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Severe Hypoglycemia and Mortality After Cardiovascular Events for Type 1 Diabetic
Patients in Sweden
Featured Article:
Tom W.C. Lung, Dennis Petrie, William H. Herman, Andrew J. Palmer,Ann-Marie Svensson, Bjorn Eliasson, and Philip M. Clarke
Diabetes Care Volume 37: 2974-2981
November, 2014
STUDY OBJECTIVE
• To examine whether previous severe hypoglycemic events were associated with the risk of all-cause mortality after major cardiovascular events in type 1 patients
Lung T. W.C. et al. Diabetes Care 2014;37:2974-2981
STUDY DESIGN AND METHODS
• Data were from the Swedish National Diabetes Register
• Patients included those with type 1 diabetes who visited a clinic during 2002–2010 and experienced a major cardiovascular complication after the visit
• Two-part model was estimated for all-cause mortality after a cardiovascular event:
1. Logistic regression for death within the first month2. Cox proportional hazards model conditional on 1-month survival
• 5-year cumulative mortality risk was estimated from the models for patients with and without prior diabetes complications
Lung T. W.C. et al. Diabetes Care 2014;37:2974-2981
RESULTS
• 1,839 patients experienced major cardiovascular events
• 403 had previously experienced severe hypoglycemic events
• 703 died within our study period
• A prior hypoglycemic event was associated with a significant increase in mortality after a cardiovascular event
• Patients with prior hypoglycemia had an estimated 5-year cumulative mortality risk of 52.4 and 39.8% for myocardial infarction and stroke, respectively
Lung T. W.C. et al. Diabetes Care 2014;37:2974-2981
Lung T. W.C. et al. Diabetes Care 2014;37:2974-2981
Lung T. W.C. et al. Diabetes Care 2014;37:2974-2981
Lung T. W.C. et al. Diabetes Care 2014;37:2974-2981
CONCLUSIONS
• Patients with type 1 diabetes in Sweden with prior severe hypoglycemic events have increased risk of mortality after a cardiovascular event
Lung T. W.C. et al. Diabetes Care 2014;37:2974-2981
Lung T. W.C. et al. Diabetes Care 2014;37:2974-2981