INTENSIVE HYPOGLYCEMIC THERAPY AS A TRIGGER FOR ELECTRICAL MYOCARDIAL INSTABILITY

In this article, we have highlighted our own results on the use of basal insulinDegludec in combination with other antihyperglycemic drugs in patients with type 2 diabetesusing long-term ECG monitoring and FreeStyle Libre glycemia. In our patient, with afavorable glycated hemoglobin level, according to the CGM, frequent episodes of hypoglycemiawere observed, which were associated with paroxysms of atrial fibrillation. This situationtestified in favor of resolving the issue of revising the therapy. Thus, we have replaced thebasal insulin Glargin with the newer generation insulin Degludek, which has a morepronounced effect on glycemic variability, therefore, its effect is more predictable. Currently,there is convincing evidence of the effect of hypoglycemia on the development of electricalinstability of the myocardium with the occurrence of fatal arrhythmias. The use of systemsfor synchronous long-term monitoring of glycemia and heart rate will allow more accuraterecording of episodes of hypoglycemia and correction of insulin therapy, thereby reducingthe risk of arrhythmias.

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