The Pharmaceutical Journal
Vol 269 No 7215 p353
14 September 2002

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Hypoglycaemia could increase risk of cancer mortality

HYPOGLYCAEMIA could increase the risk of cancer and all-cause mortality, according to results of a study presented at the European Society of Cardiology annual congress in Berlin earlier this month.

Israeli researchers followed up 14,670 patients aged 45 to 74 years with a history of myocardial infarction and/or stable angina over a mean period of eight years. They found the highest prevalence of cancer mortality occurred among patients who had hypoglycaemia — approximately twice that of patients with normal blood glucose levels (6.1 per cent compared with 2.9 per cent).

Crude all-cause mortality was higher among patients with hypoglycaemia (fasting blood glucose, below 70mg/dl; 25.2 per cent) and diabetes (fasting blood glucose, over 140mg/dl; 31.8 per cent), than among patients with euglycaemia (fasting blood glucose, 80–109mg/dl; 14.9 per cent). However, cardiovascular mortality was only higher among patients with diabetes — 17.8 per cent compared with 7.9 per cent for patients with euglycaemia.

The researchers say their results indicate hypoglycaemia is an early harbinger of increased all-cause and cancer death among patients with coronary artery disease: "Thus, the identification of low fasting glucose levels as an additional marker of mortality risk in this population could be of overwhelming clinical importance," they conclude. Further research is needed to elucidate the underlying mechanisms of hypoglycaemia and its inter-relationship with malignancy and mortality, they say.