Association Between Severe Hypoglycemia and Cardiovascular Disease Risk in Japanese Patients With Type 2 Diabetes
Open accessAbstract
Background: It remains unclear whether severe hypoglycemia is associated with cardiovascular disease ( CVD ) in Asian populations with type 2 diabetes (T2D). Furthermore, no study in Japan, where the prescription patterns differ from those in other countries, has examined this association. Methods and Results: We retrospectively included 58 223 patients (18–74 years old) with T2D. First, we examined the potential predictors of severe hypoglycemia. Then, we investigated the association between severe hypoglycemia and CVD risk. Finally, we performed an updated systematic review and meta‐analysis to incorporate our findings and recently published studies into the previous systematic review and meta‐analysis. During 134 597 person‐years from cumulative observation periods, 128 persons experienced severe hypoglycemia and 550 developed CVD events. In a multivariate Cox proportional hazard model, severe hypoglycemia was strongly and positively associated with the risk of CVD (multivariate‐adjusted adjusted hazard ratio, 3.39; 95% CI , 1.25–9.18). In a propensity score–matched cohort that had similar baseline characteristics for patients with severe hypoglycemia and those without, severe hypoglycemia was more strongly associated with the risk of CVD . An updated systematic review and meta‐analysis that included 10 studies found that severe hypoglycemia was associated with an ≈2‐fold increased risk of CVD (pooled relative risk, 1.91; 95% CI , 1.69–2.15). Conclusions: Our results suggest that severe hypoglycemia is strongly associated with an increased risk of CVD in Japanese patients with T2D, further supporting the notion that avoiding severe hypoglycemia may be important in preventing CVD in this patient population.
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Recent investigations reported that GLP-1 receptor agonists have suppressive effects on ASCVD incidence.
“and that the suppressive effects of glucagonlike peptide-1 (GLP-1) receptor agonists on ASCVD incidence800, 801).”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [800]
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- Authors
- Goto, A., Goto, M., Terauchi, Y., Yamaguchi, N., & Noda, M.
- Affiliations
- National Center for Global Health and Medicine (JP)
- Yokohama City University (JP)
- Tokyo Women's Medical University (JP)
- Corresponding author
- Goto, Atsushi
- Venue
- Journal of the American Heart Association
- Published
- 2016-03-09
- Volume
- 5
- Issue
- 3
- Pages
- e002875-e002875
- ISSN
- 2047-9980 (ISSN-L)
- PMC
- PMC4943262
- OpenAlex
- W2296265755
- Cited by
- 67
- References
- 35
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 5 · 2023: 5 · 2022: 5 · 2021: 10 · 2020: 11 · 2019: 9 · 2018: 7 · 2017: 3 · 2016: 2
- FWCI
- 7.03
- Type
- journal article
- Language
- en
- Update notices
- correction (2016-06-27)
- Open access
- gold
- doi.org
- Licence
- cc-by-nc
- Locations
- Journal of the American Heart Association (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Takeda Pharmaceutical Company
- University of Toyama
- Japan Society for the Promotion of Science (15H04779)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- severe hypoglycemia, cardiovascular risk, type 2 diabetes, Japanese patients, Asian populations, cardiovascular events, hypoglycemia prevention
- MeSH terms
- Adolescent, Adult, Aged, Blood Glucose, Cardiovascular Diseases, Diabetes Mellitus, Type 2, Female, Humans, Hypoglycemia, Hypoglycemic Agents, Japan, Male, Middle Aged, Retrospective Studies, Risk Factors, Severity of Illness Index, Time Factors, Biomarkers, Multivariate Analysis, Proportional Hazards Models, Risk Assessment, Asian People, Young Adult, Propensity Score
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