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Related Concept Videos

Dysrhythmias I: Introduction01:15

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Dysrhythmias refers to abnormalities in the heart's rhythm. They result from disruptions in the heart's electrical conduction system, which includes the sinoatrial(SA)node, atrioventricular(AV) node, the bundle of His, bundle branches, and Purkinje fibers.Definition and PathophysiologyDysrhythmias result from disorders of impulse formation, impulse conduction, or both. The heart contains specialized cells in the sinoatrial node, atrioventricular node, and the bundle of His and Purkinje fibers...
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Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...
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Oral Hypoglycemic Agents: α-Glucosidase Inhibitors01:19

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α-glucosidase inhibitors, including acarbose (Precose), miglitol (Glyset), and voglibose (Voglib) (primarily available in Asia), are drugs that control blood sugar levels by delaying the digestion of starch and disaccharides. They achieve this by inhibiting α-glucosidase enzymes in the intestine, which slow the absorption of carbohydrates in the intestine, which in turn leads to a prolonged release of the glucoregulatory hormone GLP-1 from intestinal L-cells.
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Biguanides, particularly metformin (Glucophage), are insulin sensitizers that enhance glucose uptake, thereby reducing insulin resistance. Unlike sulfonylureas, metformin doesn't prompt insulin secretion, which helps to curb hypoglycemia risk. Metformin is beneficial in treating conditions like polycystic ovary syndrome due to its insulin-resistance reduction capability. The drug's primary action involves curtailing hepatic gluconeogenesis, a significant contributor to high blood...
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For most patients, experiencing several weeks of polyuria, polydipsia, fatigue, and significant weight loss may indicate the presence of diabetes. Furthermore, adults displaying the phenotypic appearance of type 2 diabetes (particularly those who are obese and not initially insulin-requiring), may have islet cell autoantibodies, suggesting autoimmune-mediated β cell destruction and a diagnosis of latent autoimmune diabetes of adults (LADA). The categorization of glucose homeostasis is...
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Repaglinide (Prandin) and Nateglinide (Starlix), known as glinides, are oral insulin secretagogues that stimulate insulin release from pancreatic β cells by closing the ATP-sensitive potassium channels (KATP channel). Repaglinide controls insulin release from pancreatic β cells by managing potassium efflux. It shares two binding sites with sulfonylureas and also has a unique site, indicating overlapping mechanisms of action. With a rapid onset and a 4-7 hour duration, it effectively...
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Dysglycemia and arrhythmias.

Dong-Kun Sun1, Nan Zhang1, Ying Liu1

  • 1Department of Cardiology, Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin 300211, China.

World Journal of Diabetes
|September 4, 2023
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Summary

Glucose metabolism disorders like hyperglycemia, hypoglycemia, and glycemic variability are linked to cardiac arrhythmias. Tailored glycemic control is crucial to prevent these heart rhythm problems.

Keywords:
Cardiac arrhythmiaDysglycemiaGlucose variabilityHyperglycemiaHypoglycemia

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Area of Science:

  • Endocrinology
  • Cardiology
  • Metabolic Disorders

Background:

  • Glucose metabolism disorders encompass hyperglycemia, hypoglycemia, and glycemic variability.
  • These dysglycemic states are prevalent in diabetes and critically ill patients.
  • Emerging evidence links dysglycemia to various cardiac arrhythmias.

Purpose of the Study:

  • To explore the relationship between hyperglycemia, hypoglycemia, glycemic variability, and cardiac arrhythmias.
  • To understand the mechanisms linking dysglycemia to heart rhythm disturbances.
  • To emphasize the importance of customized glycemic control strategies.

Main Methods:

  • Review of experimental studies identifying mechanisms of dysglycemia-induced arrhythmias.
  • Analysis of existing literature on the association between glucose metabolism and cardiac arrhythmias.
  • Focus on supraventricular, ventricular, and bradyarrhythmias.

Main Results:

  • Dysglycemic states are associated with increased risk of atrial fibrillation, malignant ventricular arrhythmias, and bradyarrhythmias.
  • Experimental studies have elucidated potential mechanisms linking glucose dysregulation to arrhythmogenesis.
  • QT interval prolongation and heart block are also implicated.

Conclusions:

  • Minimizing hyperglycemia, hypoglycemia, and glycemic variability is essential for cardiac arrhythmia prevention.
  • A personalized glycemic control strategy is vital for patients at risk.
  • Addressing dysglycemia can mitigate cardiac arrhythmia risk.