Table 3 Hypoglycaemia-mediated effects contributing to cardiovascular dysfunction
From: Cardiac implications of hypoglycaemia in patients with diabetes – a systematic review
| 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] |