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Electrocardiographic Changes during Intravenous Glucose Loading in the Aged

ABSTRACT: The relationship between glucose tolerance values and electrocardiographic (ECG) deviations was studied in 50 subjects (25 men and 25 women, average age 73.4 years). The loading consisted of 24 gm of glucose in 60 ml of solution, given intravenously to the fasting patient. ECG records and blood determinations were obtained before the injection and 5 minutes afterward; then blood sugar was determined at 10‐minute intervals up to 60 minutes; at 60 minutes an ECG was also recorded. For a control, similar examinations had been carried out previously in 20 of the 50 subjects, the injection consisting of 60 ml of physiologic saline instead of glucose. The various deviations occurring in the ECG included depression of the ST segment, a U wave, premature beats and partial A‐V block. None of these changes had been observed after injection of physiologic saline. A possible mechanism may have been an insulin‐induced change of potassium metabolism. In view of the fact that a relatively small excess of sugar can affect myocardial metabolism, it is essential that the subject undergo the standard fasting procedure when observations are being made. On the basis of the ECG findings it is important that the dietary intake of sugar be low, particularly in persons approaching middle age.