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Severe hypoglycaemia ‘doubles risk’ of CV events

Severe hypoglycaemia doubles the risk of cardiovascular events in patients with type 2 diabetes, concludes a new analysis.

The study

The international meta-analysis of observational studies covered six studies and included 903,510 patients with type 2 diabetes. The mean age range of patients was 60 to 67 years. The studies evaluated the association of severe hypoglycaemia with cardiovascular events in patients with type 2 diabetes and had a follow-up period of one to 5.6 years. Both odds ratio and hazard ratios were used to approximate the relative risk.

The results

Severe hypoglycaemia was associated with a two-fold increase in risk of cardiovascular disease, compared with those who did not experience hypoglycaemia. During the follow-up period, 0.6% to 5.8% of participants experienced severe hypoglycaemia.

What this means for GPs

The researchers note that the results from their study ‘suggest that severe hypoglycaemia is associated with approximately twice the risk of cardiovascular disease’ and advise that ‘avoiding severe hypoglycaemia may be important to prevent cardiovascular disease in people with type 2 diabetes’.

BMJ 2013; 347, Online July 2013

Readers' comments (3)

  • Vinci Ho

    This should set up some philosophy of 'relaxing ' the target of HbA1c in the elderly diabetics particularly over 75 or 80 .

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  • what is a severe hypoglycaemia

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  • Hi Shailendra,

    Each of the studies has different parameters for severe hypoglycemia.

    E.g. The ADVANCE study defines severe hypoglycaemia as 'Hypoglycaemic episode that caused transient dysfunction of central nervous system and prevented patients from treating themselves'.

    Another study defined it as 'Hypoglycaemic episode identified by diagnosis of hypoglycaemia (ICD-9-CM codes 251.0, 251.1, 251.2 and 250.8) using healthcare claims'.

    For full details on the selection criteria for severe hypoglycaemia, please refer to the paper.

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