Higher ambient temperatures were associated with increased rates of serious hypoglycemia in non-insulin users of certain sulfonylureas, according to a recent study.

A retrospective cohort study evaluated the relationship between ambient temperature and adverse health outcomes in U.S. Medicaid beneficiaries with type 2 diabetes (T2D), stratified by antidiabetes drug use. The study, conducted from 1999 to 2010, involved nearly 3 million individuals with T2D across five states. The objective was to assess whether ambient temperature influences the rates of serious hypoglycemia, diabetic ketoacidosis (DKA), and sudden cardiac arrest based on exposure to different antidiabetic agents.

Key findings revealed a significant positive association between higher ambient temperatures and serious hypoglycemia among non-insulin users of specific second-generation sulfonylureas (SUs), including glimepiride and glyburide, but not glipizide (Wald p=0.048). Additionally, an inverse association was identified between lower temperatures and DKA occurrence among sitagliptin (a dipeptidyl peptidase-4 inhibitor [DPP-4i]) users (p=0.016), though this was not observed with exenatide, a glucagon-like peptide 1 receptor agonist (GLP1RA) (p=0.080). No significant associations were found between ambient temperature and sudden cardiac arrest in users of SUs, meglitinides, DPP-4is, or GLP-1RAs.

The study, published in BMJ Open, identifies drug-specific differences in the relationship between ambient temperature and glycemic outcomes, particularly in cases of hypoglycemia and DKA, while no associations were found for temperature-related arrhythmic events. 

Full disclosures can be found in the published study.