Severe hypos increase the risk of heart attacks in type 2 diabetes

People with type 2 diabetes that have a history of severe hypoglycemia have a higher risk of heart attacks and other cardiovascular events according to the Edinburgh Type 2 Diabetes Study.
The Edinburgh Type 2 Diabetes Study aims to assess risk of a number of diabetes complications in people with type 2 diabetes. In the latest analysis, researchers assessed 1,066 adults with type 2 diabetes between the ages of 60 and 75 years old. Of these, 87 patients reported that they’d had a severe hypo within the previous year.
Severe hypos are very low blood glucose levels that require help in treatment from someone else. Severe hypos are a short term complication that only occur in people on stronger diabetes medication such as insulin, sulphonylureas and prandial glucose regulators.
The study period monitored the participants over 4 years and 99 of the total participants experienced a major macrovascular event over this time period. The research found that patients with a history of severe hypoglycemia had a 4 times higher risk of having a heart attack over the 4 years than those without a history of severe hypos. In terms of total cardiovascular events, the risk was increased by just over 2 times for those with a history or severe hypos.
The research adds to existing evidence that has shown intensive lowering of HbA1c through stronger medication to be linked with higher rates of death. The key message is that as long as blood glucose levels can be lowered safely, without risking severe hypos occurring, this will have benefits for health. The problems of a lower HbA1c come if accompanied by severe hypos, which can result from intensively lowering HbA1c with stronger diabetes medication such as insulin and sulphonylureas.
The results appear to mirror similar results found in people with type 1 diabetes, in which a history of severe hypoglycemia was associated with greater risk of cardiovascular events.