Effect of hypoglycaemia on measures of myocardial blood flow and myocardial injury in adults with and without type 1 diabetes: A prospective, randomised, open-label, blinded endpoint, cross-over study

Radzi M. Noh (Lead / Corresponding author), Alex J. Graveling, Ninian N. Lang, Audrey C . White, Kuan Ken Lee, Nicholas L. Mills, David E. Newby, Chim C. Lang, Brian M. Frier

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Abstract

Aims: This study examined the effect of experimentally-induced hypoglycaemia on measures of myocardial blood flow and myocardial injury in adults with, and without, type 1 diabetes. Methods: In a prospective, randomised, open-label, blinded, endpoint cross-over study, 17 young adults with type 1 diabetes with no cardiovascular risk factors, and 10 healthy non-diabetic volunteers, underwent hyperinsulinaemic-euglycaemic (blood glucose 4.5–5.5 mmol/L) and hypoglycaemic (2.2–2.5 mmol/L) clamps. Myocardial blood flow was assessed using transthoracic echocardiography Doppler coronary flow reserve (CFR) and myocardial injury using plasma high-sensitivity cardiac troponin I (hs-cTnI) concentration. Results: During hypoglycaemia, coronary flow reserve trended non-significantly lower in those with type 1 diabetes than in the non-diabetic participants (3.54 ± 0.47 vs. 3.89 ± 0.89). A generalised linear mixed-model analysis examined diabetes status and euglycaemia or hypoglycaemia as factors affecting CFR. No statistically significant difference in CFR was observed for diabetes status (p =.23) or between euglycaemia and hypoglycaemia (p =.31). No changes in hs-cTnI occurred during hypoglycaemia or in the recovery period (p =.86). Conclusions: A small change in CFR was not statistically significant in this study, implying hypoglycaemia may require more than coronary vasomotor dysfunction to cause harm. Further larger studies are required to investigate this putative problem.

Original languageEnglish
Article numbere00258
Number of pages8
JournalEndocrinology, Diabetes & Metabolism
Volume4
Issue number3
Early online date7 May 2021
DOIs
Publication statusPublished - Jul 2021

Keywords

  • Cardiovascular function
  • Coronary Flow Reserve
  • Hypoglycaemia
  • Myocardial Ischaemia
  • Type 1 diabetes
  • type 1 diabetes
  • coronary flow reserve
  • hypoglycaemia
  • myocardial ischaemia
  • cardiovascular function

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