Trials suggest that hypoglycemia contributes to higher mortality in patients with type 2 diabetes mellitus (T2DM).1 It is proposed that hypoglycemia-induced cardiac arrhythmias may be one mechanism to explain this relationship.2 Preclinical studies have shown that hypoglycemia leads to upregulation of sympathetic, parasympathetic, and inflammatory pathways,3,4 which promote cardiac irritability. Definitive causal data in humans are limited.