Severe Hypoglycemia and Mortality After Cardiovascular Events for Type 1 Diabetic

Patients in Sweden

Featured Article:

Tom W.C. Lung, Dennis Petrie, William H. Herman, Andrew J. Palmer,Ann-Marie Svensson, Bjorn Eliasson, and Philip M. Clarke

Diabetes Care Volume 37: 2974-2981

November, 2014

STUDY OBJECTIVE 

• To examine whether previous severe hypoglycemic events were associated with the risk of all-cause mortality after major cardiovascular events in type 1 patients

Lung T. W.C. et al. Diabetes Care 2014;37:2974-2981

STUDY DESIGN AND METHODS

• Data were from the Swedish National Diabetes Register

• Patients included those with type 1 diabetes who visited a clinic during 2002–2010 and experienced a major cardiovascular complication after the visit

• Two-part model was estimated for all-cause mortality after a cardiovascular event:

1. Logistic regression for death within the first month2. Cox proportional hazards model conditional on 1-month survival

• 5-year cumulative mortality risk was estimated from the models for patients with and without prior diabetes complications

Lung T. W.C. et al. Diabetes Care 2014;37:2974-2981

RESULTS

• 1,839 patients experienced major cardiovascular events

• 403 had previously experienced severe hypoglycemic events

• 703 died within our study period

• A prior hypoglycemic event was associated with a significant increase in mortality after a cardiovascular event

• Patients with prior hypoglycemia had an estimated 5-year cumulative mortality risk of 52.4 and 39.8% for myocardial infarction and stroke, respectively

Lung T. W.C. et al. Diabetes Care 2014;37:2974-2981

Lung T. W.C. et al. Diabetes Care 2014;37:2974-2981

Lung T. W.C. et al. Diabetes Care 2014;37:2974-2981

Lung T. W.C. et al. Diabetes Care 2014;37:2974-2981

CONCLUSIONS

• Patients with type 1 diabetes in Sweden with prior severe hypoglycemic events have increased risk of mortality after a cardiovascular event

Lung T. W.C. et al. Diabetes Care 2014;37:2974-2981

Lung T. W.C. et al. Diabetes Care 2014;37:2974-2981