5 :: KDA, Korean Diabetes Association ::
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Subject    :    [2016 Jun;40(3)] Severe Hypoglycemia and Cardiovascular or All-Cause Mortality in Patients with Type 2 Diabetes
Writer KDA
Date 2016-07-05 17:13:57 Hit 5,380
LINK URL http://e-dmj.org/DOIx.php?id=10.4093/dmj.2016.40.3.202 (Click 318)
Diabetes Metab J. 2016 Jun;40(3):202-210. English.
Published online Apr 05, 2016.  http://dx.doi.org/10.4093/dmj.2016.40.3.202 
Copyright © 2016 Korean Diabetes Association
   
Severe Hypoglycemia and Cardiovascular or All-Cause Mortality in Patients with Type 2 Diabetes
Seon-Ah Cha,1 Jae-Seung Yun,1 Tae-Seok Lim,1 Seawon Hwang,1 Eun-Jung Yim,1 Ki-Ho Song,1 Ki-Dong Yoo,2 Yong-Moon Park,3 Yu-Bae Ahn,1 and Seung-Hyun Ko1
1Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
2Division of Cardiology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
3Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA.

Corresponding author: Seung-Hyun Ko. Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, St. Vincent's Hospital, The Catholic University of Korea, 93 Jungbu-daero, Paldal-gu, Suwon 16247, Korea. Email: kosh@catholic.ac.kr 
 
Received June 18, 2015; Accepted August 05, 2015.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.



Abstract

Background

We investigated the association between severe hypoglycemia (SH) and the risk of cardiovascular (CV) or all-cause mortality in patients with type 2 diabetes.

Methods

The study included 1,260 patients aged 25 to 75 years with type 2 diabetes from the Vincent Type 2 Diabetes Resgistry (VDR), who consecutively enrolled (n=1,260) from January 2000 to December 2010 and were followed up until May 2015 with a median follow-up time of 10.4 years. Primary outcomes were death from any cause or CV death. We investigated the association between the CV or all-cause mortality and various covariates using Cox proportional hazards regression analysis.

Results

Among the 906 participants (71.9%) who completed follow-up, 85 patients (9.4%) had at least one episode of SH, and 86 patients (9.5%) died (9.1 per 1,000 patient-years). Patients who had died were older, had a longer duration of diabetes and hypertension, received more insulin, and had more diabetic microvascular complications at baseline, as compared with surviving patients. The experience of SH was significantly associated with an increased risk of all-cause mortality (hazard ratio [HR], 2.64; 95% confidence interval [CI], 1.39 to 5.02; P=0.003) and CV mortality (HR, 6.34; 95% CI, 2.02 to 19.87; P=0.002) after adjusting for sex, age, diabetic duration, hypertension, mean glycosylated hemoglobin levels, diabetic nephropathy, lipid profiles, and insulin use.

Conclusion

We found a strong association between SH and increased risk of all-cause and CV mortality in patients with type 2 diabetes.

   
Keywords:
Cardiovascular diseases; Diabetes mellitus, type 2; Mortality; Severe hypoglycemia

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