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Hypoglycemia, Atherosclerosis Progression Link Explored

Serious hypoglycemia linked to progression of CAC only in standard therapy group of VA Diabetes Trial

MONDAY, Jan. 25, 2016 (HealthDay News) — In the Veterans Affairs Diabetes Trial, hypoglycemia was associated with coronary artery calcium (CAC) progression only in the standard therapy group (versus intensive therapy), according to research published online Jan. 19 in Diabetes Care.

Aramesh Saremi, M.D., from the Phoenix VA Health Care System, and colleagues examined the correlation between serious hypoglycemia (severe episodes with loss of consciousness or requiring assistance, or documented glucose <50 mg/dL) and progression of atherosclerosis. The correlation was assessed in 197 participants in a substudy of the Veterans Affairs Diabetes Trial.

The researcher found that 97 patients reported severe hypoglycemia or glucose <50 mg/dL (23 and 74 patients, respectively) during an average follow-up of 4.5 years between computed tomography scans. Serious hypoglycemia occurred more often in the intensive therapy versus the standard treatment group (74 versus 21 percent; P < 0.01). In the entire cohort there was no correlation between serious hypoglycemia with progression of CAC, but there was a significant interaction between serious hypoglycemia and treatment (P < 0.01). CAC progression was about 50 percent greater for participants with serious hypoglycemia in the standard therapy group, but not in the intensive therapy group, compared to those without serious hypoglycemia (median, 11.15 versus 5.4 mm³; P = 0.02).

“Despite a higher frequency of serious hypoglycemia in the intensive therapy group, serious hypoglycemia was associated with progression of CAC in only the standard therapy group,” the authors write.

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