Severe hypoglycaemia tied to increased ACS risk in older adults with diabetes

  • Nishioka Y & al.
  • J Diabetes Investig
  • 3 Oct 2019

  • International Clinical Digest
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Takeaway

  • Severe hypoglycaemia (SH) increases the risk of acute coronary syndrome (ACS) in patients with diabetes mellitus (DM), particularly within 10 days after an SH episode and among the elderly.

Why this matters

  • Older adults with DM are at increased hypoglycemia risk.

Study design

  • Retrospective population-based study using Japanese national claims data of 7,909,626 patients aged ≥35 years with diabetes.
  • ACS defined as emergency percutaneous coronary intervention.
  • Funding: Japan Agency for Medical Research and Development.

Key results

  • Over 2 years, a total of 48,118 at-risk patients experienced an SH episode.
  • Absolute ACS risk was 2.9/1000 person-years overall, and 2.1 and 3.0/1000 person-years for those with and without type 1 diabetes, respectively.
  • Absolute ACS risk in patients who did and did not experience SH episodes was 3.0 and 2.7/1000 person-years, respectively.
  • An SH episode increased absolute ACS risk in patients aged ≥70 years, 3.3 and 3.0/1000 person-years with and without SH, respectively, while risk was similar for those
  • Absolute ACS risk was 10.6/1000 person-years within 10 days of SH episode; shorter post-SH period correlated with higher absolute ACS risk.

Limitations

  • Only medication-treated patients included.
  • Lab data, medical record details unavailable.
  • ACS definition may have excluded some patients.