Hypoglycemia Linked to Atherosclerosis Progression With Standard Diabetes Therapy in VADT

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In the VADT, hypoglycemia was linked to coronary artery calcium progression in the standard therapy group.
In the VADT, hypoglycemia was linked to coronary artery calcium progression in the standard therapy group.

(HealthDay News) — In the Veterans Affairs Diabetes Trial, hypoglycemia was associated with coronary artery calcium progression only in the standard therapy group, as compared with intensive therapy, according to research published in Diabetes Care.

Aramesh Saremi, MD, from the Phoenix VA Health Care System, and colleagues examined the correlation between serious hypoglycemia (severe episodes with loss of consciousness or requiring assistance, or documented glucose lower than 50 mg/dL) and progression of atherosclerosis

The correlation was assessed in 197 participants in a substudy of the Veterans Affairs Diabetes Trial.

The researcher found that 97 patients reported severe hypoglycemia or glucose lower than 50 mg/dL (23 and 74 patients, respectively) during an average follow-up of 4.5 years between computed tomography scans. Serious hypoglycemia occurred more often in the intensive therapy vs the standard treatment group (74% vs 21%; P<.01).

In the entire cohort there was no correlation between serious hypoglycemia with progression of coronary artery calcium, but there was a significant interaction between serious hypoglycemia and treatment (P<.01). Coronary artery calcium progression was about 50% greater for participants with serious hypoglycemia in the standard therapy group, but not in the intensive therapy group, compared with those without serious hypoglycemia (median, 11.15 mm3 vs 5.4 mm³; P=.02).

"Despite a higher frequency of serious hypoglycemia in the intensive therapy group, serious hypoglycemia was associated with progression of [coronary artery calcium] in only the standard therapy group," the researchers wrote.

Reference

  1. Saremi A, Bahn GD, Raven PD; for the Veterans Affairs Diabetes Trial. A Link Between Hypoglycemia and Progression of Atherosclerosis in the Veterans Affairs Diabetes Trial (VADT). Diabetes Care. 2016;doi:10.2337/dc15-2107.
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