Cardiac implications of hypoglycaemia in patients with diabetes – a systematic review

Table 3 Hypoglycaemia-mediated effects contributing to cardiovascular dysfunction

Risk factor	Hypoglycaemic-associated effect contributing to risk factor	Reference(s)
Thrombotic tendency	↑ platelet-monocyte aggregation	[14]
	↑ soluble P-selectin levels	[14, 48]
	↑ plasminogen activator inhibitor-1	[48]
	↓ partial thromboplastin time	[49]
	↑ fibrinogen and factor VIII	[49]
Abnormal cardiac repolarization	↑ catecholamines (hypokalaemia)	[14, 50–52]
Inflammation	↑ QT interval and QT dispersal	[13, 53–56]
	↑ CD40 expression on monocytes	[14]
	↑ soluble CD40L in serum	[14]
	↑ IL-6, IL-8, TNF-α, and IL-1β	[57–60]
	↑ ICAM, VCAM, E-selectin, and VEGF	[48, 57]
Atherosclerosis	↑ inflammation	see above
	↑ endothelial dysfunction	[14, 57, 60]
	↑ oxidative stress	[57]
	↑ Aldosterone	[61]
	↑ ICAM, VCAM, and E-selectin	[48]

ISSN: 1475-2840