Hypoglycemic Morbidity and Mortality in Diabetes.

Son,  Jang Won

doi:2016.17.1.17

J Korean Diabetes > Volume 17(1); 2016 > Article

Focused Issue

The Journal of Korean Diabetes 2016;17(1):17-23.
DOI: https://doi.org/10.4093/jkd.2016.17.1.17 Published online April 12, 2016.

저혈당으로 인한 당뇨병 환자의 이환율과 사망률

손장원

Hypoglycemic Morbidity and Mortality in Diabetes.

Jang Won Son

Division of Endocrinology and Metabolism, Department of Internal Medicine, The Catholic University of Korea, Bucheon St. Mary's Hospital, Bucheon, Korea. jwsonmd@gmail.com

Abstract

Iatrogenic hypoglycemia is a major obstacle to glycemic control in patients with diabetes. Hypoglycemia has been associated with greater risk of cardiovascular disease (CVD) and mortality among patients with diabetes. Recent large randomized clinical trials have shown conflicting results regarding the impact of intensive glycemic control on CVD prevention in patients with diabetes. There is growing consensus that hypoglycemia is a possible cause for the lack of benefit on cardiovascular morbidity and mortality in large-scale diabetes outcomes trials. Acute hypoglycemia causes a cascade of physiologic effects, including hemodynamic changes, pro-thrombotic reactions and cardiac arrhythmias, presenting several potential mechanisms through which hypoglycemic events may increase cardiovascular risk. However, recent studies do not support a temporal or dose-response relationship between hypoglycemia and long-term cardiovascular risk in patients with diabetes. Recently, severe hypoglycemia was suggested as a predictor of adverse outcomes in patients with diabetes. Thus, individualized therapy was recommended in order to avoid severe hypoglycemia and any related adverse cardiovascular outcomes in patients with diabetes.

Key Words: Diabetes mellitus, Hypoglycemia, Morbidity, Mortality