A growing number of Type 2 diabetes patients have dangerously low blood sugar levels that put them at increased risk for cardiovascular disease, according to a pair of new studies released this week.
In new research published online in the journal Diabetes Care, researchers with Kaiser Permanente and Yale University School of Medicine found many patients with diabetes who take certain types of medications to lower their blood sugar experience severe low blood sugar levels, whether or not their diabetes is poorly or well controlled.
The findings are based on a survey of 9,000 patients with Type 2 diabetes that indicated nearly 11 percent experienced severe hypoglycemia in the prior year. The finding challenges the conventional wisdom that hypoglycemia (low blood sugar) is primarily a problem among diabetic patients with well-controlled diabetes.
Low blood sugar can cause unpleasant symptoms but is typically treatable with food or a sweet drink. But recent studies have found that patients with severe hypoglycemia are also at higher risk for dementia, falls, fractures, and other problems, compared with patients who did not experience hypoglycemia.
"Many clinicians may assume that hypoglycemia is not much of a problem in poorly controlled Type 2 diabetes given their high average blood sugar levels," said lead researcher Andrew Karter.
"This study suggests that we should pay much closer attention to hypoglycemia, even in poorly controlled patients. Providers should explain the symptoms of hypoglycemia, how to treat it, and how to avoid it — for example, by not skipping meals. Most of all, providers should ask all their diabetic patients whether they've experienced hypoglycemia, even those patients with very high average levels of blood sugar."
A second study, published July 30 in the online British Medical Journal BMJ.com, found Type 2 diabetics who have severe hypoglycemia are at higher risk of cardiovascular disease.
The findings — by a team of researchers from Japan, the U.S., and the Netherlands — are based on an analysis of six studies involving 903,510 patients. The results showed 5.8 percent of participants experienced severe hypoglycemia and that it doubled their risk of developing cardiovascular disease.
Given the risk, the researchers said avoiding severe hypoglycemia may be key to preventing heart disease and that "less stringent glycemic targets may be considered for Type 2 diabetic patients at high risk of hypoglycemia."
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