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首页 » 临床研究 » Diabe Care:低血糖或增加糖尿病患者心血管疾病事件及死亡的风险

Diabe Care:低血糖或增加糖尿病患者心血管疾病事件及死亡的风险

来源:生物谷 2014-12-15 14:02

2014年12月15日 讯 /生物谷BIOON/ --近日,来自英国莱斯特大学的研究者通过研究揭示了低血糖和糖尿病病人死亡率及心血管事件风险增加之间的关联,相关研究刊登于国际杂志Diabetes Care上。文章中,研究者发现,低血糖可使胰岛素治疗的糖尿病患者患心血管事件的风险增加60%,而且相比非低血糖患者而言,在相同时期内低血糖患者的死亡可能性是前者的2-2.5倍。

文章中,研究者Kamlesh Khunti表示,这项研究中我们首次报道了低血糖和1型及2型糖尿病患者死亡率和心血管事件的发病风险,而且这些风险非常显著,因此我们必须及时鉴别出出现早期症状的患者来采取一定的策略帮助减少个体低血糖的风险。

糖尿病病人患心血管疾病风险增加主要是由于血管中粥样硬化斑块的形成所致,这也是导致患者早死的主要原因,本文研究结果显示,当糖尿病病人机体的血糖水平过低非常危险时就可以诱发潜在的致死性心血管事件。

研究者Melanie Davies指出,这项研究中所得的数据证实了我们在1型和2型糖尿病患者中所观察到的情况,同时也证实了低血糖和糖尿病患者心血管事件及死亡率之间的关系,后期我们应该集中研究新型的疗法策略来帮助患者减少其心血管事件发生的风险。这项研究同时也提醒了糖尿病患者将要面临的挑战,也提示医生们要及时改变对胰岛素治疗的患者的疗法,尤其是那些心血管事件风险较高的患者。(生物谷Bioon.com)

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Hypoglycemia and Risk of Cardiovascular Disease and All-Cause Mortality in Insulin-Treated People With Type 1 and Type 2 Diabetes: A Cohort Study.

Kamlesh Khunti1,2⇑, Melanie Davies1,2, Azeem Majeed3, Brian Larsen Thorsted4, Michael Lyng Wolden4 and Sanjoy K. Paul5

OBJECTIVE Hypoglycemia has been associated with an increased risk of cardiovascular (CV) events and all-cause mortality. This study assessed whether, in a nationally representative population, there is an association between hypoglycemia, the risk of CV events, and all-cause mortality among insulin-treated people with type 1 diabetes (T1D) or type 2 diabetes (T2D). RESEARCH DESIGN AND METHODS This retrospective cohort study used data from the Clinical Practice Research Datalink database, and included all insulin-treated patients (≥30 years of age) with a diagnosis of diabetes. RESULTS In patients who experienced hypoglycemia, hazard ratios (HRs) for CV events in people with T1D were 1.51 (95% CI 0.83, 2.75; P = ns) and 1.61 (1.17, 2.22), respectively, for those with and without a history of CV disease (CVD) before the index date. In people with T2D, the HRs for patients with and without a history of CVD were 1.60 (1.21, 2.12) and 1.49 (1.23, 1.82), respectively. For all-cause mortality, HRs in people with T1D were 1.98 (1.25, 3.17), and 2.03 (1.66, 2.47), respectively, for those with and without a history of CVD. Among people with T2D, HRs were 1.74 (1.39, 2.18) and 2.48 (2.21, 2.79), respectively, for those with and without a history of CVD. The median time (interquartile range) from first hypoglycemia event to first CV event was 1.5 years (0.5, 3.5 years) and 1.5 years (0.5, 3.0 years), respectively, for people with T1D and T2D. CONCLUSIONS Hypoglycemia is associated with an increased risk of CV events and all-cause mortality in insulin-treated patients with diabetes. The relationship between hypoglycemia and CV outcomes and mortality exists over a long period.

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