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Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Aug 15, 2023; 14(8): 1163-1177
Published online Aug 15, 2023. doi: 10.4239/wjd.v14.i8.1163
Dysglycemia and arrhythmias
Dong-Kun Sun, Nan Zhang, Ying Liu, Jiu-Chun Qiu, Gary Tse, Guang-Ping Li, Leonardo Roever, Tong Liu
Dong-Kun Sun, Nan Zhang, Ying Liu, Jiu-Chun Qiu, Gary Tse, Guang-Ping Li, Tong Liu, Department 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
Gary Tse, Kent and Medway Medical School, Kent CT2 7NT, Canterbury, United Kingdom
Gary Tse, School of Nursing and Health Studies, Metropolitan University, Hong Kong 999077, China
Leonardo Roever, Department of Clinical Research, Federal University of Uberlândia, Uberlândia, 38400384, MG, Brazil
Author contributions: Sun DK and Zhang N wrote the paper and collected the data, had equal contribution to this paper; Sun DK, Zhang N, Liu Y, Qiu JC, Tse G, and Li GP have contributed to the conception, design, and review of the manuscript; and all authors have read and approve the final manuscript; Roever L and Liu T had equal contribution to this paper.
Supported by the National Natural Science Foundation of China, No. 81970270, No. 81570298, and No. 81270245; and Tianjin Key Medical Discipline (Specialty) Construction Project, No. TJYXZDXK-029A.
Conflict-of-interest statement: The authors have no competing interests to declare.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Tong Liu, FESC, MD, PhD, Full Professor, Department of Cardiology, Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, No. 23 Pingjiang Road, Hexi District, Tianjin 300211, China. liutongdoc@126.com
Received: February 28, 2023
Peer-review started: February 28, 2023
First decision: May 8, 2023
Revised: May 19, 2023
Accepted: July 5, 2023
Article in press: July 5, 2023
Published online: August 15, 2023
Abstract

Disorders in glucose metabolism can be divided into three separate but interrelated domains, namely hyperglycemia, hypoglycemia, and glycemic variability. Intensive glycemic control in patients with diabetes might increase the risk of hypoglycemic incidents and glucose fluctuations. These three dysglycemic states occur not only amongst patients with diabetes, but are frequently present in other clinical settings, such as during critically ill. A growing body of evidence has focused on the relationships between these dysglycemic domains with cardiac arrhythmias, including supraventricular arrhythmias (primarily atrial fibrillation), ventricular arrhythmias (malignant ventricular arrhythmias and QT interval prolongation), and bradyarrhythmias (bradycardia and heart block). Different mechanisms by which these dysglycemic states might provoke cardiac arr-hythmias have been identified in experimental studies. A customized glycemic control strategy to minimize the risk of hyperglycemia, hypoglycemia and glucose variability is of the utmost importance in order to mitigate the risk of cardiac arrhythmias.

Keywords: Dysglycemia, Hyperglycemia, Hypoglycemia, Glucose variability, Cardiac arrhythmia

Core Tip: Different mechanisms by which these dysglycemic states might provoke cardiac arrhythmias have been identified in experimental studies. A customized glycemic control strategy to minimize the risk of hyperglycemia, hypoglycemia and glucose variability is of the utmost importance in order to mitigate the risk of cardiac arrhythmias.