Cardiovascular Implications of Hypoglycemia in Diabetes Mellitus

Connelly, Kim A.; Yan, Andrew T.; Leiter, Lawrence A.; Bhatt, Deepak L.; Verma, Subodh

doi:10.1161/circulationaha.115.015946

Cited by 49 publications

(42 citation statements)

References 23 publications

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“…8 The potential mechanisms explaining associations between glycaemic control and mortality were not explored. 39 The finding with metformin was unexpected given its safety profile and low risk of hypoglycaemia although, to our knowledge, the impact of tight glycaemic control related to metformin has not been investigated in older people. 15 In older people, hypoglycaemia can go unrecognized and is associated with falls, 36 cognitive impairment, 16 hospitalization, 37 cardiac arrhythmias 38 and other cardiovascular events.…”

Section: Discussionmentioning

confidence: 95%

Glycaemic control and mortality in older people with type 2 diabetes: The Fremantle Diabetes Study Phase II

Bruce

Davis

2018

Diabetes Obesity Metabolism

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Section: Discussionmentioning

confidence: 95%

Glycaemic control and mortality in older people with type 2 diabetes: The Fremantle Diabetes Study Phase II

Bruce

Davis

2018

Diabetes Obesity Metabolism

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“…Moreover, post hoc analysis of the ADVANCE study showed that severe hypoglycemic events were associated with increased risk for mortality (7). Analysis of these trials and other epidemiological studies has demonstrated that frequent, recognized and unrecognized hypoglycemic events are associated with adverse outcomes (8), increased rates of dementia (9), increased cardiovascular morbidity (10,11), ventricular arrhythmias (12), mortality (13), and impaired quality of life (14).…”

mentioning

confidence: 99%

Predisposing Factors for Any and Major Hypoglycemia With Saxagliptin Versus Placebo and Overall: Analysis From the SAVOR-TIMI 53 Trial

Cahn¹,

Mosenzon

Leibowitz³

et al. 2016

Diabetes Care

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OBJECTIVETo analyze the impact of adding saxagliptin versus placebo on the risk for hypoglycemia and to identify predictors of any and major hypoglycemia in patients with type 2 diabetes included in the Saxagliptin Assessment of Vascular Outcomes Recorded in Patients with Diabetes Mellitus-Thrombolysis in Myocardial Infarction 53 (SAVOR-TIMI 53) study. RESEARCH DESIGN AND METHODSPatients with type 2 diabetes (n = 16,492) were randomized to saxagliptin or placebo and followed for a median of 2.1 years. Associations between any hypoglycemia (symptomatic or glucose measurement <54 mg/dL) or major hypoglycemia (requiring extended assistance) and patient characteristics overall and by treatment allocation were studied. RESULTSAt least one hypoglycemic event was reported in 16.6% of patients, and 1.9% reported at least one major event. Patients allocated to saxagliptin versus placebo experienced higher rates of any (hazard ratio [HR] 1.16 [95% CI 1.08, 1.25]; P < 0.001) or major (HR 1.26 [1.01, 1.58]; P = 0.038) hypoglycemia. Hypoglycemia rates (any or major) were increased with saxagliptin in patients taking sulfonylureas (SURs) but not in those taking insulin. Rates were increased with saxagliptin in those with baseline HbA 1c £7.0% and not in those with baseline HbA 1c >7.0%. Multivariate analysis of the overall population revealed that independent predictors of any hypoglycemia were as follows: allocation to saxagliptin, long duration of diabetes, increased updated HbA 1c , macroalbuminuria, moderate renal failure, SUR use, and insulin use. Predictors of major hypoglycemia were allocation to saxagliptin, advanced age, black race, reduced BMI, long duration of diabetes, declining renal function, microalbuminuria, and use of short-acting insulin. Among SURs, glibenclamide was associated with increased risk of major but not any hypoglycemia. CONCLUSIONSThe identification of patients at risk for hypoglycemia can guide physicians to better tailor antidiabetic therapy.

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“…Другими факторами риска являются пожилой возраст и когнитивные нарушения, почечная и печеночная недостаточность, длительность сахарного диабета, пропущенные или нерегулярные приемы пищи, автономная нейропатия, длительная физическая нагруз-ка, перенесенные эпизоды гипогликемии, больные с нарушенным распознаванием гипогликемии [7].…”

Section: факторы риска гипогликемииunclassified

“…et al, в 2011 г. около 282 тыс. обращений в отделения неотлож-ной медицинской помощи было связано с гипогликеми-ей у больных СД [7]. Метаанализ проспективных и ретроспективных когортных исследований продемон-стрировал, что тяжелая гипогликемия связана с высо-ким риском фатальных сердечно-сосудистых событий у больных с СД 2-го типа (ОР 2,05; 95% ДИ 1,74-2,42, р < 0,001) [8].…”

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Glycaemia Self-Control Role in Prevention of Cardiovascular Diseases in Diabetes Mellitus Patients

Шацкая¹,

Kukharenko²

2017

Med. sov.

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В настоящее время доказано, что гипогликемия является независимым фактором риска сердечно-сосудистых событий у больных сахарным диабетом. В статье рассматриваются потенциальные механизмы воздействия гипогликемии на сердеч-но-сосудистую систему и вопросы самоконтроля гликемии при сахарном диабете.Ключевые слова: сахарный диабет, гипогликемия, сердечно-сосудистый риск, контроль гликемии. О.А.SHATSKAYA, PhD in medicine, S.S. KUKHARENKO, PhD in medicine Endocrinology Scientific Center of the Ministry of Health of Russia, MoscowGlycaemia self-control role in prevention of cardiovascular diseases in diabetes mellitus patients Currently glycaemia is proved to be an independent risk factor of cardiovascular events in diabetes mellitus patients. The article considers potential hypoglycaemia action mechanisms on the cardiovascular system and glycaemia self-control issues in diabetes mellitus.

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Cardiovascular Implications of Hypoglycemia in Diabetes Mellitus

Cited by 49 publications

References 23 publications

Glycaemic control and mortality in older people with type 2 diabetes: The Fremantle Diabetes Study Phase II

Glycaemic control and mortality in older people with type 2 diabetes: The Fremantle Diabetes Study Phase II

Predisposing Factors for Any and Major Hypoglycemia With Saxagliptin Versus Placebo and Overall: Analysis From the SAVOR-TIMI 53 Trial

Glycaemia Self-Control Role in Prevention of Cardiovascular Diseases in Diabetes Mellitus Patients

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