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Severe hypoglycaemia ups ACS risk in diabetics

17 Oct 2019

The risk of acute coronary syndrome (ACS) appears to be elevated following episodes of severe hypoglycaemia, a recent study has found.

Researchers performed a retrospective, population-based analysis on the data of 7,909,626 diabetes patients (aged 35 years; 41 percent male). The absolute risk of ACS was defined as the need for emergency percutaneous coronary intervention following severe hypoglycaemia.

Over 5,087,611,521 person-days of follow-up, 37,486 cases of ACS were reported. The resulting absolute risk was 2.9 per 1,000 person-years. In those with vs without type 1 diabetes, the corresponding rates were 2.1 and 3.0 per 1,000 person-years, respectively.

Within 2 years, 48,118 at-risk patients experienced a severe hypoglycaemic episode. These patients were more likely than their no-episode counterparts to develop ACS (3.0 vs 2.7 per 1,000 person-years). They also tended to be older and more likely to receive insulin therapy, antiplatelet drugs and anticoagulants.

Adjusted regression analysis confirmed that severe hypoglycaemia was a significant risk factor for ACS (hazard ratio, 1.016, 95 percent CI, 1.012–1.021).

This ACS risk changed over time, varying according to the time elapsed after the severe hypoglycaemia episode. At 10 days after such an episode, for instance, the absolute risk of ACS was 10.6 per 1,000 person-years. This dropped to 2.2 and 2.5 per 1,000 person-years after 11–90 and 91–365 days had elapsed, respectively.

The present findings indicate that severe hypoglycaemia needs to be monitored and treated well in patients with diabetes, said researchers. Future studies are needed to better characterize the time interval after hypoglycaemia during which ACS risk should be tightly managed.

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Most Read Articles
18 May 2020
Immobilization or disuse of the forearm leads to impairment in the ability of a protein-rich meal to promote positive muscle amino acid balance, which is aggravated by dietary lipid oversupply, suggests a study. Disuse also lowers postprandial forearm amino acid uptake, but this is not exacerbated under high-fat conditions.
18 May 2020
Glucagon-like peptide-1 receptor agonists (GLP-1RA) are more effective than basal insulin in the management of total (TC) and low-density lipoprotein cholesterol (LDL-C), reveals a recent study.
17 May 2020
Increased coffee consumption among regular drinkers is associated with higher estimated glomerular filtration rate and confers protection against the risk of chronic kidney disease stages G3–G5 and albuminuria, as shown in a study.
Jairia Dela Cruz, 16 May 2020
Excess weight, greater abdominal fat, inflammation and low physical performance can all contribute to insulin resistance in middle-age Singaporean women, and these variables explain why the condition is more common among women of Chinese than Malay and Indian ethnicities, a study has found.