion: A Step Forward in Diabetes Management
This study marks a significant step in understanding and managing the risks associated with sudden cardiac arrest in people with type 2 diabetes.
By identifying specific risk factors, especially in patients without a history of cardiovascular disease, healthcare providers can tailor their approach to patient care, potentially reducing the incidence of SCA among this vulnerable population.
If you care about diabetes, please read studies about new way to achieve type 2 diabetes remission, and one avocado a day keeps diabetes at bay.
For more information about diabetes, please see recent studies about 5 dangerous signs you have diabetes-related eye disease, and results showing why pomegranate is super fruit for people with diabetes.
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