Hypoglycemia in Intensive Diabetes Control May Up Survival

Inverse relationship seen between number of hypoglycemic episodes and risk of death

FRIDAY, Jan. 6 (HealthDay News) -- For adults with type 2 diabetes, recognized and unrecognized hypoglycemia is more common in those with intensive blood sugar control, and is associated with a small but significant reduction in the risk of mortality, according to a study published online Dec. 16 in Diabetes Care.

Elizabeth R. Seaquist, M.D., of the University of Minnesota in Minneapolis, and colleagues investigated the correlation between hypoglycemic events (self-monitored blood glucose <70 mg/dL or <3.9 mmol/L) and mortality in 10,096 participants of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study. Participants were randomly assigned to an intensive strategy (target hemoglobin A1c [HbA1c] <6.0 percent) or a standard strategy (target HbA1c between 7.1 and 7.9 percent). After adjusting for variables, the risk of death was assessed.

The investigators found that, in the seven days preceding their regular four-month visit, patients in the intensive group reported a mean of 1.06 episodes, versus 0.29 episodes for participants in the standard group. Unrecognized hypoglycemia was reported by 5.8 and 2.6 percent of participants in the intensive and standard groups, respectively. For models including the frequency of hypoglycemic events, mortality hazard ratios were 0.93 in the intensive control group (P < 0.0001) and 0.98 in the standard group (P = 0.615). The hazard ratios for models including unrecognized hypoglycemia were not significant for either group.

"We found a significant inverse relationship between the number of hypoglycemic episodes and the risk of death among participants in the intensive group of the ACCORD trial," the authors write.

One of the study authors disclosed financial ties with Roche. Supplies for the study were provided by the pharmaceutical industry.

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