Why the study?
Does intensive glucose control and resulting hypoglycaemia increase the risk of cardiovascular mortality in patients with diabetes or stress-induced hyperglycaemia?
Does intensive glucose control and resulting hypoglycaemia increase the risk of cardiovascular mortality in patients with diabetes or stress-induced hyperglycaemia?
This review highlights that intensive glucose control can cause hypoglycaemia, which may act as a cardiovascular risk factor by triggering adverse haemodynamic responses and increasing cardiovascular mortality.
Clinicians should weigh hypoglycaemia risk before intensive glucose targets; leaves open net CV benefit pending dedicated RCTs.
Intensive glucose control is widely practiced in patients with diabetes mellitus and patients acutely admitted to hospitals with concomitant stress-induced hyperglycaemia. Such a strategy increases the risk of hypoglycaemia by several-fold. Hypoglycaemia leads to a surge in catecholamine levels with a profound haemodynamic response. In patients with a decreased cardiac reserve, such significant changes can culminate in serious or even fatal cardiovascular outcomes. This review is aimed at discussing in depth the evidence to date that links hypoglycaemia with cardiovascular mortality, reviewing the likely mechanisms underlying this association, as well as summarising these from a cardiologist's perspective.
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Rana et al. (2013) studied this question.
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