Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital

Prediction of severe hypoglycaemia by angiotensin-converting enzyme activity and genotype in type 1 diabetes

Research output: Contribution to journalJournal articleResearchpeer-review

  1. Gustatory sweating in people with type 1 and type 2 diabetes mellitus: Prevalence and risk factors

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Does nocturnal hypoglycaemia really improve quality of life? Reply to Søholm U, Broadley MM, Choudhary P et al [letter]

    Research output: Contribution to journalLetterResearchpeer-review

  3. Acute hypoglycemia and risk of cardiac arrhythmias in insulin-treated type 2 diabetes and controls

    Research output: Contribution to journalJournal articleResearchpeer-review

View graph of relations

AIMS/HYPOTHESIS: We have previously shown a strong relationship between high angiotensin-converting enzyme (ACE) activity, presence of the deletion (D) allele of the ACEgene and recall of severe hypoglycaemic events in patients with Type 1 diabetes. This study was carried out to assess this relationship prospectively.

METHODS: We followed 171 adult outpatients with Type 1 diabetes in a one-year observational study with the recording of severe hypoglycaemia. Participants were characterised by serum ACE activity and ACE genotype and not treated with ACE inhibitors or angiotensin II receptor antagonists.

RESULTS: There was a positive relationship between serum ACE activity and rate of severe hypoglycaemia with a 2.7 times higher rate in the fourth quartile of ACE activity compared to the first quartile (p=0.0007). A similar relationship was observed for the subset of episodes with coma (2.9 times higher rate in fourth quartile compared to first quartile; p=0.048). The impact of serum ACE activity was most pronounced in C-peptide negative subjects (4.2 times higher rate in fourth quartile compared to first quartile; p=0.003), and in this subgroup carriers of the D allele of the ACEgene had higher rates of severe hypoglycaemia compared to the group homozygous for the insertion (I) allele. In a multiple regression analysis high serum ACE activity and impaired awareness of hypoglycaemia were identified as the only significant predictors of severe hypoglycemia.

CONCLUSION: High ACE activity and the presence of the D allele of the ACE gene predict a high rate of severe hypoglycaemia in Type 1 diabetes.

Original languageEnglish
Issue number1
Pages (from-to)89-96
Number of pages8
Publication statusPublished - Jan 2003

    Research areas

  • Adult, Alleles, Awareness, C-Peptide, Diabetes Mellitus, Type 1, Female, Genotype, Humans, Hypoglycemia, Male, Middle Aged, Multivariate Analysis, Peptidyl-Dipeptidase A, Prognosis, Retrospective Studies, Risk Factors, Severity of Illness Index, Journal Article, Research Support, Non-U.S. Gov't

ID: 51548475