Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017;12(1):21-33.
doi: 10.1080/17446651.2017.1275960. Epub 2017 Jan 5.

Understanding the impact of hypoglycemia on the cardiovascular system

Ian Charles Davis  1 , Ida Ahmadizadeh  1 , Jacqueline Randell  2 , Lisa Younk  1 , Stephen N Davis  3
Affiliations

Understanding the impact of hypoglycemia on the cardiovascular system

Ian Charles Davis et al. Expert Rev Endocrinol Metab. 2017.

Abstract

Introduction: Hypoglycemia occurs commonly in insulin requiring individuals with either Type 1 or Type 2 Diabetes.

Areas covered: This article will review recent information on the pro-inflammatory and pro-atherothrombotic effects of hypoglycemia. Additionally, effects of hypoglycemia on arrhythmogenic potential and arterial endothelial dysfunction will be discussed. Effects of hypoglycemia on cardiovascular morbidity and mortality from large clinical studies in Type 1 and Type 2 DM will also be reviewed.

Expert commentary: The relative and absolute risk of severe hypoglycemia leading to death and serious adverse events in both cardiovascular and other organ systems has been highlighted following the publication of recent large clinical trials focused on glucose control and outcomes. It would be helpful if future studies could develop broader end points to include minor and moderate hypoglycemia as well as more robust methods for capturing hypoglycemia contemporaneously with adverse events. In addition, perhaps consideration of including hypoglycemia as a primary outcome, may help identify the possible cause and effect of hypoglycemia on cardiovascular morbidity and mortality.

Keywords: Atherothrombosis; Diabetes; Dysrhythmia; Fibrinolytic Balance; Hypoglycemia; Inflammation.

PubMed Disclaimer

Conflict of interest statement

Declaration of interest The author has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Figures

Figure 1
Figure 1
Pathophysiologic changes in the vasculature following hypoglycemia.
Figure 2
Figure 2
Integrated pathophysiologic pathways depicting possible mechanisms of cardiovascular disease following acute hypoglycemia.
See this image and copyright information in PMC

References

    1. Morrish NJ, Wang SL, Stevents LK, et al. Mortality and causes of death in the WHO Multinational Study of Vascular Disease in Diabetes. Diabetes. 2001;2:S14–21. - PubMed
    1. Laakso M. Hyperglycemia and cardiovascular disease in type 2 diabetes. Diabetes. 1999;48(5):937–42. - PubMed
    1. Schnell O, Cappuccio F, Genovese S, et al. Type 1 diabetes and cardiovascular disease. Cardiovasc Diabetol. 2013;12:156. - PMC - PubMed
    1. Khunti K, Davies M, Majeed A. Hypoglycemia and risk of cardiovascular disease and all-cause mortality in insulin-treated people with type 1 and type 2 diabetes: a cohort study. Diabetes Care. 2015;38(2):316–22. - PubMed
    1. Cariou B, Fontaine P, Eschwege E. Frequency and predictors of confirmed hypoglycemia in type 1 and insulin-treated type 2 dabetes mellitus patients in a real-life setting: results from the DIALOG study. Diabetes metabolism. 2015;41(2):116–25. - PubMed

LinkOut - more resources