Hypoglycemia In The Emergency, But What Awaits Us For Cardiac Risks In
Introduction: Several homeostatic changes like an increase in
sympathoadrenal response and oxidative stress occur in hypoglycemia. As
a result of these findings, an increase in inflammation and
pre-atherogenic factors is observed and these changes may lead to
endothelial dysfunction. Aim: Our study aims to reveal possible cardiac
risks (systolic-diastolic functions and endothelial dysfunctions) in
patients who have applied to the emergency department with hypoglycemia.
Methods: This cross-sectional, case-control study included 46
hypoglycemia patients who admitted to the emergency with symptoms
compatible with hypoglycemia and diagnosed with hypoglycemia and 30
healthy volunteers. All patients were evaluated with baseline
echocardiography, tissue-doppler imaging(carotid and brachial artery).
Also, the fasting blood tests of the patients referred to the internal
medicine department were examined. Results: There were no differences
between the groups regarding age, weight, body mass index, and systolic
blood pressure. Total cholesterol, LDL, HDL, Vitamin B12, TSH, and
fasting blood glucose levels were similar in the groups’ blood tests
(all p values>0.05). We observed a statistically
significant decrease in diastolic dysfunction parameters: E/A and E/e’
ratios (respectively, p=0.020 and 0.026). It was shown that insulin
resistance was influential in forming these considerable differences.
The patient group observed that the carotid intima-media thickness was
more remarkable(p=0.001), and the brachial flow-mediated dilatation
value was smaller(p=0.003), giving an idea about endothelial functions.