Evidence mapPaperPMID 40045554Full record

ArticleDiabetes, obesity & metabolism2025

Effects of insulin-induced hypoglycaemia on cardiac function in people with type 1 and type 2 diabetes and people without diabetes.

Therese Wilbek Fabricius, Clementine Verhulst, Cecilie Hornborg Svensson, Malene Wienberg, Anthonie L Duijnhouwer, Cees J Tack, Peter L Kristensen, Bastiaan E de Galan, Ulrik Pedersen-Bjergaard, Hypo‐RESOLVE consortium

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Article in Diabetes, obesity & metabolism, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

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0cells of the map it votes in
3citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Therese Wilbek FabriciusDepartment of Endocrinology and Nephrology, Nordsjællands Hospital, Hillerød, Denmark.ORCID https://orcid.org/0000-0002-6344-5408
Clementine VerhulstDepartment of Internal Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands.ORCID https://orcid.org/0000-0002-9905-7669
Cecilie Hornborg SvenssonDepartment of Endocrinology and Nephrology, Nordsjællands Hospital, Hillerød, Denmark.
Malene WienbergDepartment of Cardiology, Nordsjællands Hospital, Hillerød, Denmark.ORCID https://orcid.org/0009-0008-4196-8823
Anthonie L DuijnhouwerDepartment of Cardiology, Radboud University Medical Centre, Nijmegen, The Netherlands.ORCID https://orcid.org/0000-0001-5064-0143
Cees J TackDepartment of Internal Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands.ORCID https://orcid.org/0000-0003-0322-1653
Peter L KristensenDepartment of Endocrinology and Nephrology, Nordsjællands Hospital, Hillerød, Denmark.ORCID https://orcid.org/0000-0001-5431-824X
Bastiaan E de GalanDepartment of Internal Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands.ORCID https://orcid.org/0000-0002-1255-7741
Ulrik Pedersen-BjergaardDepartment of Endocrinology and Nephrology, Nordsjællands Hospital, Hillerød, Denmark.ORCID https://orcid.org/0000-0003-0588-4880
Hypo‐RESOLVE consortium

Funding

Innovative Medicines Initiative 2 Joint Undertaking (JU) 777460
6 · The paper itself

Abstract

aimsCardiovascular disease is the most common complication and cause of death in people with diabetes. Hypoglycaemia is independently associated with the development of cardiovascular complications, including death. The aim of this study was to assess changes in cardiac function and workload during acute hypoglycaemia in people with and without diabetes and to explore the role of diabetes type, magnitude of the adrenaline response, and other phenotypic traits. MATERIALS AND

methodWe enrolled people with type 1 diabetes (n = 24), people with insulin-treated type 2 diabetes (n = 15) and controls without diabetes (n = 24). All participants underwent a hyperinsulinaemic-normoglycaemic-(5.3 ± 0.3 mmol/L)-hypoglycaemic (2.8 ± 0.1 mmol/L)-glucose clamp. Cardiac function was assessed by echocardiography, with left ventricular ejection fraction (LVEF) as the primary endpoint.

resultsDuring hypoglycaemia, LVEF increased significantly in all groups compared to baseline (6.2 ± 5.2%, p < 0.05), but the increase was significantly lower in type 1 diabetes compared to controls without diabetes (5.8 ± 3.4% vs. 9.4 ± 5.0%, p = 0.03, 95% CI difference: -5.0, -0.3). In people with type 1 diabetes, ΔLVEF was inversely associated with diabetes duration (β: -0.16, 95% CI: -0.24, -0.53, p = 0.001) and recent exposure to hypoglycaemia (β: -0.30, 95% CI: -0.53, -0.07, p = 0.015). Hypoglycaemia also increased global longitudinal strain (GLS) in controls without diabetes (p < 0.05), but this did not occur in the two diabetes subgroups (p > 0.10).

conclusionsHypoglycaemia increased LVEF in all groups, but the increase diminished with longer disease duration and prior exposure to hypoglycaemia in type 1 diabetes, suggesting adaptation to recurrent hypoglycaemia. The increment in GLS observed in controls was blunted in people with diabetes. More research is needed to determine the clinical relevance of these findings.

Indexed as

Diabetes Mellitus, Type 1Diabetes Mellitus, Type 2Diabetic CardiomyopathiesHypoglycemiaHypoglycemic AgentsInsulinAdultBlood GlucoseCase-Control StudiesEchocardiographyFemaleGlucose Clamp TechniqueHumansMaleMiddle AgedStroke VolumeBlood GlucoseHypoglycemic AgentsInsulindiabetes complicationsheart failurehypoglycaemiatype 1 diabetestype 2 diabetes

Identifiers

PMID40045554
PMCPMC11964998

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.