Study investigates link between hypoglycemia and heart rate in type 1 diabetes

Young adults with type 1 diabetes and a history of moderate to severe hypoglycemia could be more likely to experience impaired heart rate variability, according to new research.
These findings were observed when patients with type 1 diabetes with a history were compared to patients with minor or no hypoglycemia.
For this study, scientists at Federal University of Sao Paulo, Brazil evaluated data from 99 young adults with type 1 diabetes between February 2011 and December 2013.
The researchers wanted to examine links between hypoglycemia and the presence of cardiovascular autonomic neuropathy, so they assessed heart rate variability in the participants as well as severity of hypoglycemia.
In total, 78 participants had absent or minor hypoglycemia and 21 had moderate or severe hypoglycemia. Patients in the latter group tended to be older and had type 1 diabetes for a longer duration.
The findings showed that impaired heart rate variability was a predictor of moderate or severe hypoglycemia. Diabetic nephropathy and macrovascular complications were also found to be predictors.
Patients with moderate/severe hypoglycemia also had a loss of cardioprotective effect compared to patients with absent or mild hypoglycemia.
“These results are consistent with previous studies that showed severe hypoglycemic episodes associated with impaired [CV] autonomic tests,” said study author Ticiana Paes Silva, MD.
“Our results are compatible with the loss of cardioprotective effect of vagal activity in patients with moderate/severe hypoglycemia. This may result in worse outcomes related to progression to dangerous arrhythmias for this group of patients,” concluded the authors.
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The study appears in Diabetes Metabolism &Research.