Hypoglycemia and Heart Disease

Health Professional

It's well known that individuals who live with diabetes (hyperglycemia) have an increased risk for heart disease, but did you realize that hypoglycemia (low blood glucose) is also a concern?

What is hypoglycemia?

Hypoglycemia occurs when blood glucose (also know as blood sugar) drops below normal levels. We obtain glucose from the foods we eat. Carbohydrates are a main source of glucose, such as potatoes, rice, bread, milk, and fruit.

Symptoms of hypoglycemia include:

  • hunger
  • shakiness
  • nervousness
  • sweating
  • dizziness or light-headedness
  • sleepiness
  • confusion
  • difficulty speaking
  • anxiety
  • weakness

Causes of hypoglycemia

Hypoglycemia can occur as a side effect of some diabetic medications. However, individuals without diabetes can also experience hypoglycemia, typically due to fasting or postprandial hypoglycemia which occurs ~4 hours after meals.

Either way you need to work with your physician to determine appropriate treatment.

Hypooglycemia and heart disease

The VA Diabetes Trial has spent a number of years looking at the relationship between glucose control and cardiovascular disease. The researchers wanted to determine if tight blood glucose control reduced heart disease risk.

According to research findings very low blood glucose had a greater impact on heart disease and stroke risk when compared to high blood glucose.
Study participants who experienced a low enough blood sugar to cause impaired consciousness were found to be at highest risk for cardiovascular death.

The study results also emphasize the need to implement a program to establish tight glucose control immediately at diagnosis for the greatest benefits.

The VA Diabetes trial included 1791 veterans (97% male) with type 2 diabetes and an average age of 60 years-old. Forty percent of participants had a history of heart attack, stroke, bypass surgery, and other heart conditions. Participants started with an average hemoglobin A1C level of 9.5%. The American Diabetes Association recommends a target hemoglobin A1C of 7%. (As an FYI, Hemoglobin A1C is a measurement of blood glucose control over the previous 2-3 months.)

Study participants were broken into groups and all saw improvements. Those receiving standard treatment, such as medications, dropped their Hemoglobin A1C to 8.4%. Those receiving more intensive treatment achieved a Hemoglobin A1C of 6.9%.

There are actually three studies - the VA Diabetes Trial, ACCORD, ADVANCE - that examined different strategies to lower blood glucose and reduce cardiovascular disease risk. Of course, understanding and implementing treatment plans would be easier if all three study results agreed, but it just can't be that simple. The VA Diabetes Trial is the only study that found a correlation between hypoglycemia and increased cardiovascular disease risk.

These results I'm writing about are a couple years old, so keep your eyes and ears open for new information to be released.

Hypoglycemia Treatment

I'm sharing this information so you are aware hypoglycemia (low blood glucose) can contribute to your risk for heart disease just as much, if not more, than hyperglycemia (high blood glucose). Work with your physician to treat both and maintain a healthy blood glucose level for you.

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