ArticleDiabetes research and clinical practice2015
Severe hypoglycemia and coronary artery calcification during the diabetes control and complications trial/epidemiology of diabetes interventions and complications (DCCT/EDIC) study.
Article in Diabetes research and clinical practice, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 of them syntheses that pooled it.
What it found
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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, 2 syntheses or guidelines pooled it, 45 citations in OpenAlex.
- Risk factors for hypoglycemia in patients with type 2 diabetes mellitus: a systematic review and meta-analysis.Frontiers in endocrinology · 2026Pooled it
- Sodium-glucose cotransporter 2 inhibitors as an add-on therapy to insulin for type 1 diabetes mellitus: Meta-analysis of randomized controlled trials.Acta diabetologica · 2021Pooled it
- A Link Between Hypoglycemia and Progression of Atherosclerosis in the Veterans Affairs Diabetes Trial (VADT).Diabetes care · 2016Trial
- Article
- Amylin: From Mode of Action to Future Clinical Potential in Diabetes and Obesity.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2025Review
- Early and sustained increase in time in range 1 year after initiation of hybrid close loop therapy via telemedicine in type 1 diabetes patients.Acta diabetologica · 2023Observational
- The Role of Platelets in Hypoglycemia-Induced Cardiovascular Disease: A Review of the Literature.Biomolecules · 2023Review
- Glucose-Lowering Therapy beyond Insulin in Type 1 Diabetes: A Narrative Review on Existing Evidence from Randomized Controlled Trials and Clinical Perspective.Pharmaceutics · 2022Review
- Cardiovascular Risk Management in Type 1 Diabetes.Current diabetes reports · 2021Review
- The Impact of Diabetes Mellitus on Cardiovascular Risk Onset in Children and Adolescents.International journal of molecular sciences · 2020Review
- Observational
- Cardiovascular Risk in Type 1 Diabetes Mellitus.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2019Review
- The early detection of atherosclerosis in type 1 diabetes: why, how and what to do about it.Cardiovascular endocrinology & metabolism · 2019Review
- Interdisciplinary approach to compensation of hypoglycemia in diabetic patients with chronic heart failure.Heart failure reviews · 2018Review
- Relationship of Hyperglycaemia, Hypoglycaemia, and Glucose Variability to Atherosclerotic Disease in Type 2 Diabetes.Journal of diabetes research · 2018Article
- Understanding the impact of hypoglycemia on the cardiovascular system.Expert review of endocrinology & metabolism · 2017Article
- Devices for continuous monitoring of glucose: update in technology.Medical devices (Auckland, N.Z.) · 2017Review
- Metabolic and Biochemical Stressors in Diabetic Cardiomyopathy.Frontiers in cardiovascular medicine · 2017Review
- Severe Hypoglycemia and Cardiovascular or All-Cause Mortality in Patients with Type 2 Diabetes.Diabetes & metabolism journal · 2016Article
- Article
Corrections and comments
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
Abstract
aimRecently, major attention has been paid to the role of hypoglycemia as a cardiovascular risk factor. While EURODIAB-investigators concluded that severe hypoglycemia is not a cardiovascular risk factor in type 1 diabetes, other investigators found the opposite. The primary purpose of this study was to investigate the role of severe hypoglycemia in atherosclerosis during the DCCT- and EDIC-years with special attention to overall glycemic levels. RESEARCH DESIGN AND
methodsThe effect of severe hypoglycemic rates on coronary artery calcification (CAC) was evaluated for the entire cohort (n = 1205) and glycemic stratified cohorts (HbA1C < 7.5% [58 mmol/mol], HbA1C ≥ 7.5%).
resultsThe association between CAC and mean DCCT-hypoglycemia rate was stronger than the association between CAC and mean EDIC-hypoglycemia rate. Although the DCCT-severe hypoglycemia rate without HbA1C-stratification was not significantly associated with a CAC-score ≥ 100 Agatston units (p = 0.093), the interaction between above glycemic ranges and DCCT-hypoglycemic rate was significant (p < 0.05). A sub-analysis of patients belonging to the lower glycemic range (HbA1C < 7.5%), adjusted for baseline age, gender, baseline diabetes duration, baseline neuropathy, baseline albumin excretion rate, systolic blood pressure, LDL-cholesterol, smoking status, body mass index and DCCT-A1C, indicated significant (p = 0.02) associations between DCCT-severe hypoglycemia rate and CAC-score ≥ 100. One unit increase in the natural logarithm transformed DCCT-severe hypoglycemia rate increased the risk of having a CAC ≥ 100 by 30%.
conclusionsOur results suggest a cumulative effect of hypoglycemic events on cardiovascular risk. They provide a possible link between above mentioned contradictory reports. Our findings support the relevance of personalizing glycemic goals in diabetes management beyond HbA1C.
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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.