Hypoglycemia in the emergency, is there any effect on endothelial and diastolic functions?
1Cardiology, Bilecik Training and Research Hospital, Bilecik, Turkey.
Insights
Hypoglycemia, or low blood sugar, can impair heart function, specifically diastolic function and endothelial health. This suggests a need for monitoring even in young, otherwise healthy individuals.
Area of Science:
- Cardiology
- Endocrinology
- Metabolic Syndrome
Background:
- Hypoglycemia triggers homeostatic responses including sympathoadrenal activation and oxidative stress.
- These responses can promote inflammation and pro-atherogenic factors, potentially leading to endothelial dysfunction.
Purpose of the Study:
- To investigate cardiac risks, including systolic-diastolic functions and endothelial dysfunction, in patients presenting with hypoglycemia.
- To identify potential links between hypoglycemia and cardiovascular health in emergency department patients.
Main Methods:
- A cross-sectional, case-control study involving 46 hypoglycemia patients and 30 healthy volunteers.
- Utilized echocardiography, tissue-Doppler imaging (carotid and brachial arteries), and fasting blood tests for evaluation.
Main Results:
- Hypoglycemia patients showed significantly reduced diastolic function parameters (E/A and E/e' ratios) linked to insulin resistance.
- Increased carotid intima-media thickness and reduced brachial flow-mediated dilatation were observed in the hypoglycemia group, indicating endothelial dysfunction.
Conclusions:
- Hypoglycemia is associated with both diastolic dysfunction and endothelial dysfunction.
- Even young individuals without chronic diseases experiencing hypoglycemia may require cardiovascular risk monitoring.
Introduction:
Several homeostatic changes like an increase in sympathoadrenal response and oxidative stress occur in hypoglycemia. As a result of these findings, an increase in inflammation and preatherogenic factors is observed, and these changes may lead to endothelial dysfunction.
Aim:
Our study aims to reveal possible cardiac risks (systolic-diastolic functions and endothelial dysfunctions) in patients who have applied to the emergency department with hypoglycemia.
Methods:
This cross-sectional, case-control study included 46 hypoglycemia patients who admitted to the emergency with symptoms compatible with hypoglycemia and diagnosed with hypoglycemia and 30 healthy volunteers. All patients were evaluated with baseline echocardiography, tissue-Doppler imaging (carotid and brachial artery). Also, the fasting blood tests of the patients referred to the internal medicine department were examined.
Results:
There were no differences between the groups regarding age, weight, body mass index, and systolic blood pressure. Total cholesterol, LDL, HDL, Vitamin B12, TSH, and fasting blood glucose levels were similar in the groups' blood tests (all P values > .05). We observed a statistically significant decrease in diastolic dysfunction parameters: E/A and E/e' ratios (respectively, P = .020 and 0.026). It was shown that insulin resistance was influential in forming these considerable differences. The patient group observed that the carotid intima-media thickness was more remarkable (P = .001), and the brachial flow-mediated dilatation value was smaller (P = .003), giving an idea about endothelial functions.
Conclusion:
As a message, we can say that hypoglycemia may affect diastolic functions in addition to endothelial dysfunction. Therefore, even young individuals without any chronic diseases may need follow-up in terms of possible risks.
Related Concept Videos
01:15Hypoglycemia and Glucagon
01:24Blood Pressure Imbalances and Circulatory Shock
Blood Pressure: Hypertension and Hypotension
Normal blood pressure is 120/80 mm Hg. Elevated blood pressure is 120-129/under 80 mm Hg. Hypertension, warranting treatment at 130/80 mm Hg, is often asymptomatic and can lead to severe cardiovascular events, aneurysms, peripheral arterial disease, chronic renal disease, or cardiac...
01:15Diabetes: Symptoms, Diagnosis, and Complications
01:20Pathophysiology of Diabetes
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility,...
01:30Alterations in Blood Pressure
Hypertension (High blood pressure)
Hypertension occurs when blood pressure readings consistently exceed the normal range. It is diagnosed when systolic blood pressure (the top number, indicating pressure while the heart...
01:22Diabetes Mellitus: Type 2 and Gestational