Hypoglycemia Increases The Mortality in Type 2 Diabetes

Low blood sugar is associated with cardiovascular events.

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Although a lot of diabetics struggle with high blood glucose levels, there are also those who experience frequent low blood glucose due to medication such as insulin or anti-hyperglycemic oral medication, skipping meals, or other reasons. It is a common complication in diabetics and fatal. Diabetics are often educated on the signs and symptoms of hypoglycemia so that they know when they should pop in a piece of candy.

A recent study has found that even a single episode of severe hypoglycemia may increase the risk of cardiovascular problems or death in patients who have type 2 diabetes. This research was presented recently at the American Heart Association Epidemiology and Prevention/Lifestyle and Cardiometabolic Health 2017 Scientific Sessions.

The study found that 192 participants in the study reported a hypoglycemic episode, severe enough to warrant an emergency department visit. Out of the 192 participants, approximately 33% died within the first 3 years after the hypoglycemic episode. The study results also showed that the risk of cardiovascular disease and/or death is 2 times higher in patients who had a severe hypoglycemic episode compared to individuals who did not.




There is also increasing evidence that shows that hypoglycemia can cause heart attacks. In a study with 19 participants with type 2 diabetes and heart disease, continuous glucose monitoring and electrocardiogram (ECG) were done simultaneously. It was found that 10 out of 54 episodes of hypoglycemia were associated with angina (chest pain) and ECG changes were present in 6 out of the 10 episodes.

There were also several reports that associated hypoglycemia with cardiac arrhythmias that can lead to sudden death. Although studies showing that hypoglycemia as a major contributor to cardiovascular events is limited, preexisting cardiovascular issues with the addition of hypoglycemia may cause a major cardiovascular event.

References

Mortality in type 2 diabetes increased with severe hypoglycemia episode. Endocrinology Advisor. Accessed 3/21/2017.

Hanefeld M. Hypoglycemia and cardiovascular risk: is there a link? Diabetes Care. 2016; 39:S205-S209.