PMID- 31447782
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200225
IS  - 1664-2392 (Print)
IS  - 1664-2392 (Electronic)
IS  - 1664-2392 (Linking)
VI  - 10
DP  - 2019
TI  - The Association of Hypoglycemia Assessed by Continuous Glucose Monitoring With 
      Cardiovascular Outcomes and Mortality in Patients With Type 2 Diabetes.
PG  - 536
LID - 10.3389/fendo.2019.00536 [doi]
LID - 536
AB  - Objective: Hypoglycemia has been shown to promote inflammation, a common 
      pathogenic process, in many chronic health conditions including diabetes and 
      cardiovascular disease. The aim of this study was to investigate the association 
      of hypoglycemia, assessed by continuous glucose monitoring (CGM) with major 
      adverse cardiovascular event (MACE) outcomes and all-cause mortality. Methods: A 
      retrospective cohort study was conducted with 1,520 patients with type 2 diabetes 
      mellitus (T2DM). The severity of hypoglycemia event was assessed by CGM system. 
      Results: Three hundred and forty-seven participants experienced hypoglycemia 
      events (323 with mild hypoglycemia and 24 with severe hypoglycemia). A fraction 
      of 72.62% hypoglycemia was asymptomatic. During a median follow-up of 31 months, 
      380 participants reached the primary outcome of MACE (61 cardiovascular death, 50 
      non-fatal myocardial infarction [MI], 116 non-fatal stroke, 153 unstable angina 
      requiring hospitalization), 80 participants died before the end of the study. In 
      multivariate Cox regression models, hypoglycemia was associated with 
      cardiovascular death (HR 2.642[95CI% 1.398-4.994]), non-fatal stroke (HR 1.813 
      [95CI% 1.110-2.960]) and all-cause mortality (HR 1.960 [95 CI% 1.124- 3.418]) 
      after the full adjustment. Hypoglycemia was not associated with non-fatal MI and 
      unstable angina. The HR of severe hypoglycemia was higher than mild hypoglycemia 
      for cardiovascular death. Patients with symptomatic and asymptomatic hypoglycemia 
      had similar MACE outcomes and all-cause mortality. Conclusions: CGM is effective 
      to detect asymptomatic and nocturnal hypoglycemia. Hypoglycemia is associated 
      with an increased risk of non-fatal stroke, cardiovascular related death, and 
      total mortality. The cardiovascular mortality is dose-dependent on the severity 
      of hypoglycemia.
FAU - Wei, Wei
AU  - Wei W
AD  - Department of Endocrinology, Tongji Medical College, The Central Hospital of 
      Wuhan, Huazhong University of Science and Technology, Wuhan, China.
FAU - Zhao, Shi
AU  - Zhao S
AD  - Department of Endocrinology, Tongji Medical College, The Central Hospital of 
      Wuhan, Huazhong University of Science and Technology, Wuhan, China.
FAU - Fu, Sha-Li
AU  - Fu SL
AD  - Department of Endocrinology, Tongji Medical College, The Central Hospital of 
      Wuhan, Huazhong University of Science and Technology, Wuhan, China.
FAU - Yi, Lan
AU  - Yi L
AD  - Department of Endocrinology, Tongji Medical College, The Central Hospital of 
      Wuhan, Huazhong University of Science and Technology, Wuhan, China.
FAU - Mao, Hong
AU  - Mao H
AD  - Department of Endocrinology, Tongji Medical College, The Central Hospital of 
      Wuhan, Huazhong University of Science and Technology, Wuhan, China.
FAU - Tan, Qin
AU  - Tan Q
AD  - Department of Cardiology, Tongji Medical College, The Central Hospital of Wuhan, 
      Huazhong University of Science and Technology, Wuhan, China.
FAU - Xu, Pan
AU  - Xu P
AD  - Department of Neurology, Tongji Medical College, The Central Hospital of Wuhan, 
      Huazhong University of Science and Technology, Wuhan, China.
FAU - Yang, Guo-Liang
AU  - Yang GL
AD  - Department of Information, Tongji Medical College, The Central Hospital of Wuhan, 
      Huazhong University of Science and Technology, Wuhan, China.
LA  - eng
PT  - Journal Article
DEP - 20190806
PL  - Switzerland
TA  - Front Endocrinol (Lausanne)
JT  - Frontiers in endocrinology
JID - 101555782
PMC - PMC6691179
OTO - NOTNLM
OT  - CGM system
OT  - MACE
OT  - T2DM
OT  - all-cause mortality
OT  - hypoglycemia
EDAT- 2019/08/27 06:00
MHDA- 2019/08/27 06:01
PMCR- 2019/01/01
CRDT- 2019/08/27 06:00
PHST- 2019/04/23 00:00 [received]
PHST- 2019/07/18 00:00 [accepted]
PHST- 2019/08/27 06:00 [entrez]
PHST- 2019/08/27 06:00 [pubmed]
PHST- 2019/08/27 06:01 [medline]
PHST- 2019/01/01 00:00 [pmc-release]
AID - 10.3389/fendo.2019.00536 [doi]
PST - epublish
SO  - Front Endocrinol (Lausanne). 2019 Aug 6;10:536. doi: 10.3389/fendo.2019.00536. 
      eCollection 2019.