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Hypoglycemia, diabetes and atherosclerosis: is there a link?

Ignacio Conget & Marga Gimenez

Cardiovascular disease represents a major cause of morbidity and mortality in subjects with diabetes mellitus. Hypoglycemia associated with glucose-lowering therapy causes recurrent morbidity and represents a significant barrier to successful treatment of the disease. The response to hypoglycemia includes direct and indirect changes mainly related to the activation of the sympathoadrenal axis, which produces significant changes in the cardiovascular system. The latest results derived from several recent large randomized clinical trials have raised the major point that severe hypoglycemia may increase the risk of a poor outcome in patients with Type 2 diabetes. The concept that hypoglycemia could be a potential aggravating factor for atherosclerotic processes is discussed in this article.