When we talk about keeping the heart healthy—especially for people living with type 2 diabetes—we often focus on the usual suspects: diet, exercise, and managing blood sugar. But new research suggests that there are other, less obvious risks that also deserve attention.
A recent study presented at the European Association for the Study of Diabetes (EASD) Annual Meeting in Hamburg, Germany, has uncovered some surprising factors linked to sudden cardiac arrest (SCA) in people with type 2 diabetes.
SCA is a serious and often fatal condition where the heart suddenly stops beating. It accounts for up to half of all heart-related deaths and about 20% of total deaths in wealthier countries.
People with type 2 diabetes already face double the risk of sudden cardiac arrest compared to those without diabetes. But for individuals who don’t have a history of heart disease, it’s especially important to understand other risks that might not be so obvious.
Researchers from Amsterdam UMC in the Netherlands, led by Peter Harms, examined the medical records of nearly 4,000 people with type 2 diabetes living in the Noord-Holland region. Between 2010 and 2019, 689 of them experienced sudden cardiac arrest. The team compared each case with up to five similar individuals who had not experienced SCA.
They looked at a wide range of health data and medication use in the five years leading up to each SCA event. And what they discovered may change how we think about risk.
One of the biggest surprises was the link between certain common medications and increased SCA risk. These included:
- Macrolide antibiotics (used to treat infections)
- Antipsychotic drugs, such as haloperidol
- Prokinetics, which are medications often prescribed for stomach issues like nausea
What these medications have in common is that they are known to prolong the QTc interval—a measure of how the heart’s electrical system resets between beats. When the QTc is too long, the heart becomes more vulnerable to dangerous rhythms that can lead to sudden cardiac arrest.
This connection suggests that doctors should be extra cautious when prescribing these medications to people with type 2 diabetes, especially if they already have other risk factors for heart problems.
Another unexpected finding was the link between low fasting blood sugar and a 150% increase in SCA risk—particularly in people without a known history of heart disease. This is especially important because tight blood sugar control is often seen as a good thing in diabetes care.
However, these findings suggest that being too aggressive in lowering blood sugar might backfire. Very low glucose levels can stress the body and affect the heart’s rhythm, potentially triggering SCA.
For people who do have heart disease, other factors played a stronger role in SCA risk. These included:
- Albuminuria – a sign of kidney damage where protein leaks into the urine
- Heart failure – where the heart struggles to pump blood effectively
Both conditions are already known to raise heart risk, but this study strengthens the link with sudden cardiac arrest.
Peter Harms, the study’s lead researcher, explained that while general practitioners and specialists often look out for common heart risk factors in diabetes—like high blood pressure—they may not always think about less obvious dangers like low blood sugar or QTc-prolonging medications.
This study shows that managing diabetes involves more than just keeping blood sugar in check. It’s about creating a balanced approach that looks at the whole person—including their heart health, kidney function, medication use, and even how aggressively their blood sugar is being controlled.
This research is an important reminder that “good” diabetes control isn’t always as simple as pushing numbers down. While avoiding high blood sugar is key, aiming for extremely low fasting glucose might put certain patients at risk—especially if they don’t have existing heart issues that would normally raise a red flag.
The findings also call for more careful review of medications that can affect heart rhythms. Many of these drugs are commonly prescribed, and their risks may be underestimated in diabetes care.
By widening the lens through which we view diabetes management, doctors and patients can work together to create more personalized care plans. These plans should not only control blood sugar but also take into account long-term heart safety.
Type 2 diabetes is already a complex condition—but this study shows it’s even more layered when it comes to heart risk. With better awareness of hidden factors like medication choices and low blood sugar levels, healthcare providers can offer more thoughtful, protective care.
Ultimately, understanding these risks can help prevent tragic events like sudden cardiac arrest and lead to healthier, safer outcomes for people living with diabetes.
If you care about diabetes, please read studies about Vitamin D and type 2 diabetes, and what you need to know about avocado and type 2 diabetes.
For more information about diabetes, please see recent studies about how to eat to prevent type 2 diabetes, and 5 vitamins that may prevent complication in diabetes.
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