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Severe hypoglycemia as a preventable risk factor for cardiovascular disease in patients with type 2 diabetes mellitus

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초록

Glucose-lowering medication and lifestyle modification are essential for optimal glycemic control in patients with type 2 diabetes mellitus (T2DM). However, glucose- lowering agents, particularly insulin and insulin secretagogues, may cause hypoglycemia, which has multiple negative effects on the cardiovascular (CV) system and may cause death. Previous studies using institutional data from the Korean Nationwide Health Insurance database have consistently found a causal relationship between severe hypoglycemia and CV outcomes and mortality. Screening for high-risk patients, appropriate management, and intensive individualized education are the most effective measures and essential for the prevention of harmful hypoglycemic events. Based on identified risk factors that predict severe hypoglycemia, we developed an 1-year risk prediction model for severe hypoglycemia that can be used in clinical settings. In this review, we describe the current understanding of severe hypoglycemia and the clinical implications in patients with T2DM. Furthermore, we highlight the importance of intensive individualized education for high-risk patients and the risk prediction model to reduce severe hypoglycemia.

Abstract

Glucose-lowering medication and lifestyle modification are essential for optimal glycemic control in patients with type 2 diabetes mellitus (T2DM). However, glucose- lowering agents, particularly insulin and insulin secretagogues, may cause hypoglycemia, which has multiple negative effects on the cardiovascular (CV) system and may cause death. Previous studies using institutional data from the Korean Nationwide Health Insurance database have consistently found a causal relationship between severe hypoglycemia and CV outcomes and mortality. Screening for high-risk patients, appropriate management, and intensive individualized education are the most effective measures and essential for the prevention of harmful hypoglycemic events. Based on identified risk factors that predict severe hypoglycemia, we developed an 1-year risk prediction model for severe hypoglycemia that can be used in clinical settings. In this review, we describe the current understanding of severe hypoglycemia and the clinical implications in patients with T2DM. Furthermore, we highlight the importance of intensive individualized education for high-risk patients and the risk prediction model to reduce severe hypoglycemia.

참고문헌 (50)

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관련 논문AI추천

Blood electrolyte disturbances during severe hypoglycemia in Korean patients with type 2 diabetes강미연대한내과학회 · The Korean Journal of Internal Medicine2015 · 제30권 제5호Frequency and Severity of Hypoglycemia in Type 2 Diabetes Mellitus Patients Treated with a Sulfonylurea-Based Regimen at University-Affiliated Hospitals in Korea: The Naturalistic Evaluation of Hypoglycemic Events in Diabetic Subjects Study김우식, Be Long Cho, Byung Yeon Yu, Chang Gyu Park, Chun Soo Lim, Dong Hoon Choi, In Hyeon Jung, Kyung Pyo Kang, Sang Hyun Kim, Sang Jae Lee, Wonju Jeung, Won Yong Sin, Yon Su Kim대한가정의학회 · Korean Journal of Family Medicine2019 · 제40권 제4호Increasing Individual Target Glucose Levels to Prevent Hypoglycemia in Patients with Diabetes김현아, Choi Whan-Seok, Kim Churlmin, Kim Hun-Sung, Shin Juyoung대한가정의학회 · Korean Journal of Family Medicine2021 · 제42권 제4호Exercise Strategies to Prevent Hypoglycemia in Patients with DiabetesAh Reum Jung, Churlmin Kim, Hun-Sung Kim, Hyunah Kim, Whan-Seok Choi대한가정의학회 · Korean Journal of Family Medicine2021 · 제42권 제2호Cardiovascular Outcome Trials of Sodium Glucose Cotransporter 2 Inhibitor and Its Possible Cardioprotective Mechanism강은석, 조용인한국지질동맥경화학회 · 지질·동맥경화학회지2018 · 제7권 제1호Insulin therapy for adult patients with type 2 diabetes mellitus: a position statement of the Korean Diabetes Association, 2017고승현, 김난희, 김진화, 김현진, 문민경, 박석오, 이병완, 이상열, 최경묵, 허규연, the Committee of Clinical Practice Guideline of KDA대한내과학회 · The Korean Journal of Internal Medicine2017 · 제32권 제6호

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