J Korean Diabetes.  2016 Mar;17(1):17-23. 10.4093/jkd.2016.17.1.17.

Hypoglycemic Morbidity and Mortality in Diabetes

• Son JW

• KMID: 2161126
• DOI: http://doi.org/10.4093/jkd.2016.17.1.17

Abstract

Iatrogenic hypoglycemia is a major obstacle to glycemic control in patients with diabetes. Hypoglycemia has been associated with greater risk of cardiovascular disease (CVD) and mortality among patients with diabetes. Recent large randomized clinical trials have shown conflicting results regarding the impact of intensive glycemic control on CVD prevention in patients with diabetes. There is growing consensus that hypoglycemia is a possible cause for the lack of benefit on cardiovascular morbidity and mortality in large-scale diabetes outcomes trials. Acute hypoglycemia causes a cascade of physiologic effects, including hemodynamic changes, pro-thrombotic reactions and cardiac arrhythmias, presenting several potential mechanisms through which hypoglycemic events may increase cardiovascular risk. However, recent studies do not support a temporal or dose-response relationship between hypoglycemia and long-term cardiovascular risk in patients with diabetes. Recently, severe hypoglycemia was suggested as a predictor of adverse outcomes in patients with diabetes. Thus, individualized therapy was recommended in order to avoid severe hypoglycemia and any related adverse cardiovascular outcomes in patients with diabetes.

Keyword

Diabetes mellitus; Hypoglycemia; Morbidity; Mortality

MeSH Terms

Arrhythmias, Cardiac
Cardiovascular Diseases
Consensus
Diabetes Mellitus
Hemodynamics
Humans
Hypoglycemia
Mortality*