Abstract 12158: Impact of Heart Failure on Hypoglycemic Complications in Patients with Type 2 Diabetes in Clinical Practice: Results of DiaRegis
Background: Patients with type 2 diabetes have an increased risk of heart failure (HF). However data on the co-morbidity burden and in particular the incidence of hypoglycaemia are scarce.
Methods: DiaRegis is a German prospective registry including patients with type-2 diabetes being treated with oral mono- or dual anti-diabetic combination therapy in 2009/2010. We examined differences in co-morbidity and the incidence of hypoglycaemia in diabetic outpatients with and without present HF.
Results: Of 3,746 patients, 9.9% had HF. Median age was 66.0 years, 46.8% were female. HF patients were older, had a longer diabetes duration, and had more co-morbid diseases. Hypoglycaemia was more frequent in patients with heart failure in the 12 months preceding enrolment, which was most pronounced for those requiring medical assistance and help from another person (non-medical assistance), respectively. They received less metformin (Met) in monotherapy and more sulfonylureas (SU), both drugs known to interfere with the incidence of heart failure. After enrolment insulin treatment was initiated in 21.4% patients with HF versus 16.6% patients without HF (p<0.05). Incident stroke/TIA, angina pectoris, PCI, and peripheral angioplasty were significantly increased in patients with HF after a 6 months follow-up. Furthermore, hypoglycaemic events were 50% more frequent in patients with HF in the 12 months preceding enrolment and at the 6 months follow-up. Heart failure was an independent predictor of hypglycemia (OR 1.99, p<0.01).
Conclusions: Patients with type 2 diabetes and heart failure have a substantially increased co-morbidity burden compared to patients without heart failure and report to have experienced nearly twice as much episodes of hypoglycaemia, especially those requiring medical assistance. Particular attention should be given to an appropriate pharmacotherapy in diabetic patients with heart failure to avoid hypoglycemic complications.
- © 2011 by American Heart Association, Inc.