Severe Hypoglycemia, Cardiac Structure and Function, and Ris
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This study aimed to assess the association of severe hypoglycemia measured at baseline with cardiovascular disease (CVD) among community-dwelling older individuals with diabetes, a group particularly susceptible to hypoglycemia.

Researchers included older adults with diabetes from the Atherosclerosis Risk in Communities (ARIC) study who attended visit 5 (2011–2013, baseline). Severe hypoglycemia at baseline was defined with use of first position ICD-9 codes from hospitalizations, emergency department visits, and ambulance calls. We examined cross-sectional associations of severe hypoglycemia with echocardiographic indices of cardiac structure-function. They prospectively evaluated the risks of incident or recurrent CVD (coronary heart disease, stroke, or heart failure) and all-cause mortality.

-- Among 2,193 participants, 79 had a history of severe hypoglycemia at baseline.

-- Severe hypoglycemia was associated with a lower left ventricular (LV) ejection fraction, higher LV end diastolic volume, higher E-to-A ratio, and higher septal E/e?.

-- In adjusted models, severe hypoglycemia was associated with incident or recurrent CVD and all-cause mortality among those without prevalent CVD.

Conclusively, these findings suggest that a history of severe hypoglycemia is associated with alterations in cardiac function and is an important marker of future cardiovascular risk in older adults.