Study: Severe Hypoglycemia Increases Risk of CVD and Death in Patients with Diabetes

According to a recent study, severe hypoglycemia is independently associated with cardiovascular disease (CVD) and death in patients with diabetes.

The study, presented at the 2017 American Heart Association Epidemiology and Prevention and Lifestyle and Cardiometabolic Health Scientific Sessions, examined the association of hypoglycemia with CVD and all-cause mortality using rigorous adjustments for likely confounders not accounted for in previous studies.
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The researchers followed 464 participants involved in the Atherosclerosis Risk in Communities (ARIC) study, who were age 65 years or older at Visit 4 (1996-1998) and had diabetes and CMS Part B Insurance. The researchers identified severe hypoglycemia using ICD-9 codes from hospitalizations, emergency department visits, and ambulance services and assessed incidences of CVD events and death through 2013. In addition, researchers used hypoglycemia as a time-varying exposure in progressively adjusted Cox models, which included demographics, clinical characteristics, comorbidities, and more.

Overall, hypoglycemic events occurred in 65 participants before a CVD event or censoring and in 94 participants before death or censoring. Researchers found that the crude incidence rates of CVD and death were higher in participants with hypoglycemia compared with participants without hypoglycemia (CVD: 10.6 vs. 5.08 per 100 person-years (PY), p<0.001; death: 14.3 vs. 4.5 per 100 PY, p<0.001). 

Hypoglycemia remained strongly associated with CVD and death even after adjusting for age, sex, and race.

“After adjustment for rigorously measured shared risk factors, hypoglycemia was associated with both CVD and death. These results suggest that severe hypoglycemia may influence CVD risk and death independently of diabetes severity and general vulnerability,” the researchers concluded.

—Melissa Weiss

Reference:

Lee AK, Warren B, Lee CJ, et al. Abstract 43: Associations of severe hypoglycemia with cardiovascular disease and all-cause mortality in older adults with diabetes: the Atherosclerosis Risk in Communities (ARIC) Study. Circulation 2017;135:A43.