Are the variations in ECG morphology associated to different blood glucose levels? implications for non-invasive glucose monitoring for T1D paediatric patients

Martina Andellini; Rossana Castaldo; Owain Cisuelo; Monica Franzese; Muhammad Salman Haleem; Matteo Ritrovato; Leandro Pecchia; Riccardo Schiaffini

doi:10.1016/j.diabres.2024.111708

Are the variations in ECG morphology associated to different blood glucose levels? implications for non-invasive glucose monitoring for T1D paediatric patients

Diabetes Res Clin Pract. 2024 May 14:212:111708. doi: 10.1016/j.diabres.2024.111708. Online ahead of print.

Authors

Martina Andellini¹, Rossana Castaldo², Owain Cisuelo³, Monica Franzese², Muhammad Salman Haleem⁴, Matteo Ritrovato⁵, Leandro Pecchia⁶, Riccardo Schiaffini⁵

Affiliations

¹ University of Warwick, School of Engineering, Coventry, UK; Bambino Gesù Children's Hospital, IRCCS, Rome, Italy. Electronic address: martina.andellini@opbg.net.
² IRCCS Synlab SDN, Naples, Italy.
³ University of Warwick, School of Engineering, Coventry, UK.
⁴ University of Warwick, School of Engineering, Coventry, UK; Queen Mary University of London, School of Electronic Engineering and Computer Science, UK.
⁵ Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
⁶ University of Warwick, School of Engineering, Coventry, UK; Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Roma, Italy; University Campus Bio-Medico of Rome, Via Alvaro del Portillo 21, 00128 Roma, Italy.

PMID: 38754787
DOI: 10.1016/j.diabres.2024.111708

Abstract

Aims: Recent clinical trials and real-world studies highlighted those variations in ECG waveforms and HRV recurrently occurred during hypoglycemic and hyperglycemic events in patients with diabetes. However, while several studies have been carried out for adult age, there is lack of evidence for paediatric patients. The main aim of the study is to identify the correlations of variations in ECG Morphology waveforms with blood glucose levels in a paediatric population.

Methods: T1D paediatric patients who use CGM were enrolled. They wear an additional non-invasive wearable device for recording physiological data and respiratory rate. Glucose metrics, ECG parameters and HRV features were collected, and Wilcoxon rank-sum test and Spearman's correlation analysis were used to explore if different levels of blood glucose were associated to ECG morphological changes.

Results: Results showed that hypoglycaemic events in paediatric patients with T1D are strongly associated with variations in ECG morphology and HRV.

Conclusions: Results showed the opportunity of using the ECG as a non-invasive adding instrument to monitor the hypoglycaemic events through the integration of the ECG continuous information with CGM data. This innovative approach represents a promising step forward in diabetes management, offering a more comprehensive and effective means of detecting and responding to critical changes in glucose levels.

Keywords: Blood glucose; ECG morphology; HRV; Type 1 diabetes paediatric.