Prevalence and Clinical Characteristics of Sudden Death in 606 Diabetics

Abstract

Althugh unexpected sudden death in diabetics with autonomic neuropathy has previously been reported, the prevalence and clinical characteristics of sudden death have not been extensively evaluated. For this study we have investigated the prevalence and clinical characteristics of sudden death in 606 diabetics.The mean follow up period was 7 years.
Furthermore, the corrected QT interval (QTc) as a marker of sympathetic nerve function in these diabetics was compared with 45 age and sex matched healthy controls to evaluate the association of QTc prolongation with sudden death.
1) Among the 606 diabetics, 127 were already deceased and 39 of these (c. a. 31%) had been judged to be sudden deaths.
2) These sudden death cases tended to be eldery, and were frequently associated with hypertension, ischemic heart disease, autonomic or peripheral neuropathy, gangrene and nephropathy, as compared with survivors.
3) Although cardiac or cerebrovascular accidents were the major causes of death, the causes of sudden death in more than half of the cases could not be determined.
4) QTc intervals, in both diabetic survivors (418±26msec, p<0.05) and sudden death cases (445±33msec, p<0.01), were longer than that in controls (401±17msec).
5) The QTc prolongation in sudden death subjects might be attributable to autonomic neuropathy.