Alexandra K. Lee, MSPH, from the Johns Hopkins Bloomberg School of Public Health in Baltimore, and colleagues used data from the Atherosclerosis Risk in Communities Study (analytic baseline, 1996 to 1998) to identify 1209 participants with diagnosed diabetes. International Classification of Diseases-9 codes from hospitalizations, emergency department visits, and ambulance calls (through 2013) were utilized to identify severe hypoglycemic episodes.
The researchers identified 195 participants with at least 1 severe hypoglycemic episode over a median follow-up of 15.3 years. Following severe hypoglycemia, the 3-year cumulative incidence of mortality was 28.3% , and that of coronary heart disease was 10.8%. Even after adjustments, severe hypoglycemia was associated with coronary heart disease (hazard ratio [HR], 2.02), all-cause mortality (HR, 1.73), cardiovascular mortality (HR, 1.64), and cancer mortality (HR, 2.49). There was no association between hypoglycemia and stroke, heart failure, atrial fibrillation, or non-cardiovascular and non-cancer death.
“Severe hypoglycemia is clearly indicative of declining health and is a potent marker of high absolute risk of cardiovascular events and mortality,” the authors write.
Lee AK, Warren B, Lee CJ, et al. The association of severe hypoglycemia with incident cardiovascular events and mortality in adults with type 2 diabetes. Diabetes Care. 2017 Nov. doi: 10.2337/dc17-1669