Insulin treatment improves microalbuminuria and other cardiovascular risk factors in patients with type 2 diabetes mellitus.
OBJECTIVE
Insulin treatment of patients with type 2 diabetes causes hyperinsulinaemia and improves glycaemic control. We have studied how this affects risk factors for cardiovascular disease.


METHODS
Patients with secondary failure to oral hypoglycaemic agents were studied whilst still taking oral agents and after insulin treatment for 8 weeks in an open study.


METHODS
Department of Internal Medicine, University Hospital, Linköping.


METHODS
Ten consecutive patients with type 2 diabetes and secondary failure to oral hypoglycaemic agents.


METHODS
Switching oral treatment to insulin treatment.


METHODS
Effect on several cardiovascular risk factors.


RESULTS
Fasting and postprandial plasma insulin concentrations were increased by insulin treatment whereas C-peptide concentrations were lowered. HbA1c was reduced from 8.9 +/- 0.3% (mean +/- SEM) to 6.3 +/- 0.2% after 8 weeks. There was a weight gain of 2.8 +/- 0.7 kg. Plasma concentrations of total- and very-low-density-lipoprotein (VLDL) cholesterol, VLDL-, low density lipoprotein and high-density-lipoprotein triglycerides were all reduced. The plasma concentration of apolipoprotein B was also lowered. Tissue plasminogen activator antigen measured after venous occlusion showed a significant reduction whilst plasminogen activator inhibitor 1 activity was 26.0 +/- 9.8 IU ml-1 on oral treatment and 18.2 +/- 4.7 IU ml-1 on insulin treatment (NS). Albumin excretion in the urine was reduced and the percentage reduction correlated with the percentage lowering of the tissue plasminogen activator antigen concentration after venous occlusion but not with the percentage change of basal tissue plasminogen activator antigen concentration.


CONCLUSIONS
Insulin treatment of patients with type 2 diabetes and secondary failure to oral hypoglycaemic agents causes hyperinsulinaemia and improves or has no unfavourable effect on several cardiovascular risk factors.
Lindström
T
T
Department of Internal Medicine, Faculty of Health Sciences, University Hospital, Linköping, Sweden.
Olsson
A G
AG
von Schenck
H
H
Wallentin
L
L
Arnqvist
H J
HJ
D000328:Adult; D000368:Aged; D000419:Albuminuria / Q000209:etiology / Q000517:prevention & control*; D000704:Analysis of Variance; D001777:Blood Coagulation / Q000187:drug effects; D001786:Blood Glucose / Q000187:drug effects; D001794:Blood Pressure / Q000187:drug effects; D002096:C-Peptide / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology / Q000517:prevention & control*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood / Q000627:therapeutic use*; D008074:Lipoproteins / Q000097:blood; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
D001786:Blood Glucose; D002096:C-Peptide; D007328:Insulin; D008074:Lipoproteins