A Diabetes Care study examined the relationship between self-reported episodes of severe hypoglycemia among some 9000 Kaiser Permanente patients and glycated hemoglobin values measured roughly 4 months earlier. The researchers note a U-shaped relationship, with patients at the lowest and highest levels of hemoglobin likely to have experienced hypoglycemia. They say hypoglycemia was “common at all levels of glycemic control,” affecting 11% of patients in the past year.

A BMJ meta-analysis of six studies encompassing over 900,000 people finds that hypoglycemia is associated with a roughly twofold increase in cardiovascular disease. This was not due to confounding. The authors say their findings point to an advantage for glucose-lowering agents with a low likelihood of inducing hypoglycemia (e.g., metformin).