History of severe hypoglycemia in type II diabetes mellitus unmasked significant atherosclerotic coronary artery disease: a matched case-control study

Abstract BackgroundHistory of severe hypoglycemia (SH) has been associated with cardiovascular (CV) events among patients with type II diabetes mellitus (T2DM). In this study, we screened patients with SH for atherosclerotic coronary artery disease (ACAD) .MethodsWe conducted a matched case-control study involving 28 T2DM patients with SH within the last 5 years with no documented ACAD and matched them with 28 T2DM patients with no SH. All subjects underwent coronary artery calcium scoring (CACS) followed by CT coronary angiography (CCTA) if indicated.ResultsHistory of SH in T2DM was associated with 78% (22 out of 28) incidence of significant ACAD compared to 46% (13 out of 28) in those without SH, based on either CACS≥400, or at least one coronary artery with ≥50% stenosis from CCTA, ( P =0.026).ConclusionThis study supported that SH in T2DM is associated with ACAD compared to T2DM without SH.