Hypoglycemia and Cardiovascular Disease: Lessons from Outcome Studies

• Published in: Current diabetes reports 2015-12, Vol.15 (12), p.117-117, Article 117
• Main Authors: Pistrosch, Frank, Hanefeld, Markolf
• Format: Article
• Language: English
• Subjects: Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - etiology; Clinical Trials as Topic; Diabetes; Diabetes Mellitus, Type 2 - complications; Humans; Hypoglycemia - complications; Incidence; Macrovascular Complications in Diabetes (VR Aroda and A Getaneh; Medicine; Medicine & Public Health; Outcome Assessment (Health Care); Risk Factors; Section Editors; Topical Collection on Macrovascular Complications in Diabetes
• ISSN: 1534-4827; 1539-0829
• DOI: 10.1007/s11892-015-0678-2

Severe hypoglycemia is recognized to be one of the strongest predictors of macrovascular events, adverse clinical outcomes, and mortality in patients with type 2 diabetes. Large clinical trials have reported an increased hazard ratio for all-cause mortality and cardiovascular events in patients with type 2 diabetes and severe hypoglycemia. However, these trials also reported an increased hypoglycemia-associated mortality rate in patients allocated to standard treatment by a factor of 1.5–2 despite a significant 50 % to 70 % lower incidence of hypoglycemia compared to the intensive treatment group. Although the potential for a causal relationship has been demonstrated in mechanistic studies, the evidence from large prospective studies suggest that other pre-existing cardiovascular risk factors in addition to hypoglycemia may be the major link to the final cardiovascular event, and that a low blood glucose level can trigger these events in patients with a high cardiovascular risk.