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Current Diabetes Reports

, 15:117 | Cite as

Hypoglycemia and Cardiovascular Disease: Lessons from Outcome Studies

  • Frank PistroschEmail author
  • Markolf Hanefeld
Macrovascular Complications in Diabetes (VR Aroda and A Getaneh, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Macrovascular Complications in Diabetes

Abstract

Severe hypoglycemia is recognized to be one of the strongest predictors of macrovascular events, adverse clinical outcomes, and mortality in patients with type 2 diabetes. Large clinical trials have reported an increased hazard ratio for all-cause mortality and cardiovascular events in patients with type 2 diabetes and severe hypoglycemia. However, these trials also reported an increased hypoglycemia-associated mortality rate in patients allocated to standard treatment by a factor of 1.5–2 despite a significant 50 % to 70 % lower incidence of hypoglycemia compared to the intensive treatment group. Although the potential for a causal relationship has been demonstrated in mechanistic studies, the evidence from large prospective studies suggest that other pre-existing cardiovascular risk factors in addition to hypoglycemia may be the major link to the final cardiovascular event, and that a low blood glucose level can trigger these events in patients with a high cardiovascular risk.

Keywords

Hypoglycemia Diabetes Cardiovascular risk Outcome trials 

Notes

Acknowledgments

M.H. and F.P. prepared and reviewed the manuscript.

Compliance with Ethical Standards

Conflict of Interest

Frank Pistrosch declares that he has no conflict of interest.

Markolf Hanefeld reports grants from Sanofi and nonfinancial support from Medtronic.

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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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Study Center Professor HanefeldGWT TU-Dresden GmbHDresdenGermany
  2. 2.Medical Clinic IIIUniversitätsklinikum “Carl Gustav Carus”DresdenGermany

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