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Atrial fibrillation can cause major hyperglycemia
V Rigalleau1, L Baillet, M Hocini
1Nutrition-Diabétologie, Hôpital Haut-Lévêque, 33600 Pessac, France. vincent.rigalleau@wanadoo.fr
Diabetes & Metabolism
|August 1, 2002
Summary
Symptomatic atrial fibrillation can significantly increase insulin needs in type 2 diabetes patients. Restoring normal heart rhythm with cardioversion helped normalize insulin requirements, suggesting a direct link.
Area of Science:
- Cardiology
- Endocrinology
- Metabolic Disorders
Background:
- Type 2 diabetes mellitus (T2DM) management often involves insulin therapy.
- Atrial fibrillation (AF) is a common cardiac arrhythmia.
- Insulin resistance is a key feature of T2DM.
Observation:
- A 66-year-old woman with well-controlled, insulin-treated T2DM presented with a ten-fold increase in daily insulin dose.
- This surge in insulin requirement occurred after the onset of symptomatic atrial fibrillation.
- Investigations for other causes of insulin resistance were negative.
Findings:
- Insulin requirements returned to baseline levels only after successful electric cardioversion of atrial fibrillation.
- This case highlights a direct correlation between symptomatic AF and severe hyperglycemia in T2DM.
Implications:
- Symptomatic atrial fibrillation should be recognized as a potential cause of acute hyperglycemia and increased insulin resistance.
- Clinicians should consider screening for cardiac arrhythmias in diabetic patients with unexplained changes in glycemic control.
- Further research may elucidate the pathophysiological mechanisms linking AF and insulin resistance.