Warning as medications for common condition linked to risk of cardiac arrest
British Heart Foundation outlines cardiac arrest symptoms
The research, to be presented at the annual meeting of the European Association for the Study of Diabetes (EASD) in Hamburg, Germany, carried a stark warning.
Diabetics who are prescribed antibiotic and antipsychotic drugs, or prokinetics (used to treat nausea and vomiting), are more likely to suffer from a deadly cardiac arrest.
These commonly prescribed drugs are associated with a change in the functioning of the heart’s electrical system, known as QT-prolongation.
- Prokinetics – domperidone
- Antibiotics – macrolides, fluoroquinolones
- Antipsychotics – haloperidol.
New figures from Diabetes UK show that 4.3 million people are now living with a diagnosis of type 2 diabetes in the UK.
READ MORE… Screen A&E patients for undiagnosed diabetes
Thus, if any diabetics have been prescribed QTc-prolonging antibiotics, for example, they could be more likely to experience a life-threatening cardiac arrest.
A cardiac arrest occurs when the heart stops pumping blood, which is a leading cause of death.
People who have type 2 diabetes have a two-fold increased risk of a sudden cardiac arrest, researcher Peter Harms, of Amsterdam UMC, said.
Harms and colleagues carried out a study to assess which clinical characteristics in GP records are associated with sudden cardiac arrest and type 2 diabetes, with and without a cardiovascular disease history.
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The study involved 3,919 individuals who have type 2 diabetes; 689 had a sudden cardiac arrest in the Dutch region of Noord-Holland from 2010-2019.
Clinical measurements included blood pressure, blood glucose readings, medication used, and medical history for five years prior to sudden cardiac arrest.
Several characteristics were associated with an increased risk of a sudden cardiac arrest in both people with and without a cardiovascular disease history.
Associated risk factors of a sudden cardiac arrest:
- History of arrhythmias (68 percent increase in risk)
- Unknown smoking behaviour (40 percent increase in risk)
- Insulin use (138 percent increase)
- QTc-prolonging prokinetic medication (66 percent increase in risk).
Diabetics without a history of cardiovascular disease were also at increased risk of cardiac arrest if they had low fasting glucose.
Low fasting glucose (less than 4.5 mmol/mol), the researchers say, is “an indication of too strict glycaemic control”.
This was associated with a 150 percent increased risk of a sudden cardiac arrest.
Other risk factors included: severe hypertension, unhealthy blood fats, and QTc-prolonging medication.
Mr Harms said: “Our results underline the need for GPs to be aware of the hazards of too strict glycaemic control and the prescription of commonly used antibiotics, antipsychotics and prokinetics.”
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