Severe Hypoglycemia Linked to High Risk for CV Events in Adults With T2D

Human heart illustration.
Human heart illustration.
Findings from a new study suggest that episodes of severe hypoglycemia in patients with diabetes are associated with high rates of subsequent cardiovascular events.

Adults diagnosed with type 2 diabetes who experience a severe hypoglycemic event may have a higher absolute risk for an adverse cardiovascular event, according to a study published in Diabetes Care.

The study investigators identified individuals with diabetes enrolled in the Atherosclerosis Risk in Communities study who had experienced at least one severe hypoglycemic episode. The purpose of the study was to examine the association between severe hypoglycemic events and both cardiovascular and mortality outcomes.

The researchers found 186 individuals with type 2 diabetes who experienced at least 1 event of severe hypoglycemia. The 3-year cumulative incidence of coronary heart disease after an event of severe hypoglycemia was 10.8% (hazard ratio [HR] 2.02; 95% CI, 1.27-3.20). The overall mortality rate in those who had a severe hypoglycemic event was 28.3% (HR 1.64; 95% CI, 1.15-2.34).

Cancer mortality was also found to be increased in those who had a severe hypoglycemic event (HR 2.49; 95% CI, 1.46-4.24). Interestingly, hypoglycemia was not found to be associated with increased risk for stroke, heart failure, or atrial fibrillation.

Researchers concluded that a severe hypoglycemic event in an individual diagnosed with type 2 diabetes increases the individual’s risk for a cardiovascular event and their overall mortality significantly. 

Therefore, clinicians should be aware of the morbidity and mortality associated with a severe hypoglycemic event and should closely monitor patients with type 2 diabetes who have had a recent severe hypoglycemic event.

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Lee AK, Warren B, Lee CJ, et al. The association of severe hypoglycemia with incident cardiovascular events and mortality in adults with type 2 diabetes [published online November 10, 2017]. Diabetes Care. doi: 10.2337/dc17-1669