Techniques are provided for use with an implantable
medical device such as a pacemaker or implantable cardioverter / defibrillator (ICD) for predicting and detecting
hypoglycemia. In one example, the device tracks changes in a paced
depolarization integral (PDI). A significant increase in PDI over a relatively short period of time indicates the onset of
hypoglycemia (this can also be confirmed with QT changes). Upon detection of
hypoglycemia, appropriate warning signals are generated to alert the patient. Certain therapies automatically provided by the implantable device may also be controlled in response to hypoglycemia. For example, if the patient is an
insulin-dependent diabetic and the implantable device is equipped with an
insulin pump capable of delivering
insulin directly into the bloodstream,
insulin delivery is automatically suspended until blood glucose levels return to acceptable levels. If the device is an ICD, it may be controlled to begin charging
defibrillation capacitors upon detection of hypoglycemia so as to permit prompt delivery of a
defibrillation shock, which may be needed if hypoglycemia triggers
ventricular fibrillation. The detection techniques may be used in conjunction with other hypoglycemia detection techniques to improve detection specificity.