Comparison of the effects of SGLT 2 inhibitors and sulfonylurea on electrocardiographic parameters

Abstract

Objective: Tp-e, QT, and Tp-e / QT are parameters showing ventricular repolarization. The increase in these parameters causes an increase in cardiovascular mortality, mostly due to malignant arrhythmias. Our study aimed to compare the long-term changes in electrocardiographic parameters in patients with uncontrolled diabetes despite using metformin, with the addition of SGLT 2 inhibitor or sulfonylurea (SU) to the treatment. Method: This retrospective study was enrolled in 133 type 2 DM patients with uncontrolled diabetes who applied to the internal medicine outpatient clinic, using single oral antidiabetic agents. The patients were divided into two groups as SU and SGLT 2 inhibitor additive. SU was added to the treatment of 69 patients, and SGLT 2 inhibitor was added to 64 patients. 12-lead superficial ECG records of participants who received combined therapy for at least six months were analyzed and compared. RR distance, QT interval, and Tp-e intervals were measured on the ECG. QTc was calculated using Bazzet's formula. (QT/ √ RR). Tp-e / QT and Tp-e / QTc ratios were calculated. Results: Seventy-eight (58.6%) of the participants were female, and 55 (41.4) were male. The age and gender distribution of both groups were similar. The group to which SGLT 2 inhibitor was added, Tp-e, QT, and QTc distances were significantly lower than the SU group (p <0.001 for each). Also, the Tp-e / QT and Tp-e / QTc ratios were significantly greater in the SU group (0.210 ± 0.029 vs 0.190 ± 0.03; p <0.001 and 0.201 ± 0.051 vs 0.184 ± 0.032; p = 0.022 respectively). Conclusions: In our study, we showed that the addition of SGLT2 inhibitors to monotherapy in people with diabetes with poor glycemic control has a positive effect on ECG parameters, which are indicators of repolarization, compared to other oral antidiabetics.