The Association of Severe Hypoglycemia With Incident Cardiovascular Events and Mortality in Adults With Type 2 Diabetes

Abstract

Severe hypoglycemia is clearly indicative of declining health and is a potent marker of high absolute risk of cardiovascular events and mortality.

Exposure to hypoglycemia and risk of stroke

“…A prospective study of participants with diagnosed diabetes from the Atherosclerosis Risk in Communities (ARIC) aimed to determine the link between severe hypoglycemia and cardiovascular disease observed that prior severe hypoglycemia exposure increases the risk of coronary heart disease, all‐cause mortality, and cardiovascular mortality . However, no association between prior exposure to severe hypoglycemia and stroke was observed .…”

“…A prospective study of participants with diagnosed diabetes from the Atherosclerosis Risk in Communities (ARIC) aimed to determine the link between severe hypoglycemia and cardiovascular disease observed that prior severe hypoglycemia exposure increases the risk of coronary heart disease, all‐cause mortality, and cardiovascular mortality . However, no association between prior exposure to severe hypoglycemia and stroke was observed . Recently published secondary analysis of the double‐blind Trial Comparing Cardiovascular Safety of Insulin Degludec versus Insulin Glargine in Patients with Type 2 Diabetes at High Risk of Cardiovascular Events (DEVOTE) trial also evaluated the association between exposure to severe hypoglycemia and a major adverse cardiovascular event (MACE), defined as either cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke .…”

Diabetes News

“…Dr Elizabeth Selvin (Johns Hopkins University, Baltimore, MD) reviewed the evidence linking hypoglycemia to CVD and neurological disease in people with type 2 diabetes, focusing on the Atherosclerosis Risk in Communities Study (ARIC) study. Results showed significant associations between severe hypoglycemia and coronary heart disease, all‐cause mortality, and cardiovascular mortality when adjusted for myriad factors . Nonsignificant trends toward association between severe hypoglycemia and heart failure, atrial fibrillation, and peripheral artery disease were also found .…”

“…Results showed significant associations between severe hypoglycemia and coronary heart disease, all‐cause mortality, and cardiovascular mortality when adjusted for myriad factors . Nonsignificant trends toward association between severe hypoglycemia and heart failure, atrial fibrillation, and peripheral artery disease were also found . Dr Selvin noted that cause and effect cannot be isolated in these studies, which are not designed to investigate hypoglycemia specifically.…”

Direct medical costs in the preceding, event and subsequent years of a first severe hypoglycaemia episode requiring hospitalization: A population‐based cohort study

“…Given that insulin use accounts for one-fourth of all treatments for diabetes mellitus (DM), 1 the number of insulin-related DM complications is expected to rise further by 2045 with the growing number of DM patients. 4 Evidence from large prospective cohort studies revealed that SH is associated with an accelerated cognitive decline in the elderly, 5 an elevated risk of cardiovascular disease, [6][7][8] all-site cancer 9 and mortality, 6,7,9,10 along with the requirement for emergency admissions and hospitalizations. The use of oral anti-diabetic drugs can also result in SH events.…”