Atsushi Goto, Ph.D., of the National Center for Global Health and Medicine in Tokyo, and colleagues performed a systematic review and meta-analysis of observational studies to examine the association between severe hypoglycemia and risk of cardiovascular disease in people with type 2 diabetes.
The researchers found six eligible studies involving 903,510 participants after screening 3,443 citations for cohort studies. According to conventional random effects meta-analysis, severe hypoglycemia was strongly associated with increased risk of cardiovascular disease (relative risk, 2.05). The excess fraction of cardiovascular disease incidence that was attributed to severe hypoglycemia (the population attributable fraction) was 1.56 percent. Moderate heterogeneity across the studies was indicated, but most subgroups showed similar results in stratified analysis. Bias analysis suggested that confounding from comorbid severe illness did not account for the association between severe hypoglycemia and cardiovascular disease.
“The findings support the notion that avoiding severe hypoglycemia may be important to prevent cardiovascular disease in people with type 2 diabetes,” the authors write.