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Hypoglycaemia and Cardiovascular Disease Risk in Patients with Diabetes

Niki Katsiki1, Kalliopi Kotsa1, Anca P Stoian2

  • 1Division of Endocrinology and Metabolism, Diabetes Center, First Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece.

Current Pharmaceutical Design
|September 11, 2020
PubMed

Insights

Hypoglycaemia, a side effect of diabetes treatment, is linked to increased cardiovascular risk and mortality. Careful glycaemic control is crucial, especially in older adults, to mitigate these dangers.

Area of Science:

  • Endocrinology
  • Cardiology
  • Geriatrics

Background:

  • Hypoglycaemia is a significant side effect of insulin therapy and secretagogues in type 1 and type 2 diabetes mellitus.
  • Associations between hypoglycaemia and cardiovascular (CV) risk are increasingly recognized.
  • Potential mechanisms include sympathoadrenal activation, endothelial dysfunction, inflammation, and impaired autonomic reflexes.

Purpose of the Study:

  • To review the associations between hypoglycaemia and various cardiovascular diseases (CVDs).
  • To discuss the link between hypoglycaemia and dementia.
  • To highlight factors influencing the hypoglycaemia-CV relationship.

Main Methods:

  • This is a narrative review.
  • Literature search on hypoglycaemia, cardiovascular diseases, and dementia.
  • Synthesis of existing evidence on the topic.

Main Results:

  • Severe hypoglycaemia is associated with coronary heart disease (CHD), CV mortality, and all-cause mortality.
  • Evidence supports a link between hypoglycaemia and cardiac arrhythmias, potentially leading to sudden death.
  • Data on hypoglycaemia's association with stroke, carotid disease, and peripheral artery disease (PAD) is limited.
  • A bidirectional association exists between hypoglycaemia and dementia, particularly in the elderly.

Conclusions:

  • Hypoglycaemia poses significant cardiovascular risks, including increased mortality and arrhythmias.
  • The relationship between hypoglycaemia and cerebrovascular/peripheral vascular disease requires further investigation.
  • Individualized glycaemic targets are essential, especially in elderly patients with diabetes, to balance hypoglycaemia risk and disease management.
Keywords:
Hypoglycaemiacardiac arrhythmiascardiovascular riskcarotid diseasecoronary heart diseasedementiamortalityperipheral artery diseasestroke

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