USA: Severe Hypoglycemia and Heart Failure Risk

Severe hypoglycemia is associated with a greater risk of heart failure, reveals a study of a large cohort of adults with type 2 diabetes. The study appears in the Journal of Clinical Endocrinology & Metabolism.

In the study, Justin B Echouffo-Tcheugui, Johns Hopkins School of Medicine, Baltimore, MD, USA, and colleagues evaluated the association of severe hypoglycemia with incident HF among individuals with type 2 diabetes. The association was investigated in participants of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study.

The researchers assessed severe hypoglycemia episodes during the initial 24 months following randomization and defined using 2 methods:

• Symptomatic, severe hypoglycemic event requiring medical assistance (first definition); or
• Requiring any assistance (second definition).

They prospectively followed participants without HF at baseline and during the first 24 months of the study for HF hospitalization. Adjusted hazard ratios (HR) were generated for the association of severe hypoglycemia and incident HF.

Study Findings

• Among 9208 participants (mean age 63 years, 38% female, 62% White), 365 had ≥ 1 episode of severe hypoglycemia.
• Over a median follow-up duration of 3 years, there were 249 incident HF events.
• After multivariable adjustment for relevant confounders, participants with severe hypoglycemia requiring medical assistance had a 68% higher relative risk of incident HF (HR 1.68), as compared with individuals who never experienced any episode of hypoglycemia.
• Severe hypoglycemia requiring any assistance was also associated with a 49% higher relative risk of HF (HR 1.49).

The authors concluded, "in a large cohort of adults with type 2 diabetes, severe hypoglycemia was independently associated with greater risk of incident HF."

Reference

Justin B Echouffo-Tcheugui, Arnaud D Kaze, Gregg C Fonarow, Sam Dagogo-Jack, Severe Hypoglycemia and Incident Heart Failure Among Adults With Type 2 Diabetes, The Journal of Clinical Endocrinology & Metabolism, 2021;, dgab794, https://doi.org/10.1210/clinem/dgab794