By Colin Kenny, Editor – Diabetes Distilled
People with diabetes who experience severe hypoglycaemia are at a high risk of cardiovascular events. Investigators wanted to clarify the temporal relationship between hypoglycaemia and cardiovascular events, so they conducted a large matched-control, longitudinal study. Within the first month following a severe hypoglycaemic event, there was a significant increase in the incidence of cardiovascular disease and all-cause mortality. These increased risks dropped significantly each month for 6 months after the severe hypoglycaemic event.
In this observational cohort study, information about 360,000 patients newly diagnosed with diabetes between 1999 and 2001 from the Taiwan Longitudinal Cohort of Diabetes Patients Database was analysed. Each patient in the study cohort – whose first severe hypoglycaemic episode was after 2002 – was matched with two control patients without severe hypoglycaemia. A total of 10,157 patients with severe hypoglycaemia and 20,314 matched controls were recruited.
There was a significantly higher risk of cardiovascular disease and all-cause mortality within the first month after severe hypoglycaemia compared with the matched controls. Following severe hypoglycaemia, the incidence of cardiovascular disease dropped 17.3% per month for the first 4 months and slowly decreased in subsequent months. The monthly reduction in all-cause mortality was 16.6% in months 0–6 and 3.24% in months 6–17.
Practitioners should inform patients prone to severe hypoglycaemia that they are at an increased risk of cardiovascular events in the month afterwards.
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