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Hypoglycemia as a Driver of Cardiovascular Risk in Diabetes

  • Amir MoheetEmail author
  • Elizabeth R. Seaquist
Clinical Trials and Their Interpretations (J Plutzky, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Clinical Trials and Their Interpretations

Abstract

Severe hypoglycemia in patients with diabetes is associated with increased risk of adverse cardiovascular events and death. Recent large randomized clinical trials in individuals with type 2 diabetes have shown that intensive glycemic control may result in increased mortality, and hypoglycemia has been investigated as a possible cause. Acute hypoglycemia is a proarrhythmic, proinflammatory, and prothrombotic state, and several mechanisms have been proposed to explain how hypoglycemia might increase cardiovascular morbidity and mortality. However, data from large clinical trials do not provide strong evidence to establish hypoglycemia as a cause of increased mortality. Severe hypoglycemia is also a marker of frailty and a predictor of adverse outcomes in patients with diabetes. Individualized therapy should be the goal in patients with diabetes to avoid severe hypoglycemia and any related adverse outcomes.

Keywords

Hypoglycemia Diabetes mellitus Cardiovascular risk Hypoglycemia-associated autonomic failure Mortality Type 2 diabetes mellitus Type 1 diabetes mellitus Severe hypoglycemia 

Notes

Compliance with Ethics Guidelines

Conflict of Interest

A. Moheet declared no conflict of interest. E.R. Seaquist serves/has served as a consultant for AMG Medical, SkyePharma, Merck, and Sanofi-Aventis and is the PI on a grant from Lilly within the last three years.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Papers of particular interest, published recently, have been highlighted as: • Of importance

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Division of Endocrinology and Diabetes, Department of MedicineUniversity of Minnesota MMC 101MinneapolisUSA

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