Effects of insulin‐induced hypoglycaemia on cardiac function in people with type 1 and type 2 diabetes and people without diabetes
Authors' conclusion
Hypoglycaemia increased LVEF in all groups, but the increase diminished with longer disease duration and prior exposure to hypoglycaemia in type 1 diabetes, suggesting adaptation to recurrent hypoglycaemia. The increment in GLS observed in controls was blunted in people with diabetes. More research is needed to determine the clinical relevance of these findings.
Study context
- Population
- People with T1D, insulin-treated T2D and controls without diabetes undergoing a hyperinsulinaemic-normoglycaemic (5.3 ± 0.3 mmol/L)-hypoglycaemic (2.8 ± 0.1 mmol/L) glucose clamp
- Participants
- 24 / 15 / 24
- Comparison
- T1D vs insulin-treated T2D vs controls without diabetes during insulin-induced hypoglycaemia
- T1Dn = 24
- Insulin-treated T2Dn = 15
- Controlsn = 24reference
- Outcome
- LVEF (left ventricular ejection fraction) by echocardiography
- Follow-up
- During hypoglycaemia vs baseline
Methodological detailshyperinsulinaemic-normoglycaemic-hypoglycaemic glucose clamp, echocardiography
- Hyperinsulinaemic-normoglycaemic-hypoglycaemic glucose clamp
- Echocardiography
Main finding
As reported in the abstract
Increase in LVEF during hypoglycaemia
95% CI −5.0 to −0.3; P = 0.03
- Left ventricular ejection fraction (LVEF) increased significantly in all groups vs baseline
- 6.2 ± 5.2%, p < 0.05
Further findings
Association of ΔLVEF with diabetes characteristics in T1D
| β (95% CI) | P value | |
|---|---|---|
| Diabetes durationInverse association | −0.16 (−0.24 to −0.53) | P = 0.001 |
| Recent exposure to hypoglycaemiaInverse association | −0.30 (−0.53 to −0.07) | P = 0.015 |
Global longitudinal strain (GLS) · during hypoglycaemia
- GLS increased in controls
- P < 0.05
- No GLS increase in the two diabetes subgroups
- P > 0.10
Original publication
Effects of insulin‐induced hypoglycaemia on cardiac function in people with type 1 and type 2 diabetes and people without diabetes. Diabetes Obes Metab. Published 5 March 2025. doi:10.
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