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06-10-2009 | Diabetes | Article

Increased incidence of hypoglycemia linked to MI in diabetic patients

Abstract

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MedWire News: Diabetic individuals who experience myocardial infarction (MI) are more than twice as likely to have hypoglycemic events in the preceding year as diabetics without MI, report researchers.

Reporting at the European Association for the Study of Diabetes 45th Annual Meeting in Vienna, Austria, Donald Miller (Boston University School of Public Health, Bedford, Massachusetts, USA) said that a recent analysis of healthcare claims found a 42% increased risk for MI in diabetic patients who experienced hypoglycemia.

In this study, Miller and team used data collected from the US Veterans Health Administration Diabetes Epidemiology cohorts. They identified 63,519 diabetic patients with first MI between 2000 and 2004 and no previous history of MI, unstable angina, or cardiac surgery. They also selected 1,009,746 matched controls with diabetes, but no MI.

The researchers used diagnosis codes from inpatient and outpatient encounters to determine the prevalence of hypoglycemic events severe enough to require hospitalization in the year preceding first MI, excluding the day before admission and the day of admission, to reduce ascertainment bias.

They found that hypoglycemic events were significantly more common in cases than controls, at 9.6% versus 4.2%, with a noticeably greater difference in the weeks immediately preceding MI. Hypoglycemia within the previous 2 weeks increased the risk for MI by 65% and within the previous 6 months by 20% compared with controls.

“It remains to be determined whether hypoglycemia is simply a marker for increased risk of imminent MI or has direct effect in causing the infarction,” say Miller and team.

“Clinicians should be cognizant of these potential risks in managing diabetes patients.”

Miller added that further studies that “give details of conditions just prior to the hypoglycemia and what leads to potential elevated risks for MI,” are needed.

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2009

By Helen Albert