Hypoglycemia and Adverse Cardiovascular Outcomes: Are They Related?

In the ADVANCE trial, intensive glycemic control was compared with standard control in 11,000 adults with long-standing type 2 diabetes. As the investigators reported previously (JW Gen Med Jun 6 2008), intensive control did not lower rates of cardiovascular events or death, and the proportion of patients with hypoglycemia was greater in the intensive-treatment group than in the standard-treatment group (2.7% vs. 1.5% for severe hypoglycemia; 52% vs. 37% for minor hypoglycemia). One question is whether hypoglycemia was related to adverse vascular outcomes or excess mortality in ADVANCE; to address this question, the researchers conducted this additional analysis.

Severe hypoglycemia indeed was associated with significantly elevated risk for …