MILLIONS of Britons with type 2 diabetes could be at greater risk of sudden cardiac arrest if they took certain commonly prescribed drugs, a study suggests.
More than 4.3 million people in the UK are living with diabetes, and 90 per cent of them (3.9 million) have type 2, according to Diabetes UK.
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People with type 2 diabetes who take certain antibiotics, antipsychotics and prokinetic drugs may be at greater risk of sudden cardiac arrestCredit: Alamy
The charity estimates that around 850,000 million people do not know they have the condition.
Research has now shown that people with type 2 diabetes who take some commonly prescribed antibiotics, antipsychotics and prokinetic drugs are twice as likely to experience sudden cardiac arrest – when the heart suddenly stops pumping blood around the body.
But this can be difficult to predict, said the research team from the University of Amsterdam Medical Center, especially if sufferers have no history of cardiovascular disease (CVD), they said.
Lead author Peter Harms of Amsterdam UMC and his team evaluated the GP records of 689 people with type 2 diabetes who suffered sudden cardiac arrest between 2010 and 2019.
Read more about type 2 diabetes
Slightly more than half of them – 352 – had a history of cardiovascular disease, while the remaining 337 did not.
The team compared this with the health data of 3,230 control subjects – healthy people without type 2 diabetes.
The research team identified several factors that increase the risk of sudden cardiac arrest.
In people without a history of CVD, taking QTc-prolonging antipsychotics increased the risk of sudden cardiac arrest by 187 percent, while QTc-prolonging antibiotics increased the risk by 66 percent.
Other factors that increased the risk of a fatal cardiac event included low blood sugar (150 percent), very high blood pressure (121 percent) and high cholesterol (64 percent).
But taking prokinetic drugs that prolong the QTc interval increased the risk of sudden cardiac arrest in people with type 2 diabetes by 66 percent — regardless of whether they had a history of CVD.
Many common medications, including some prokinetic drugs, antibiotics, and antipsychotics, can alter the functioning of the heart’s electrical system.
This is known as QT prolongation, so the drugs are described as prolonging the QTc interval.
Prokinetics that prolong QTc include domperidone, the research team said.
Marcolides and fluoroquinolones are antibiotics that fit into that category. As for antipsychotics that prolong the QTc interval, haloperidol is one of them.
Prokinetic drugs are used to treat gastrointestinal symptoms such as nausea and vomiting.
Commenting on the findings – which were presented at the European Association for the Study of Diabetes (EASD) Annual Meeting in Hamburg, Germany – Mr Harms said: “General practitioners will already be aware that classic cardiovascular risk factors such as high blood pressure raise the risk of sudden cardiac death. stagnation in people with type 2 diabetes.
“However, the relationship between low fasting glucose and antibiotics, antipsychotics and prokinetic drugs is less well known.
“Our results highlight the need for general practitioners to be aware of the dangers of overly strict glycemic control and the prescription of antibiotics, antipsychotics and prokinetic agents that are often used.”
Glycemic control refers to maintaining blood glucose levels within desirable levels to prevent hypoglycemia and hyperglycemia – low and high blood sugar.
According to the British Heart Foundation (BHF), there are more than 30,000 out-of-hospital cardiac arrests in the UK every year and only one in 10 of those sufferers survive.
It comes after research from the University of Cambridge found that being diagnosed with type 2 diabetes before the age of 30 could cut your life expectancy by 14 years.
What are the signs of sudden cardiac arrest?
Cardiac arrest is different from a heart attack.
While the former is caused by the heart suddenly stopping pumping blood through the body, the latter occurs when blood flow to the heart is suddenly blocked by something like a blood clot.
Cardiac arrests can happen without warning, causing someone to collapse and be:
- unconsciously
- inadequate
- they are not breathing or not breathing normally – this may mean they are making gasping sounds
It requires immediate medical attention so call 999 immediately if you think this has happened to someone.
Cardiac arrest is caused by a dangerously abnormal heart rhythm that occurs when the heart’s electrical system doesn’t work properly, according to the British Heart Foundation.
Not all abnormal heart rhythms are life-threatening, but some mean the heart can’t pump blood around the body.
Some people may not experience any symptoms before sudden cardiac arrest, while others may experience:
- Fatigue
- Dizziness
- Shortness of breath
- Nausea
- Chest pain
- Palpitations (rapid or strong heartbeat)
- Loss of consciousness
Sources: BHF, Johns Hopkins Medicine
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