ReviewClinical cardiology2014
Hypoglycemia from a cardiologist's perspective.
Review in Clinical cardiology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 48 citations in OpenAlex.
- Hypoglycaemia when adding sulphonylurea to metformin: a systematic review and network meta-analysis.British journal of clinical pharmacology · 2016Pooled it
- Korean Society of Interventional Cardiology Expert Consensus for the Management of Chronic Coronary Syndrome: Part 1.Korean circulation journal · 2026Review
- Clinical and pathophysiological links between hypoglycemia and cardiovascular risk in type 2 diabetes mellitus.Frontiers in clinical diabetes and healthcare · 2026Review
- Monitoring individualized glucose levels predicts risk for bradycardia in type 2 diabetes patients with chronic kidney disease: a pilot study.Scientific reports · 2024Article
- Machine learning-based prediction of risk factors for abnormal glycemic control in diabetic cancer patients receiving nutrition support: a case-control study.Hormones (Athens, Greece) · 2023Article
- Use of disease-modifying drugs in diabetic patients with heart failure with reduced ejection fraction.Heart failure reviews · 2023Review
- Assessment of Electrocardiographic Response to Fluctuating Blood Glucose Levels in People Without Diabetes.Journal of diabetes science and technology · 2023Article
- The Role of Platelets in Hypoglycemia-Induced Cardiovascular Disease: A Review of the Literature.Biomolecules · 2023Review
- The Use of β-Blockers in Heart Failure with Reduced Ejection Fraction.Journal of cardiovascular development and disease · 2021Review
- Beyond A1C-Standardization of Continuous Glucose Monitoring Reporting: Why It Is Needed and How It Continues to Evolve.Diabetes spectrum : a publication of the American Diabetes Association · 2021Article
- A new look at brittle diabetes.Journal of diabetes and its complications · 2021Review
- Review of the veteran affairs diabetes trial: Lessons learned.Reviews in endocrine & metabolic disorders · 2020Review
- Glycemia and Atherosclerotic Cardiovascular Disease: Exploring the Gap Between Risk Marker and Risk Factor.Frontiers in cardiovascular medicine · 2020Review
- Impact of sitagliptin combination therapy and hypoglycemia in Japanese patients with type 2 diabetes: a multi-center retrospective observational cohort study.Journal of pharmaceutical health care and sciences · 2020Article
- Day-to-day fasting self-monitored blood glucose variability is associated with risk of hypoglycaemia in insulin-treated patients with type 1 and type 2 diabetes: A post hoc analysis of the SWITCH Trials.Diabetes, obesity & metabolism · 2019Article
- The Association of Biochemical Hypoglycemia with the Subsequent Risk of a Severe Hypoglycemic Event: Analysis of the DCCT Data Set.Diabetes technology & therapeutics · 2019Article
- Pathophysiology and aetiology of hypoglycaemic crises.The Journal of small animal practice · 2018Review
- β1-Adrenergic receptor deficiency in ghrelin-expressing cells causes hypoglycemia in susceptible individuals.The Journal of clinical investigation · 2016Article
- Association of silent hypoglycemia with cardiac events in non-diabetic subjects with acute myocardial infarction undergoing primary percutaneous coronary interventions.BMC cardiovascular disorders · 2016Observational
- Potential glycemic overtreatment in patients ≥75 years with type 2 diabetes mellitus and renal disease: experience from the observational OREDIA study.Diabetes, metabolic syndrome and obesity : targets and therapy · 2015Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Hypoglycemia in people with diabetes mellitus (DM) has been potentially linked to cardiovascular morbidity and mortality. Pathophysiologically, hypoglycemia triggers activation of the sympathoadrenal system, leading to an increase in counter-regulatory hormones and, consequently, increased myocardial workload and oxygen demand. Additionally, hypoglycemia triggers proinflammatory and hematologic changes that provide the substrate for possible myocardial ischemia in the already-diseased diabetic cardiovascular system. Hypoglycemia creates electrophysiologic alterations causing P-R-interval shortening, ST-segment depression, T-wave flattening, reduction of T-wave area, and QTc-interval prolongation. Patients who experience hypoglycemia are at an increased risk of silent ischemia as well as QTc prolongation and consequent arrhythmias. The Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial showed an increase in all-cause mortality with intensive glycemic control, whereas the Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation (ADVANCE) study and Veteran's Affairs Diabetes Trial (VADT) showed no benefit with aggressive glycemic control. Women, elderly patients, and those with renal insufficiency are more vulnerable to hypoglycemic events. In fact, hypoglycemia is the most common metabolic complication experienced by older patients with DM in the United States. The concurrent use of medications like β-blockers warrants caution in DM because they can mask warning signs of hypoglycemia. Here we aim to elucidate the pathophysiology, review the electrocardiographic changes, analyze the current clinical literature, and consider the safety considerations of hypoglycemia as it relates to the cardiovascular system. In conclusion, in the current era of DM and its vascular ramifications, hypoglycemia from a cardiologist's perspective deserves due attention.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.