image: This is Professor Kamlesh Khunti of the University of Leicester Diabetes Research Centre. view more
Credit: University of Leicester
A study involving scientists from the University of Leicester has established a link between hypoglycaemia and increased risk of cardiovascular events and mortality in patients with diabetes.
Professors Kamlesh Khunti and Melanie Davies, scientists from the University of Leicester's Diabetes Research Centre, have confirmed an association between hypoglycaemia and an increased risk of cardiovascular events and mortality in insulin-treated patients with diabetes, which could lead to changes in the way some patients' treatment is managed. The results were published online in the journal Diabetes Care on December 9.
As part of an international collaboration with scientists from Imperial College London, the QIMR Berghofer Medical Research Institute and Novo Nordisk A/S - using data from the UK Clinical Practice Research Datalink database - Professors Khunti and Davies demonstrated that, following hypoglycaemia, insulin-treated patients with diabetes had an ~60% higher risk of cardiovascular events, and were between 2-2.5 times more likely to die over the same period as patients who did not experience hypoglycaemia.
The research was supported by the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care East Midlands (NIHR CLAHRC EM), and the NIHR Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit.
Kamlesh Khunti, Professor of Primary Care Diabetes & Vascular Medicine at the University of Leicester, who led the research, said: "This is one of the first studies to report the risk of cardiovascular events and mortality in people with both type 1 and type 2 diabetes. The risks are very significant and we need to identify these patients early with a view to implementing strategies to reduce their risk of hypoglycaemia."
Patients with diabetes are at higher risk of cardiovascular disease due to the formation of atherosclerotic plaques in blood vessels; this is a major cause of early death in these patients. The results of the study show that hypoglycaemia, which occurs when a patient's blood glucose becomes dangerously low, can trigger potentially fatal cardiovascular events.
Melanie Davies, Professor of Diabetes Medicine at the University of Leicester and Honorary Consultant at Leicester's Hospitals, commented: "The data from this important and large piece of research confirms what we already know in people with type 2 diabetes and extends our knowledge in those with type 1 diabetes. It also confirms the significance of hypoglycaemia and the link with an increased risk of cardiovascular events, a risk that persists over a long time period. Going forward we need to focus on management strategies that help patients minimise their risk of having hypoglycaemic events."
The findings of this investigation are a stark reminder of the challenges facing patients with diabetes and could lead to changes in the management of insulin-treated patients, particularly those at high risk of cardiovascular events.
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Notes to editors:
This study was published in Diabetes Care on December 9 2014. doi: 10.2337/dc14-0920
Professor Kamlesh Khunti and Professor Melanie Davies are based at the Diabetes Research Centre, University of Leicester.
Email: kk22@le.ac.uk
Tel: +44 (0)116 258 4005
Hypoglycaemia is one of the most common and serious side effects of insulin therapy.
This retrospective cohort study used data from the Clinical Practice Research Datalink (CPRD) database. The CPRD holds anonymized, longitudinal, primary care records of ~5% of the population registered with a general practice in the UK and is widely used for epidemiological research.
After exclusion criteria were applied, 3,260 patients with type 1 diabetes and 10,422 patients with type 2 diabetes were included in the study from a primary data set of 265,868 individuals who had received a diagnosis of diabetes.
This study was supported by the National Institute for Health Research. Funding for this investigation was also provided by Novo Nordisk A/S, Bagsværd, Denmark.
The University of Leicester's Diabetes Research Centre is part of the Leicester Diabetes Centre -an alliance between the University Hospitals of Leicester NHS Trust (Leicester's Hospitals), the University of Leicester, the local community and Primary Care.
About the National Institute for Health Research:
The National Institute for Health Research (NIHR) is funded by the Department of Health to improve the health and wealth of the nation through research. Since its establishment in April 2006, the NIHR has transformed research in the NHS. It has increased the volume of applied health research for the benefit of patients and the public, driven faster translation of basic science discoveries into tangible benefits for patients and the economy, and developed and supported the people who conduct and contribute to applied health research. The NIHR plays a key role in the Government's strategy for economic growth, attracting investment by the life-sciences industries through its world-class infrastructure for health research. Together, the NIHR people, programmes, centres of excellence and systems represent the most integrated health research system in the world. For further information, visit the NIHR website.
CLAHRC EM website is http://www.clahrc-em.nihr.ac.uk
Journal
Diabetes Care