New research has suggested that moderate to severe hypoglycemia in young adults may increase the risk of impaired heart rate variability, a marker of autonomic dysfunction.
These findings were witnessed when comparing patients with type 1 diabetes and no or slight hypoglycemia, to patients with type 1 who had a history of hypoglycemia.
Researchers from the Federal University of Sao Paulo, Brazil, evaluated data from 99 adults with an average age of 26 years from February 2011 to December 2013.
They set out to examine the relationship between hypoglycemia and the occurrence of cardiovascular autonomic neuropathy. Cardiovascular autonomic neuropathy refers to nerve damage that affects the functioning of the heart.
To do this, the researchers measured heart rate variability through spectral analysis and hypoglycemia severity in the patients.
In the cohort, it was found that 78 participants either didnt have, or had only minor, hypoglycemia, and 21 participants had moderate to severe hypoglycemia. Participants in the second group tended to have had type 1 diabetes for a longer period of time, and were older.
The findings revealed that impaired heart rate variability, diabetic nephropathy and macrovascular complications were all predictors of moderate to severe hypoglycemia.
"We found, in patients with type 1 diabetes, significant association between [cardiovascular autonomic neuropathy] and moderate/severe hypoglycemia according to the [hypoglycemia] score," said study author Ticiana Paes Silva, MD.
"These results are consistent with previous studies that showed severe hypoglycemic episodes associated with impaired [CV] autonomic tests.
"Our results are compatible with the loss of cardioprotective effect of vagal activity in patients with moderate/severe hypoglycemia. This may result in worse outcomes related to progression to dangerous arrhythmias for this group of patients."
The research was published in Diabetes Metabolism &Research.