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associate the high frequency of hypoglycemia in diabetes with a higher risk of mortality
Jano.es · May 27, 2013 17:19
Experts defend the use of magnetic resonance to do the dismissal of ischemic heart disease in patients with risk of coronary heart disease.
Hypoglycemia is the most frequent acute complication in the treatment of diabetes.More than 35% of patients with type 1 diabetes (DM1), and 1 to 3% of patients with type 2 diabetes (DM2), will experience at least one severe hypoglycemia episode, a complication that limits intensive control of diabetes andThat, in the words of Dr. Manuel Gargallo, "the more glucose control intensifies, the greater the risk of hypoglycemia."
During the 'Cardiometabolic Risk Session' sponsored by the Boehringer - Lilly Alliance in Diabetes, which has been held within the framework of the 55th Congress of the Spanish Society of Endocrinology and Nutrition (SEEN), Dr. Gargallo has talked about the role ofHypoglycemia in cardiovascular morbidity and mortality."Hypoglycemia," he said, "can cause acute cardiovascular accidents, such as chest angina or myocardial infarction, and is associated with a greater risk of cardiovascular mortality. However, it is not clear if this complication alone is directly responsibleof cardiovascular diseases, or it is only a risk marker. "
Although studies are not conclusive in this regard, the SEEN diabetes mellitus working group recommends, as a priority objective of the DM2, to avoid hypoglycemia by its association with a greater probability of abandonment of treatment, greater cost and greater deterioration of qualitylife.
Dr. Gargallo has also explained that the patient's profile suffering from hypoglycemia is that of "an elderly, smoker, who also has deterioration of renal function and microvascular complications." Hypoglycemia occurs when glucose descends sharply toplace below 70 mg/dl.
Therefore, the endocrinologist ensures that the best way to prevent this complication is to review and adapt the pharmacological treatment to the patient's way of life.In this sense, he has indicated that, in recent times, "they are proliferating safer drugs that reduce the glycemia of high values to normal values, but not at lower values of the recommended ones. These are incredine drugs: on the one hand,DDP-4 inhibitors and, on the other, the Anologists of the LPG-1 ".
Disades of ischemic heart disease
For his part, Dr. Pedro María Azcárate, a cardiologist at the San Pedro Hospital (Logroño), has referred to the controversy about whether it is justified to perform routine explorations in asymptomatic diabetics to diagnose the presence of ischemic heart disease, a disease that causes deathof more than two thirds of patients with diabetes.In fact, diabetes injures the cardiovascular system in such a way that heart disease and blood vessels constitute the first cause of mortality in diabetics.
While some studies suggest that the cardiovascular risk of patients with diabetes would be equivalent to patients who have already suffered a heart attack, there are experts who point out that these trials did not take into account that people with diabetes do not form a homogeneous population and existDifferent levels of risk among them, which would not justify the preventive control of ischemic heart disease in asymptomatic patients.
Dr. Azcárate, formed in this field, has defended the realization of the decrease using magnetic resonance in patients with moderate-high risk of coronary heart disease and in which the presence of it is clinically suspected."It is a very versatile technique, precise and with a great spatial resolution. In addition, it is very sure because, unlike the TAC, it does not use radiation," he concluded.
