Association of Hypoglycemia and Acute Myocardial Infarction in Patients with Type 2 Diabetes Admitted to a Tertiary Hospital in Bangladesh

A BSTRACT Background: Hypoglycemia is a frequent complication among diabetic patients on insulin or secretagogues. Hypoglycemia-induced acute myocardial infarction (AMI) is critical but often overlooked. Materials and methods: This cross-sectional study was conducted over 1 year in BIRDEM General Hospital. A total of 111 patients with type 2 diabetes mellitus presenting with hypoglycemia were observed for 48 h for clinical signs, electrocardiogram changes, and elevated troponin I. Data were analyzed using SPSS version 23. The Chi-square tests and logistic regression were performed; significance was set at P < 0.05. Results: The mean age of participants was 58 ± 12 years; 59% were female. Most patients were aged 60–70 years (37.8%). Dyslipidemia (91.9%) and hypertension (74.8%) were common comorbidities. Chronic kidney disease was present in 26.1%. The mean random blood glucose at admission was 2.56 ± 0.48 mmol/L. Premixed insulin was the most commonly used therapy (43.2%). Myocardial infarction (MI) developed in 13.5% of patients within 48 h. Male gender (odds ratio [OR]: 5.015), smoking (OR: 7.600), hypertension (OR: 5.765), age >60 years (OR: 7.68), and diabetes duration >10 years (OR: 8.35) were significantly associated with MI. Conclusion: Hypoglycemia may unmask underlying coronary artery disease. Hypoglycemia, along with male gender, smoking, hypertension, older age, and longer diabetes duration, significantly increases the risk of MI, emphasizing the need to avoid hypoglycemia while striving for good glycemic control.