CommentaryDeath during Intensive Glycemic Therapy of Diabetes: Mechanisms and Implications
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Cited by (109)
American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan—2022 Update
2022, Endocrine PracticeCitation Excerpt :A meta-analysis of prospective and retrospective clinical trials demonstrated that severe hypoglycemia doubled the risk of CV events, whereas an observational trial showed that, over a period of 5 years, mortality was 3.4 times higher among persons who reported severe hypoglycemia at baseline.1207,1208 The proposed mechanism for these effects posits that hypoglycemia reduces baroreceptor sensitivity and increases sympathoadrenal system activity, which can trigger a fatal ventricular arrhythmia in the setting of reduced baroreflex sensitivity.1209 Other short- and long-term consequences of severe hypoglycemia include neurologic conditions ranging from temporary cognitive impairment to dementia as well as major vascular events such as stroke, MI, acute cardiac failure, ventricular arrhythmias, and sudden death.1108,1200,1210
Stress, hypoglycemia, and the autonomic nervous system
2022, Autonomic Neuroscience: Basic and ClinicalAging and comorbidities influence the risk of hospitalization and mortality in diabetic patients experiencing severe hypoglycemia
2022, Nutrition, Metabolism and Cardiovascular DiseasesCitation Excerpt :Despite clinical evidence demonstrating that tight glucose control can improve both microvascular and macrovascular outcomes in patients with DM, hypoglycemia remains a key constraint to fulfill this goal due to its potential cardiovascular, neurocognitive and psychological consequences [2,3]. Depending on its severity, it poses an increased risk of death [4,5]. The link between hypoglycemia and mortality appears unsolved and, in recent years, lively debates focused on the possible impact of hypoglycemia on cardiovascular risk [6–8].
Prevalence of severe hypoglycemia in a cohort of patients with type 1 diabetes
2021, Endocrinologia, Diabetes y Nutricion
Funding: The author's original work cited was supported, in part, by National Institutes of Health grants R37 DK27085, M01 RR00036 (now UL1 RR24992), P60 DK20579, and T32 DK07120 and by a fellowship award from the American Diabetes Association.
Conflict of Interest: The author has served as a consultant to Merck & Co., Bristol-Myers Squibb/AstraZeneca, MannKind Corp., and Novo Nordisk Inc. in the past year. He does not receive research funds from, hold stock in, or speak for any pharmaceutical or device firm.
Authorship: Ms. Janet Dedeke, the author's assistant, prepared this manuscript, which was written by Dr. Cryer.
An invited editorial for The American Journal of Medicine.