Frequent episodes of hypoglycemia tied to increased adverse CV events: Study

Hypoglycemia has been linked to increased cardiovascular (CV) events, however there is limited data about frequency of hypoglycemic episodes and CV outcomes. 

Researchers have found in a recent study that there is an increased incidence of cardiovascular events in Type 2 Diabetes patients who experience frequent hypoglycemia episodes. The study was published in the journal, " Diabetes" 2020.

Blood sugar is commonly considered too high if it is higher than 130 mg/dl before a meal or higher than 180 mg/dl two hours after food.

At the same time for many people, a fasting blood sugar of 70 milligrams per deciliter (mg/dL), or 3.9 millimoles per liter (mmol/L), or below should serve as an alert for hypoglycemia. Episodes of low blood sugar or Hypoglycemia are linked to complications and need immediate treatment.

For recurring episodes of hypoglycemia, eating frequent small meals throughout the day is a stopgap measure to help prevent blood sugar levels from getting too low.

Hypoglycemia is a condition that occurs in diabetics with poor blood sugar control. It is a marker of the severity of diabetes. It can deteriorate the functioning of health leading to the failing of various systems like respiratory, digestive, and various skin diseases. There is substantial evidence that suggests that Hypoglycemia is associated with increased cardiovascular disease risk. As there is little evidence about the frequency of hypoglycemia and cardiovascular (CV) disease risk, researchers from Cleveland Clinic conducted a study to evaluate the association of frequent hypoglycaemic episodes with incident cardiovascular disease events in adults with type 2 diabetes mellitus.

The researchers collected the required data from the national database for adults with T2DM. They divided the data as cases, who had >5 hypoglycaemic episodes and controls having 1 to 5 hypoglycaemic episodes in one year. Primary outcomes were overall CV adverse events, acute myocardial infarction (MI), cerebrovascular accident (CVA), and cardiac arrhythmias. Odds ratios (OR) and 95% confidence interval (CI) for the OR were calculated for the risk of association between the number of hypoglycaemic episodes and incident CV events.

The key findings of the study were:

• Out of a total of 61,917,780 patients in Explorys, 4,882,710 had T2DM.

• Patients with >5 hypoglycaemic episodes in 1 year (cases) had a higher incident risk of overall CV adverse events when compared to controls.

• In the stratified analysis, patients with frequent hypoglycaemic episodes had a significantly higher incidence of cardiac arrhythmias, acute myocardial infarction, and CVA.

Thus, the researchers concluded that Adults having Type 2 diabetes and frequent hypoglycaemic episodes of >5/year tend to have a higher incidence of adverse CV events.

For further reading, click the following link: https://doi.org/10.2337/db20-161-OR