Low fasting blood glucose ups CVD risk in absence of DM or cardiovascular disease

Takeaway

• In people without diabetes mellitus (DM) or cardiovascular disease (CVD), a low fasting blood glucose (<72 mg/dL) is associated with increased risk for major cardiovascular events, stroke, and all-cause mortality.

Why this matters

• Results of this meta-analysis of prospective studies suggest the need for heightened vigilance and preventive measures in patients with low values.

Key results

• Compared with normal fasting blood glucose, fasting values <72 mg/dL were linked to increased (adjusted HRs; 95% CIs):
  • All-cause mortality: 1.56 (1.09-2.23),
  • Total stroke: 1.08 (1.03-1.13),
  • Ischemic stroke: 1.06 (1.01-1.10), and
  • Major cardiovascular events: 1.05 (1.03-1.07).
• No increased risk for hemorrhagic stroke.
• Fasting blood glucose <83 mg/dL was not linked to increased risks.
• Study heterogeneity was high: I², 67%-77%.

Study design

• Systematic review, meta-analysis of 11 articles covering 129 prospective studies that included 2,674,882 people without diabetes or CVD (mean age, 48 years; 32% women; average follow-up, 14.3 [range, 1-20] years).
• Funding: Ministry of Science and Technology, Taiwan.

Limitations

• Reasons for low blood glucose not known.
• Variable definitions of low fasting blood glucose among studies.