Glucose patterns and cardiac arrhythmias in older adults with diabetes

Abstract Type 2 diabetes and cardiac arrhythmias are both highly prevalent in older age. There is growing awareness that diabetes affects the electrical conduction system in the heart. Asymptomatic arrhythmias are thought to be particularly common in older adults, especially in the setting of diabetes. Many of these arrhythmias are thought to be harmful, but their impact on cardiovascular outcomes and mortality in older adults with diabetes is not clear. Prior research has shown that glycemic variability and hypoglycemia in diabetes contribute to a high burden of atrial and ventricular arrhythmias. However, prior studies have not collected concomitant information on glucose patterns and ECG recordings. We contend the glycemic patterns (low, high, and variable glucose) may acutely contribute to cardiac arrhythmias in diabetes. To address this question, we will conduct continuous glucose monitoring and leadless “patch” ECG monitoring in a population of adults with diabetes aged 60 years and older to assess coinciding variations in glycemia and cardiac rhythm. We will relate these patterns to current health status and long-term clinical outcomes. Our research will inform the role of low, high, and variable glucose in leading to cardiac arrhythmias and subsequent outcomes in older adults with diabetes.