POSSIBILITIES OF ELECTRIC MYOCARDIAL INSTABILITY CORRECTION USING ADEQUATE HYPOGLYCEMIC THERAPY
Keywords:
hypoglycemic therapy, diabetes mellitus, glycated hemoglobin, atrial fibrillationAbstract
In this article, we have highlighted our own results on the use of basal insulin Degludec in combination with other antihyperglycemic drugs in patients with type 2 diabetes using long-term ECG monitoring and FreeStyle Libre glycemia. In our patient, with a favorable glycated hemoglobin level, according to the CGM, frequent episodes of hypoglycemia were observed, which were associated with paroxysms of atrial fibrillation. This situation testified in favor of resolving the issue of revising the therapy. Thus, we have replaced the basal insulin Glargin with the newer generation insulin Degludek, which has a more pronounced effect on glycemic variability, therefore, its effect is more predictable. Currently, there is convincing evidence of the effect of hypoglycemia on the development of electrical instability of the myocardium with the occurrence of fatal arrhythmias. The use of systems for synchronous long-term monitoring of glycemia and heart rate will allow more accurate recording of episodes of hypoglycemia and correction of insulin therapy, thereby reducing the risk of arrhythmias.
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