Tatsuya Noda, MD, PhD  a lecturer in the department of public health, health management and policy at Nara Medical University in Japan, and colleagues conducted a research about the risk of Acute Coronary Syndrome in patients with severe hypoglycemia. The findings were published in the Journal of Diabetes Investigation. Noda and colleagues collected data of 7,909,626 adults aged at least 35 years with diabetes from 2014 to 2016 in the National Database of Health Insurance Claims and Specific Health Check-ups in Japan. The researchers analyzed cases of severe hypoglycemia and acute coronary syndrome (ACS) that contributed to percutaneous coronary intervention in emergency and the time between the two incidents. Following are the key points of the study:

  • Absolute ACS risk was 1.016 times greater for those who experienced severe hypoglycemia vs. those who did not based on fully adjusted models.
  • Among adults aged at least 70 years, the researchers found an absolute ACS risk of 3.3 per 1,000 person-years for those who experienced severe hypoglycemia and an absolute ACS risk of 3 per 1,000 person-years for those who did not.
  • Among adults younger than 70 years, the researchers found an absolute ACS risk of 2.4 per 1,000 person-years in those who experienced hypoglycemia and an absolute ACS risk of 2.3 per 1,000 person-years for those who did not.
  • In the first 10 days after severe hypoglycemia, the researchers found an absolute ACS risk of 10.6 per 1,000 person-years. Absolute ACS risk was 2.2 per 1,000 person-years in days 11 to 90 and 2.5 per 1,000 person-years in days 91 to 365.
  • Older adults with diabetes may be more likely to develop acute coronary syndrome if they experience severe hypoglycemia.

“The risk of ACS was higher immediately after a severe hypoglycemic episode, and this was confirmed by an adjusted regression analysis,” the researchers wrote. These findings highlight that it is important to avoid severe hypoglycemia while treating diabetes, particularly in elderly patients.