CardioExchange Archive

CardioExchange, an NEJM practice community for medical professionals dedicated to improving cardiac patient care, was active from 2009 to 2015. CardioExchange fostered discussion between clinicians from across the globe.

October 8th, 2010

Analysis of ADVANCE Explores Role of Hypoglycemia

A new analysis of the ADVANCE (Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation) trial sheds light on the role of hypoglycemia in recent trials of glucose control. In a paper in the New England Journal of Medicine, the ADVANCE investigators report that 2.1% of 11,140 patients with type 2 diabetes developed severe hypoglycemia in the course of the trial. Patients with severe hypoglycemia had a significantly elevated risk of major macrovascular events, major microvascular events, and death from a cardiovascular cause or from any cause.

However, the investigators did not find either a temporal or a dose-response relationship between hypoglycemia and outcome. The authors conclude that “although our findings cannot exclude the possibility that severe hypoglycemia has a direct causal link with these outcomes, they suggest that it is as likely to be a marker of vulnerability to a wide range of adverse clinical outcomes.”

Categories: General, Prevention, Vascular
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