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Severe Hypoglycemia Associated with CV Mortality Risk in Type 1

Nov 21, 2014

A previous history of severe hypoglycemia is linked to increased death rates after a cardiovascular event in type 1 diabetes patients…

Hypoglycemia is the most common and life-threatening complication of type 1 diabetes. The average type diabetes patient experiences about two episodes of hypoglycemia per week. Patients with type 1 diabetes are more prone to hypoglycemia than those with type 2 diabetes due to tight insulin therapy. In this study, severe hypoglycemia is considered an episode of hypoglycemia that requires hospitalization. Researchers examined the mortality risk after a major cardiovascular complication in type 1 diabetes patients with prior severe hypoglycemic events.


They used data from the Swedish National Diabetes Register (NDR) linked to hospital records, prescription data, and death records. Patients with type 1 diabetes who had experienced major cardiovascular events after the clinic visit were selected between 2002-2010. The authors estimated the impact on 5-year mortality risk at the age of 60 with and without prior diabetes complications.

The results showed that 403 out of 1,839 participants who experienced major cardiovascular events had prior severe hypoglycemic events and 703 died within the study period. A prior hypoglycemic episode was associated with a significant increase in mortality after a cardiovascular event (HR 1.79; 95% CI 1.37-2.35) within the first month and after one month (HR 1.25; 95% CI 33.4-46.3). Participants with previous hypoglycemia had an estimated 5-year cumulative mortality risk of 52.4% for MI and 39.8% for stroke.

The researchers concluded that patients with a history of a hypoglycemic event had an even greater mortality risk after a major cardiovascular event, with an additional 10% being dead at the 5-year mark.

Practice Pearls:

  • Hypoglycemia is a common and life-threatening side effect in type 1 diabetes.
  • The study found evidence that patients with type 1 diabetes with prior severe hypoglycemia events have a higher mortality rate after CVD events.

Lung L, Petrie D, Herman W, et al. “Severe hypoglycemia and mortality after cardiovascular events for type 1 diabetic patients in Sweden”. American Diabetes Association. August 4, 2014. “http://care.diabetesjournals.org/content/37/11/2974.full?sid=83ba4419-631b-4e07-9d51-6d54c437b4f3”