Severe Hypoglycemia may Indicate Future Cardiovascular Risk in Older Adults

Researchers included 2193 older adults with diabetes from the Atherosclerosis Risk in Communities (ARIC) study who attended visit 5 (2011–2013, baseline). They determined severe hypoglycemia at baseline using first position ICD-9 codes from hospitalizations, emergency department visits, and ambulance calls. They examined cross-sectional associations of severe hypoglycemia with echocardiographic indices of cardiac structure-function. They also evaluated the risks of an incident or recurrent CVD (coronary heart disease, stroke, or heart failure) and all-cause mortality prospectively, from baseline to 31 December 2018, using negative binomial and Cox regression models.

Key findings of the study were:

• Among 2,193 participants, researchers identified 79 participants with a history of severe hypoglycemia at baseline.

• They found that severe hypoglycemia was associated with a lower left ventricular (LV) ejection fraction (adjusted β-coefficient −3.66%), higher LV end-diastolic volume (14.80 mL), higher E-to-A ratio (0.11), and higher septal E/e′ (2.48).

• Using adjusted models, they found that severe hypoglycemia was associated with an incident or recurrent CVD (incidence rate ratio 2.19) and all-cause mortality (hazard ratio 1.71) among those without prevalent CVD.

The authors concluded, "Our findings suggest that a history of severe hypoglycemia is associated with alterations in cardiac function and is an important marker of future cardiovascular risk in older adults".

For further information:

https://care.diabetesjournals.org/content/44/1/248